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Microstructural Abnormalities of the Secondary Motor Area Coordinating Sensory and Motor Functions in Patients with Complex Regional Pain Syndrome

Author(s): Ye-Ha Jung, Soo-Hee Choi, Jae-Hun Kim, Won Joon Lee, Joon Hwan Jang, Jee Youn Moon, Yong Chul Kim,Do-Hyung Kang


Objective Complex regional pain syndrome (CRPS), which is characterized by persistent pain with related sensorimotor symptoms, involves structural and functional changes in the brain cortices. Further study on the microstructure of the brain using diffusion kurtosis imaging (DKI) is needed in patients with CRPS. This cross-sectional study investigated the neural underpinnings of the microstructure of the brains of patients with CRPS.

Methods DKI was performed on 25 patients with CRPS and 23 healthy controls. The mean kurtosis was determined by voxel-based analyses.


Compared with healthy controls, patients had a significantly higher mean kurtosis in the bilateral supplementary motor area (SMA), right dorsal premotor area, left precuneus, and cerebellar vermis. Higher pain intensity in patients according to the McGill Pain Questionnaire
was associated with a lower mean kurtosis of the left SMA (r=–0.469, P=0.024). The significant association between the mean kurtosis of the left SMA and precuneus observed in healthy controls was not observed in patients.


Our findings suggest that the wide variety of symptoms encompassing the sensory and motor systems of patients with CRPS are associated with microstructural impairment of the secondary motor area, which receives sensory information and projects motor information.
This measure could potentially help clinicians to understand microstructural abnormalities of the secondary motor area coordinating sensory and motor functions.

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