Neuroimmune alterations in the complex regional pain syndrome

Huygen, Frank; Bruijn, Anke G. J. de; Klein, Jan; Zijlstra, Freek J.

doi:10.1016/s0014-2999(01)01310-3

Cited by 58 publications

(62 citation statements)

References 141 publications

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“…Based on our recent review of the literature on pathophysiology on CRPS [2] we hypothesised that, as a result of a genetic and/or acquired immunologic disorder, a normal sterile inflammatory response after trauma or surgical procedure becomes exacerbated. Secondarily based on sensitisation of the dorsal horn and higher centres, sensory, vasomotor, sudomotor, motor and trophic changes develop which might be responsible for the chronic clinical picture of this disease.…”

Section: Introductionmentioning

confidence: 99%

Mast cells are involved in inflammatory reactions during Complex Regional Pain Syndrome type 1

Huygen¹,

Ramdhani²,

et al. 2004

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Section: Introductionmentioning

confidence: 99%

Mast cells are involved in inflammatory reactions during Complex Regional Pain Syndrome type 1

Huygen¹,

Ramdhani²,

et al. 2004

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“…So far it is poorly understood how a minor injury can result in such a stage with far greater pain and discomfort than was ever observed in the healing period after the initial injury (Veldman et al 1993). It is quite certain that damaged nerves of the sympathetic nervous system, which are responsible for blood flow and temperature, play an important role in the development of CRPS1 (Huygen et al 2001). Furthermore, the release of bio-active inflammatory mediators such as neuropeptides, cytokines and eicosanoids also contribute to the acute signs of the disease such as pain, loss of function, redness, swelling and increasing temperature (Birklein et al 2001a, Huygen et al 2002.…”

Section: Introductionmentioning

confidence: 99%

Computer-assisted skin videothermography is a highly sensitive quality tool in the diagnosis and monitoring of complex regional pain syndrome type�I

Huygen

Niehof

Klein

et al. 2004

European Journal of Applied Physiology

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The use of thermography in the diagnosis and evaluation of complex regional pain syndrome type 1 (CRPS1) is based on the presence of temperature asymmetries between the involved area of the extremity and the corresponding area of the uninvolved extremity. The interpretation of thermographic images is, however, subjective and not validated for routine use. The objective of the present study was to develop a sensitive, specific and reproducible arithmetical model as the result of computer-assisted infrared thermography in patients with early stage CRPS1 in one hand. Eighteen patients with CRPS1 on one hand and 13 healthy volunteers were included in the study. The severity of the disease was determined by means of pain questionnaires [visual analogue scale (VAS) pain and McGill Pain Questionnaire], measurements of mobility (active range of motion) and oedema volume. Asymmetry between the involved and the uninvolved extremities was calculated by means of the asymmetry factor, the ratio and the average temperature differences. The discrimination power of the three methods was determined by the receiver-operating curve (ROC). The regression between the determined temperature distributions of both extremities was plotted. Subsequently the correlation of the data was calculated. In normal healthy individuals the asymmetry factor was 0.91 (0.01) (SD), whereas in CRPS1 patients this factor was 0.45 (0.07) (SD). The performance of the arithmetic model based on the ROC curve was excellent. The area under the curve was 0.97, the P value was <0.001, the sensitivity 92% and specificity 94%. Furthermore, the temperature asymmetry factor was correlated with the duration of the disease and VAS pain. In conclusion, in resting condition, videothermography is a reliable additive diagnostic tool of early stage CRPS1. This objective tool could be used for monitoring purposes during experimental therapeutic intervention.

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“…Nerve growth factor is one of the cytokines activated by the substance P, and its activity leads to nociceptive sensitization, enhanced osteopenia with increased cytokine content (Sabsovich et al, 2008). Tumor necrosis factor alpha is another pro-inflammatory cytokine postulated to play a role in the development of CRPS changes after trauma and its expression is increased in CRPS patients (Huygen et al, 2001). Although the increased level of the tumor necrosis factor is an important mediator of regional nociceptive sensitization, it does not contribute to the enhanced bone loss (Sabsovich et al, 2008).…”

Section: Radiographic Findingsmentioning

confidence: 99%