Predictors of Self-Reported Neglect-like Symptoms and Involuntary Movements in Complex Regional Pain Syndrome Compared to Other Chronic Limb Pain Conditions

OBJECTIVE: In addition to pain, people with complex regional pain syndrome (CRPS) often report inattention to and disengagement from their affected limb (i.e., "neglect-like symptoms"). Understanding how these symptoms relate to other characteristics of CRPS, and chronic pain generally, could provide insights for preventing and treating CRPS. METHODS: We administered an online survey to people who received a diagnosis of CRPS (n = 335) and other chronic limb pain (n = 407). Neglect-like symptoms were assessed using the Neurobehavioral questionnaire. RESULTS: A principal component analysis identified two components: motor and cognitive neglect-like symptoms, and involuntary movements. Internal consistency of the components was acceptable. We conducted regression analyses with these as outcomes. Having CRPS, a painful lower limb, higher pain intensity, and somatic symptoms were associated with more motor and cognitive neglect-like symptoms. Having CRPS, higher pain intensity, depression, and somatic symptoms were associated with more involuntary movements. Age, gender, anxiety, disease duration, hours of pain per day, affected side, whether the limb was the most painful body part, and number of pain-related medical diagnoses were no predictors. Finally, motor and cognitive neglect-like symptoms were related to tremor; and involuntary movements to changes in skin color, swelling, sweating, toenails, weakness, and tremor. CONCLUSIONS: This study confirms the specificity of inattention to and disengagement from the affected limb in CRPS, independent of other factors. Furthermore, two components of the Neurobehavioral questionnaire were disentangled: motor and cognitive neglect-like symptoms, and involuntary movements. Results could potentially help clinicians to better assess neglect-like symptoms in chronic pain

Habitat deterioration promotes the evolution of direct development in metamorphosing species

Although metamorphosis is widespread in the animal kingdom, several species have evolved life-cycle modifications to avoid complete metamorphosis. Some species, for example, many salamanders and newts, have deleted the adult stage via a process called paedomorphosis. Others, for example, some frog species and marine invertebrates, no longer have a distinct larval stage and reach maturation via direct development. Here we study which ecological conditions can lead to the loss of metamorphosis via the evolution of direct development. To do so, we use size-structured consumer-resource models in conjunction with the adaptive-dynamics approach. In case the larval habitat deteriorates, individuals will produce larger offspring and in concert accelerate metamorphosis. Although this leads to the evolutionary transition from metamorphosis to direct development when the adult habitat is highly favorable, the population will go extinct in case the adult habitat does not provide sufficient food to escape metamorphosis. With a phylogenetic approach we furthermore show that among amphibians the transition of metamorphosis to direct development is indeed, in line with model predictions, conditional on and preceded by the evolution of larger egg sizes

Reply to a comment by Carol S. Prentice, Paul Mann, and Luis R. Peña on: “Historical perspective on seismic hazard to Hispaniola and the northeast Caribbean region” by U. ten Brink et al.

Author Posting. © American Geophysical Union, 2013. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 118 (2013): 1606–1608, doi:10.1002/jgrb.50147.2013-10-1

Significant earthquakes on the Enriquillo Fault System, Hispaniola, 1500–2010 : implications for seismic hazard

This paper is not subject to U.S. copyright. The definitive version was published in Bulletin of the Seismological Society of America 102 (2012): 18-30, doi:10.1785/0120110077.Historical records indicate frequent seismic activity along the north-east Caribbean plate boundary over the past 500 years, particularly on the island of Hispaniola. We use accounts of historical earthquakes to assign intensities and the intensity assignments for the 2010 Haiti earthquakes to derive an intensity attenuation relation for Hispaniola. The intensity assignments and the attenuation relation are used in a grid search to find source locations and magnitudes that best fit the intensity assignments. Here we describe a sequence of devastating earthquakes on the Enriquillo fault system in the eighteenth century. An intensity magnitude MI 6.6 earthquake in 1701 occurred near the location of the 2010 Haiti earthquake, and the accounts of the shaking in the 1701 earthquake are similar to those of the 2010 earthquake. A series of large earthquakes migrating from east to west started with the 18 October 1751 MI 7.4–7.5 earthquake, probably located near the eastern end of the fault in the Dominican Republic, followed by the 21 November 1751 MI 6.6 earthquake near Port-au-Prince, Haiti, and the 3 June 1770 MI 7.5 earthquake west of the 2010 earthquake rupture. The 2010 Haiti earthquake may mark the beginning of a new cycle of large earthquakes on the Enriquillo fault system after 240 years of seismic quiescence. The entire Enriquillo fault system appears to be seismically active; Haiti and the Dominican Republic should prepare for future devastating earthquakes

Validation of the Leiden Visual Sensitivity Scale and Visual Discomfort Scale in Chronic Pain Conditions

Discomfort provoked by normally innocuous visual stimuli has been reported by people with chronic pain. Visual discomfort may be higher in pain conditions in which central sensitization is implicated, such as Complex Regional Pain Syndrome (CRPS) and fibromyalgia. In an online study, we validated the Leiden Visual Sensitivity Scale (L-VISS) and Visual Discomfort Scale (VDS) in people with CRPS (n = 57), fibromyalgia (n = 75), and general chronic pain (n = 53); investigated whether these groups and pain-free controls (n = 125) differed in visual discomfort; and evaluated the effect of age. The L-VISS and VDS had good internal consistency. Both scales were positively related with experimentally induced visual distortions for mid-spatial frequency striped patterns, suggesting good construct validity. The scales were positively related with each other, and dissociated between the pain and pain-free groups in similar ways, suggesting good construct validity. There was no relationship between age and L-VISS scores and a small negative relationship between age and VDS scores. Visual discomfort was highest in the fibromyalgia group, followed by the CRPS group. This research confirms the utility of the L-VISS and VDS for measuring visual sensitivity in chronic pain and adds to evidence that central sensitization is an important mechanism of visual discomfort