24.06.11 - Clinical features and pathophysiology of complex regional pain syndrome
Together with an international group of renown CRPS researchers, researchers from TREND published a review on the clinical features and pathophysiological mechanisms of CRPS in The Lancet Neurology, the leading journal in the field of neurology.
That a minor injury can trigger a complex condition like CRPS has fascinated and perplexed scientists for a long time. However, understanding of CRPS has increased substantially in the past decade. In this review the authors present a multidisciplinary overview of CRPS that integrates findings across relevant fields and puts them into perspective.
The authors conclude that epidemiological, genetic, and experimental studies suggest that the disease mechanism of CRPS is multifactorial in nature and is characterized by an aberrant host response to tissue injury. They hypothesize that (neurogenic) inflammation, increased sensitivity to painful stimuli, disturbance of local circulation and maladaptive changes in the nervous system account for most or all of the clinical features of CRPS. Differences between patients in the extent to which these mechanisms are affected account for the clinical heterogeneity of the disorder.
The authors argue that the responsible mechanisms can be conceptualised as a framework. Each component of this framework should be considered in the management of these patients. This means that each of these components should be assessed, diagnosed, and monitored. Finally, consideration of the multiple mechanisms implicated in the pathophysiology of CRPS should provide a basis for biomarker discovery and more targeted therapeutic interventions.
Authors: J. Marinus, G.L. Moseley, F. Birklein, R. Baron, C. Maihöfner, W.S. Kingery, J.J. van Hilten
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