Educated in England, at the University of Durham Medical School and graduated in 1965. Obtained membership of Royal College of Physicians in 1968 and elected Fellow in 1993. Immigrated to Canada in 1976 and became a Fellow of Royal College of Physicians of Canada in1979. He is a full professor within the Faculty of Medicine, University of Ottawa and has been teaching at the University of Ottawa...

Chronic pain patients show substantial psychological distress, including depressed mood, anxiety, and anger. Nevertheless, the causal role of negative mood in the course of chronic pain conditions remains unclear. This study prospectively investigated the relationship between daily pain, negative mood, and social support in 109 people with reflex sympathetic dystrophy syndrome. Participants com...

Many aspects of bilateral presentation or recurrence of reflex sympathetic dystrophy (RSD) are unknown. For this reason 1183 consecutive patients with RSD were analyzed. In 10 patients RSD started in symmetrical limbs. In 34 patients RSD recurred in the same limb after a period of no or few complaints and in 76 patients RSD recurred in one or more limbs other than the first limb. Compared to 10...

In a recent study, Ebitz and Moore described how subthreshold electrical microstimulation of the macaque frontal eye fields (FEF) modulates the pupillary light reflex. This elegant study suggests that the influence of the FEF and prefrontal cortex on attentional modulation of cortical visual processing extends to the subcortical circuit that mediates a very basic reflex, the pupillary light ref...

Chronic reflex sympathetic dystrophy is a painful, disabling disorder for which no treatment with proven effect is available. We performed a randomized trial in a 2 to 1 ratio of patients, in which 36 patients were treated with spinal cord stimulation and physical therapy (SCS+PT), and 18 patients received solely PT. Twenty-four SCS+PT patients were given a permanent spinal cord stimulation sys...

Complex regional pain syndrome type I (CRPS-I), formerly reflex sympathetic dystrophy (RSD), is a chronic pain syndrome of unknown aetiology. Its diagnosis is a clinical one, for which several criteria systems have been defined. Despite their widespread use, the reliability of these criteria has never been studied. In this interobserver study 25 chronic CRPS patients were interviewed and examin...

Postural reflex activity during unperceived perturbation of standing was investigated in 38 elderly subjects (70-96 years old) and 10 younger adults (19-48 years old), and it was related in the elderly group to a history of unexplained falling in the 12 months prior to testing. Ankle torque (T) and ankle angle (A) were recorded during unperceived forward pulls to obtain the ankle stiffness (Del...

This study examined the effects of 3 wk of either endurance or strength training on plasticity of the neural mechanisms involved in the soleus H reflex and V wave. Twenty-five sedentary healthy subjects were randomized into an endurance group (n = 13) or strength group (n = 12). Evoked V-wave, H-reflex, and M-wave recruitment curves, maximal voluntary contraction (MVC), and time-to-task-failure...

S INCE the American Civil War, clinicians and neuroscientists have been mystified by patterns of persistent pain and cutaneous hypersensitivity after injuries to the limbs that are accompanied by remarkable neurovascular, sudomotor, motor, and trophic changes. These syndromes traditionally were labeled as reflex sympathetic dystrophy or causalgia, according to the absence or presence of identif...

This retrospective study was undertaken to determine the usefulness of intravenous regional anesthetic (IVRA) blocks containing ketorolac and lidocaine in the management of sympathetically-mediated pain, and to determine what factors, if any, predicted success with this technique. Sixty-one patients with reflex sympathetic dystrophy presenting to a university-affiliated teaching hospital's pain...