Complex regional pain syndrome–up-to-date

Birklein, Frank; Dimova, Violeta

doi:10.1097/pr9.0000000000000624

Cited by 106 publications

(117 citation statements)

References 103 publications

Supporting

Mentioning

101

Contrasting

Unclassified

Order By: Relevance

“…CRPS is a challenging chronic condition to treat successfully [79]. Due to its multifaceted pathophysiology, there is unlikely ever to be any general treatment for this syndrome.…”

Section: Treatment Optionsmentioning

confidence: 99%

Molecular Aspects of Regional Pain Syndrome

Baronio

Sadia

Paolacci

et al. 2020

Pain Research and Management

View full text Add to dashboard Cite

The purpose of this review is to summarize the pathophysiology of complex regional pain syndrome (CRPS), the underlying molecular mechanisms, and potential treatment options for its management. CRPS is a multifactorial pain condition. CRPS is characterized by prolonged or excessive pain and changes in skin color and temperature, and/or swelling in the affected area, and is generally caused by stimuli that lead to tissue damage. An inflammatory response involving various cytokines and autoantibodies is generated in response to acute trauma/stress. Chronic phase pathophysiology is more complex, involving the central and peripheral nervous systems. Various genetic factors involved in the chronicity of pain have been identified in CRPS patients. As with other diseases of complex pathology, CRPS is difficult to treat and no single treatment regimen is the same for two patients. Stimulation of the vagus nerve is a promising technique being tested for different gastrointestinal and inflammatory diseases. CRPS is more frequent in individuals of 61–70 years of age with a female to male ratio of 3 : 1. Menopause, migraine, osteoporosis, and asthma all represent risk factors for CRPS and in smokers the prognosis appears to be more severe. The pathophysiological mechanisms underlying CRPS involve both inflammatory and neurological pathways. Understanding the molecular basis of CRPS is important for its diagnosis, management, and treatment. For instance, vagal nerve stimulation might have the potential for treating CRPS through the cholinergic anti-inflammatory pathway.

show abstract

“…CRPS is a challenging chronic condition to treat successfully [79]. Due to its multifaceted pathophysiology, there is unlikely ever to be any general treatment for this syndrome.…”

Section: Treatment Optionsmentioning

confidence: 99%

Molecular Aspects of Regional Pain Syndrome

Baronio

Sadia

Paolacci

et al. 2020

Pain Research and Management

View full text Add to dashboard Cite

show abstract

“…Although the exact pathophysiology of CRPS-I is unknown, a possible mechanism is posttraumatic inflammation [23]. Posttraumatic inflammation is the key mechanism underlying the observed symptoms in the CPIP mouse model, an animal model that exhibits clinical symptoms of CRPS type I [35,36]. Therefore, the authors hypothesized that the injection of MSCs with immunomodulatory properties could reduce mechanical allodynia in CPIP model mice.…”

Section: Discussionmentioning

confidence: 99%

The effect of human mesenchymal stem cell injection on pain behavior in chronic post-ischemia pain mice

Yoo

Lee

et al. 2020

Korean J Pain

View full text Add to dashboard Cite

Background: Neuropathic pain (NP) is considered a clinically incurable condition despite various treatment options due to its diverse causes and complicated disease mechanisms. Since the early 2000s, multipotent human mesenchymal stem cells (hMSCs) have been used in the treatment of NP in animal models. However, the effects of hMSC injections have not been studied in chronic post-ischemia pain (CPIP) mice models. Here, we investigated whether intrathecal (IT) and intrapaw (IP) injections of hMSCs can reduce mechanical allodynia in CPIP model mice. Methods: Seventeen CPIP C57/BL6 mice were selected and randomized into four groups: IT sham (n = 4), IT stem (n = 5), IP sham (n = 4), and IP stem (n = 4). Mice in the IT sham and IT stem groups received an injection of 5 μL saline and 2 × 10 4 hMSCs, respectively, while mice in the IP sham and IP stem groups received an injection of 5 μL saline and 2 × 10 5 hMSCs, respectively. Mechanical allodynia was assessed using von Frey filaments from pre-injection to 30 days post-injection. Glial fibrillary acidic protein (GFAP) expression in the spinal cord and dorsal root ganglia were also evaluated. Results: IT and IP injections of hMSCs improved mechanical allodynia. GFAP expression was decreased on day 25 post-injection compared with the sham group. Injections of hMSCs improved allodynia and GFAP expression was decreased compared with the sham group. Conclusions: These results suggested that hMSCs may be also another treatment modality in NP model by ischemia-reperfusion.

show abstract

“…Die fixierte CRPS-Dystonie entspricht einer Sollwertverstellung des Gleichgewichts der Motoneurone der Flexoren und Extensoren im Rückenmark. Aus diesem Grund findet sich bei fast allen Patienten das gleiche Muster [12].…”

Section: Motorische Symptomeunclassified