dysynchiria - a possible explanation
DESCRIPTION
A possible explanation of Dysynchiria, based on some research by Acerra and Moseley, Neurology 2005;65:751–3TRANSCRIPT
Lorimer Moseley NHMRC Senior Research Fellow Prince of Wales Medical Research Institute & School of Medical Sciences, University of New South Wales, Sydney, Australia
Team leader The GAMFI project University of Oxford, UK
Dysynchiria Watching the mirror image of the unaffected limb elicits pain on the affected side
Acerra & Moseley 2005 Neurology 65: 751-3
ThisisNicole.SheistouchingthegoodhandofsomeonewithCRPS,whohastheirbadhandbehindthemirror.
Acerra & Moseley 2005 Neurology 65: 751-3
So,oneputstheirhandseithersideofamirror….
Acerra & Moseley 2005 Neurology 65: 751-3
So,oneputstheirhandseithersideofamirror….thenmovestheirheadabitsothatitlooksliketheyareseeingbothhandswhentheyareactuallyseeingtherighthandanditsmirrorimage.
Acerra & Moseley 2005 Neurology 65: 751-3
So,oneputstheirhandseithersideofamirror….thenmovestheirheadabitsothatitlooksliketheyareseeingbothhandswhentheyareactuallyseeingtherighthandanditsmirrorimage.
Acerra & Moseley 2005 Neurology 65: 751-3
When you touch the good hand, nothing extraordinary happens…..
experience
normal
Acerra & Moseley 2005 Neurology 65: 751-3
When you touch the intact hand, one feels the touch on BOTH hands
experience
“Synchiria”
Phantom/stroke
Acerra & Moseley 2005 Neurology 65: 751-3
experience
“dysynchiria”
pain
CRPS1
When you touch the good hand, one feels that touch on that hand but it also HURTS the other hand.
Acerra & Moseley 2005 Neurology 65: 751-3
o p o o
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A
x x x x
x x
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p p
p p
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B
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Allodynia
Parasthaesia
Responsetolighttouch
BeforeRx ADerRx
Acerra & Moseley 2005 Neurology 65: 751-3
Widediametersensoryneuron
Visualfieldinput
S1‘representaJve’neurons S2‘representaJve’neuronswithbimodalinput
ThisisapossibleexplanaJonforthephenomenonofdysynchiria.
Acerra & Moseley 2005 Neurology 65: 751-3
Widediametersensoryneuron
Visualfieldinput
S1‘representaJve’neurons S2‘representaJve’neuronswithbimodalinput
Acerra & Moseley 2005 Neurology 65: 751-3
Widediametersensoryneuron
Visualfieldinput
S1‘representaJve’neurons S2‘representaJve’neuronswithbimodalinput
Normalstate
Acerra & Moseley 2005 Neurology 65: 751-3
Widediametersensoryneuron
Visualfieldinput
S1‘representaJve’neurons S2‘representaJve’neuronswithbimodalinput
SensiJsedstate
ThisisapossibleexplanaJonforthephenomenonofdysynchiria.InasensiJsedstate,thevisually‐evokedacJvaJonofbimodalneuronsinS2mightbeenoughto‘ignite’thenetworkofneuronsthatevokespain.
Acerra & Moseley 2005 Neurology 65: 751-3