Dew -

Forgive me for not going first to the question you raised about loss of short term memory. I know with me, whatever are the structural effects of CRPS, the principle day-to-day culprit is Baclofen, a drug I take for spasms, and one that has no ready substitutes for me, where I've been on everything else in its class, without success. I don't know if you're on it, but it might be worth thinking about if you are.

Digging a little deeper into the article you posted, I found the lead article it cited, also by Apkarian at al. It's one that's been referred to in a number of threads on the old BT and three on NT. [See, in particular, http://neurotalk.psychcentral.com/sh...ad.php?t=12479 for a 2007 thread that also includes an upload of a related article.] However, it's important and certainly bears repeating, that this article should be understood by everyone with chronic CRPS and is available in free full text. So, without further introduction:

"Chronic back pain is associated with decreased prefrontal and thalamic gray matter density," Apkarian AV, Sosa Y, Sonty S, Levy RM, Harden RN, Parrish TB, Gitelman DR, J Neurosci. 2004 Nov 17;24(46):10410-5, free full text at: http://www.jneurosci.org/cgi/content/full/24/46/10410

Department of Physiology and Institute of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. a-apkarian@northwestern.edu

The role of the brain in chronic pain conditions remains speculative. We compared brain morphology of 26 chronic back pain (CBP) patients to matched control subjects, using magnetic resonance imaging brain scan data and automated analysis techniques. CBP patients were divided into neuropathic, exhibiting pain because of sciatic nerve damage, and non-neuropathic groups. Pain-related characteristics were correlated to morphometric measures. Neocortical gray matter volume was compared after skull normalization. Patients with CBP showed 5-11% less neocortical gray matter volume than control subjects. The magnitude of this decrease is equivalent to the gray matter volume lost in 10-20 years of normal aging. The decreased volume was related to pain duration, indicating a 1.3 cm3 loss of gray matter for every year of chronic pain. Regional gray matter density in 17 CBP patients was compared with matched controls using voxel-based morphometry and nonparametric statistics. Gray matter density was reduced in bilateral dorsolateral prefrontal cortex and right thalamus and was strongly related to pain characteristics in a pattern distinct for neuropathic and non-neuropathic CBP. Our results imply that CBP is accompanied by brain atrophy and suggest that the pathophysiology of chronic pain includes thalamocortical processes.

PMID: 15548656 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

Please note as well that is is heavily referred to in the most recent Apkarian article cited above; I should have really included it there. Sorry.

Mike