A Review of Psychosocial Factors in Complex Regional Pain Syndrome

Lohnberg, Jessica A.; Altmaier, Elizabeth M.

doi:10.1007/s10880-012-9322-3

Cited by 77 publications

(66 citation statements)

References 35 publications

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“…Proposed mechanisms include cortical change and reorganization. Psychological factors, such as depression and anxiety, may be premorbid or occur in response to pain; addressing these components is an important part of managing the disorder [111,112]. …”

Section: Common Post-stroke Pain Subtypesmentioning

confidence: 99%

Post Stroke Pain: Identification, Assessment, and Therapy

2015

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Background: Pain is a common complication after stroke and is associated with the presence of depression, cognitive dysfunction, and impaired quality of life. It remains underdiagnosed and undertreated, despite evidence that effective treatment of pain may improve function and quality of life. Summary: We provide an overview of the means for clinical assessment and risk factors for the development of post-stroke pain, then review the newest available literature regarding the commonest post-stroke pain syndromes, including central post-stroke pain, complex regional pain syndrome, musculoskeletal pain including shoulder subluxation, spasticity-related pain, and post-stroke headache, as well as the available epidemiology and current treatment options. Key Messages: In the best interests of optimizing quality of life and function after stroke, clinicians should be aware of pain as a common complication after stroke, identify those patients at highest risk, directly inquire as to the presence and characteristics of pain, and should be aware of the options for treatment for the various pain syndromes.

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Section: Common Post-stroke Pain Subtypesmentioning

confidence: 99%

Post Stroke Pain: Identification, Assessment, and Therapy

2015

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“…8,9 More broadly, a recent meta-analysis of 24 separate studies on cognition in pain patients concluded that there was a consistent moderate effect of pain on working memory. 10 In a related study, it was observed that approximately 20% of the new patients to a multidisciplinary pain center showed clinically significant impairment on neurocognitive testing.…”

Section: Introductionmentioning

confidence: 99%

Brain Neuroplastic Changes Accompany Anxiety and Memory Deficits in a Model of Complex Regional Pain Syndrome

Tajerian

Leu²,

Zou³

et al. 2014

Anesthesiology

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Background Complex regional pain syndrome (CRPS) is a painful condition with ~50,000 annual new cases in the United States. It is a major cause of work-related disability, chronic pain after limb fractures and persistent pain after extremity surgery. Additionally, CRPS patients often experience cognitive changes, anxiety and depression. The supraspinal mechanisms linked to these CRPS-related comorbidities remain poorly understood. Methods We used a previously-characterized mouse model of tibia fracture/cast immobilization showing the principal stigmata of CRPS (n=8–20/group) observed in humans. Our central hypothesis was that fracture/cast mice manifest changes in measures of thigmotaxis (indicative of anxiety) and working memory reflected in neuroplastic changes in amygdala, perirhinal cortex, and hippocampus. Results We demonstrate that nociceptive sensitization in these mice is accompanied by altered thigmotactic behaviors in the zero maze but not open field assay, and working memory dysfunction in novel object recognition and social memory but not in novel location recognition. Furthermore, we found evidence of structural changes and synaptic plasticity including changes in dendritic architecture and decreased levels of synaptophysin and brain derived neurotrophic factor in specific brain regions. Conclusions Our findings provide novel observations regarding behavioral changes and brain plasticity in a mouse model of CRPS. In addition to elucidating some of the supraspinal correlates of the syndrome, this work supports the potential use of therapeutic interventions that not only directly target sensory input and other peripheral mechanisms, but also attempt to ameliorate the broader pain experience by modifying its associated cognitive and emotional comorbidities.

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“…low-back pain, arthrosis) and limb immobilisation (Marinus 2011) may increase the risk of its development. Psychological traits, such as depression, anxiety, neuroticism and anger, have so far been discounted as risk factors for the development of CRPS : Lohnberg 2013, although further prospective studies are required to substantiate this assertion .…”

Section: Background Description Of the Conditionmentioning

confidence: 99%

“…People with CRPS experience significant suffering and disability (Bruehl 2010;Lohnberg 2013). Preliminary data suggest that interference with activities of daily living, sleep, work and recreation is common and further contributes to a diminished quality of life (Galer 2000;Geertzen 1998;Kemler 2000;Sharma 2009).…”

Section: Background Description Of the Conditionmentioning

confidence: 99%