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=8â20/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.