De Schoenmacker, Iara; Mollo, Anna; Scheuren, Paulina Simonne; Sirucek, Laura; Brunner, Florian; Schweinhardt, Petra; Curt, Armin; Rosner, Jan; Hubli, Michèle (2023). Central sensitization in CRPS patients with widespread pain: A cross-sectional study. Pain medicine, 24(8), pp. 974-984. Oxford University Press 10.1093/pm/pnad040
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OBJECTIVE
Widespread pain hypersensitivity and enhanced temporal summation of pain (TSP) are commonly reported in patients with complex regional pain syndrome (CRPS) and discussed as proxies for central sensitization. This study aimed to directly relate such signs of neuronal hyperexcitability to the pain phenotype of CRPS patients.
METHODS
Twenty-one CRPS patients and 20 healthy controls (HC) were recruited. The pain phenotype including spatial pain extent (assessed in % body surface) and intensity were assessed and related to widespread pain hypersensitivity, TSP, and psychological factors. Quantitative sensory testing (QST) was performed in the affected, the contralateral and a remote (control) area.
RESULTS
CRPS patients showed decreased pressure pain thresholds in all tested areas (affected: t(34)=4.98, p < 0.001, contralateral: t(35)=3.19, p = 0.005, control: t(31)=2.65, p = 0.012). Additionally, patients showed increased TSP in the affected area (F(3,111)=4.57, p = 0.009) compared to HC. TSP was even more enhanced in patients with a high compared to a low spatial pain extent (F(3,51)=5.67, p = 0.008), suggesting pronounced spinal sensitization in patients with extended pain patterns. Furthermore, the spatial pain extent positively correlated with the Bath Body Perception Disturbance Scale (ρ = 0.491; p = 0.048).
CONCLUSION
Overall, we provide evidence that the pain phenotype in CRPS, i.e., spatial pain extent, might be related to sensitization mechanism within the central nociceptive system. This study points towards central neuronal excitability as a potential therapeutic target in patients with more widespread CRPS.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Rosner, Jan |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1526-4637 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
23 Mar 2023 10:46 |
Last Modified: |
02 Aug 2023 00:12 |
Publisher DOI: |
10.1093/pm/pnad040 |
PubMed ID: |
36946277 |
Uncontrolled Keywords: |
central sensitization complex regional pain syndrome quantitative sensory testing spatial pain extent temporal summation of pain |
BORIS DOI: |
10.48350/180540 |
URI: |
https://boris.unibe.ch/id/eprint/180540 |
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