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Brain, Vol. 124, No. 10, 2098-2104, October 2001
© 2001 Oxford University Press

Pain and the body schema

Evidence for peripheral effects on mental representations of movement

John Schwoebel1,2, Robert Friedman3, Nanci Duda2 and H. Branch Coslett2,1

1 Moss Rehabilitation Research Institute, 2 Department of Neurology, University of Pennsylvania School of Medicine and 3 Department of Anesthesiology, Temple University School of Medicine, Philadelphia, Pennsylvania, USA

Correspondence to: H. Branch Coslett, University of Pennsylvania Medical Center, 3rd Floor Gates Bldg, 3400 Spruce St, Philadelphia, PA 19104-4283, USA E-mail hbc{at}mail.med.upenn.edu or Robert Friedman, Department of Anesthesiology, Temple University School of Medicine, 3401 N. Broad St., Philadelphia, PA 19140, USA E-mail FRIEDMR{at}tuhs.temple.edu

Some accounts of body representations postulate a real-time representation of the body in space generated by proprioceptive, somatosensory, vestibular and other sensory inputs; this representation has often been termed the `body schema'. To examine whether the body schema is influenced by peripheral factors such as pain, we asked patients with chronic unilateral arm pain to determine the laterality of pictured hands presented at different orientations. Previous chronometric findings suggest that performance on this task depends on the body schema, in that it appears to involve mentally rotating one's hand from its current position until it is aligned with the stimulus hand. We found that, as in previous investigations, participants' response times (RTs) reflected the degree of simulated movement as well as biomechanical constraints of the arm. Importantly, a significant interaction between the magnitude of mental rotation and limb was observed: RTs were longer for the painful arm than for the unaffected arm for large-amplitude imagined movements; controls exhibited symmetrical RTs. These findings suggest that the body schema is influenced by pain and that this task may provide an objective measure of pain.


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