Recurrent Postoperative CRPS I in Patients With Abnormal Preoperative Sympathetic Function

Ackerman, William E.; Ahmad, Mahmud

doi:10.1016/j.jhsa.2007.10.017

Cited by 28 publications

(18 citation statements)

References 32 publications

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“…Local hyperalgesia in CRPS-affected vs. -unaffected extremity 43 Increased mediators of peripheral sensitization (see Inflammatory Factors later) Altered SNS function Bilateral reductions in SNS vasoconstrictive function predict CRPS occurrence prospectively 50,51 Vasoconstriction to cold challenge is absent in acute CRPS but exaggerated in chronic CRPS 46,55,61 Sympatho-afferent coupling 48 Circulating catecholamines Lower norepinephrine levels in CRPS-affected vs. -unaffected limb 55,62,63 Exaggerated catecholamine responsiveness because of receptor up-regulation related to reduced SNS outflow 63,64…”

Section: Peripheral Sensitizationmentioning

confidence: 99%

An Update on the Pathophysiology of Complex Regional Pain Syndrome

2010

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Complex regional pain syndrome (CRPS) is a neuropathic pain disorder with significant autonomic features. Few treatments have proven effective, in part, because of a historically poor understanding of the mechanisms underlying the disorder. CRPS research largely conducted during the past decade has substantially increased knowledge regarding its pathophysiologic mechanisms, indicating that they are multifactorial. Both peripheral and central nervous system mechanisms are involved. These include peripheral and central sensitization, inflammation, altered sympathetic and catecholaminergic function, altered somatosensory representation in the brain, genetic factors, and psychophysiologic interactions. Relative contributions of the mechanisms underlying CRPS may differ across patients and even within a patient over time, particularly in the transition from "warm CRPS" (acute) to "cold CRPS" (chronic). Enhanced knowledge regarding the pathophysiology of CRPS increases the possibility of eventually achieving the goal of mechanism-based CRPS diagnosis and treatment.

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Section: Peripheral Sensitizationmentioning

confidence: 99%

An Update on the Pathophysiology of Complex Regional Pain Syndrome

2010

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“…A plausible theory which may be applied to our patient is that of a poorly regulated neurohumoral sympathetic nervous system allowing her CRPS to spread. Studies by Schurmann and Ackerman both showed that patients with impaired peripheral vasoconstrictor activity are more prone to developing CRPS (15,16). CRPS alters levels of nitric oxide, nitric oxide synthase, calcitonin gene‐related peptide, endothelin‐1, tumor necrosis factor alpha, interleukins, and endothelial‐dependent vasodilator functions (17–19).…”

Section: Resultsmentioning

confidence: 99%

Pathophysiology of the Spreading of Complex Regional Pain Syndrome Revisited: A Case Report

Azari

Lü

Clarke

et al. 2011

Neuromodulation: Technology at the Neural Interface

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“…Amongst the best examples is Complex Regional Pain Syndrome (CRPS) which can reoccur following re-injury (e.g., following surgery (Ackerman and Ahmad, 2008; Van Dam and Elliot, 2014)), suggesting a preordained state. Brain imaging studies in children report altered networks for the previously affected vs. unaffected limb, even after the pain has disappeared (Lebel et al, 2008).…”

Section: When Pain Pops Out To Conscious Awareness – Insights Frommentioning

confidence: 99%

Subliminal (latent) processing of pain and its evolution to conscious awareness

Borsook

Youssef

Barakat

et al. 2018

Neuroscience & Biobehavioral Reviews

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By unconscious or covert processing of pain we refer to nascent interactions that affect the eventual deliverance of pain awareness. Thus, internal processes (viz., repeated nociceptive events, inflammatory kindling, re-organization of brain networks, genetic) or external processes (viz., environment, socioeconomic levels, modulation of epigenetic status) contribute to enhancing or inhibiting the presentation of pain awareness. Here we put forward the notion that for many patients, ongoing sub-conscious changes in brain function are significant players in the eventual manifestation of chronic pain. In this review, we provide clinical examples of nascent or what we term pre-pain processes and the neurobiological mechanisms of how these changes may contribute to pain, but also potential opportunities to define the process for early therapeutic interventions.

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Recurrent Postoperative CRPS I in Patients With Abnormal Preoperative Sympathetic Function

Cited by 28 publications

References 32 publications

An Update on the Pathophysiology of Complex Regional Pain Syndrome

An Update on the Pathophysiology of Complex Regional Pain Syndrome

Pathophysiology of the Spreading of Complex Regional Pain Syndrome Revisited: A Case Report

Subliminal (latent) processing of pain and its evolution to conscious awareness

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