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Abnormal capacity for grip force control in patients with congenital insensitivity to pain

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Abstract

Congenital insensitivity to pain (CIP), which is an extremely rare sensory neuropathy, is defined as the absence of normal responses to noxious stimuli. Although motor function is not directly impaired in CIP patients, it is likely that the sensory deficit affects the motor control system. In order to characterize motor capacity in CIP patients, we here measured grip force and acceleration of a held object in 12 patients with CIP and 12 age-matched able-bodied subjects. The results demonstrated that the grip force during the object grasp-lift-holding task was significantly greater, less reproducibility and greater fluctuation in the acceleration of the object in CIP patients than in normal subjects. Moreover, some patients showed absence of temporal coupling between the grip and load force, suggesting that anticipatory modulation of the grip force was at least partly impaired. As far as the authors know, this is the first study to characterize motor control ability in patients with CIP. The observed abnormal motor capacity can be at least partly attributed to a lack of sensory inputs mediated by Aδ and unmyelinated C-, specifically C-tactile, fibers. The present results may provide information useful for the prevention of secondary injury and education for patients during the developmental stage.

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Acknowledgments

We thank Dr. Masahiro Iijima and Ms. Kimiko Shirakawa for their considerable contributions to the clinical assessment and extend our thanks to Tomorrow, Japan Association of Patients with Congenital Insensitivity to Pain with Anhidrosis (CIPA), for their cooperation. This work was supported by a Health and Labour Sciences research grant for research on intractable diseases.

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Authors and Affiliations

  1. Department of Rehabilitation for the Movement Functions, Research Institute of the National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokotozawa, Saitama, 359-8555, Japan

    Noritaka Kawashima

  2. Research Center for Advanced Science and Technology, The University of Tokyo, 4-6-1 Komaba, Meguro, Tokyo, 153-8904, Japan

    Masaki O. Abe

  3. Graduate school of Health and Welfare Sciences, International University of Health and Welfar, 1-3-3 Mimnami-Aoyama, Minato, Tokyo, 107-0062, Japan

    Tsutomu Iwaya

  4. Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan

    Nobuhiko Haga

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  1. Noritaka Kawashima
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  2. Masaki O. Abe
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  3. Tsutomu Iwaya
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  4. Nobuhiko Haga
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Correspondence to Noritaka Kawashima.

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Kawashima, N., Abe, M.O., Iwaya, T. et al. Abnormal capacity for grip force control in patients with congenital insensitivity to pain. Exp Brain Res 218, 579–588 (2012). https://doi.org/10.1007/s00221-012-3050-7

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  • DOI: https://doi.org/10.1007/s00221-012-3050-7

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