Complex regional pain syndrome after mRNA-based COVID-19 vaccination.
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ABSTRACT:
SUBMITTER: Horisawa S
PROVIDER: S-EPMC9796353 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
Publications
Complex regional pain syndrome after mRNA-based COVID-19 vaccination.
Horisawa Shiro S Ando Tamon T Kawamata Takakazu T Taira Takaomi T
Clinical neurology and neurosurgery 20221228
We describe the case of a 17-year-old woman diagnosed with complex regional pain syndrome (CRPS) at a pain clinic after the second dose of the COVID-19 vaccine. She was referred to our department for surgical treatment of movement disorder seven months after the second inoculation. Baclofen (50 µg), administered intrathecally, improved the involuntary movements of her right hand. After administration of zolpidem (5 mg), involuntary movements of the right index finger almost disappeared. However, ...[more]
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Project description:we successfully identified pain-related genes through genome-wide expression profiling in blood from CRPS patients. We found that 80 genes were differentially expressed between 4 CRPS patients (2 CRPS I and 2 CRPS II) and 5 controls (cut-off value: 1.5-fold change and p < 0.05). Most of those genes were associated with signal transduction, developmental processes, cell structure and motility, and immunity and defense. The expression levels of 12 genes selected from the microarray were confirmed in 24 CRPS patients and 18 controls by quantitative reverse transcription-polymerase chain reaction. We focused on matrix metalloproteinase 9 (MMP9) that showed statistically significant difference from controls and the highest relative fold change in CRPS II patients to controls by qPCR validation (6.4 ± 2.47 times and p = 0.001). Identification of pain-related genes in peripheral blood of complex regional pain syndrome (CRPS) using cDNA microarray. Comparative gene expression profiles in peripheral blood of 5 healthy controls and 4 CRPS patients.
2013-06-06 | E-GEOD-47603 | biostudies-arrayexpress
Project description:IntroductionComplex regional pain syndrome (CRPS) is a clinical disorder that can develop following surgery or trauma. Based on the most prominent underlying pathophysiological mechanisms, CRPS can be classified into different subtypes, namely inflammatory, nociplastic/neuropathic, vasomotor, and motor. Depending on the subtype, personalized treatment can be applied. If conservative treatments are insufficient or ineffective, more invasive treatments may be recommended. This article provides an overview of the most recent insights into CRPS and discusses the most common invasive treatments.MethodsThe literature regarding interventional treatments for CRPS has been systematically reviewed and summarized.ResultsBisphosphonates are effective in treating the inflammatory subtype, while ketamine can provide pain relief for the nociplastic/neuropathic subtype. Sympathetic blocks are effective in addressing vasomotor disturbances. For patients with refractory symptoms, neurostimulation is a viable option due to its multimechanistic properties for all subtypes. End-of-line motor disturbances may benefit from intrathecal baclofen.ConclusionsCRPS is a debilitating condition with an unpredictable course. The effectiveness of treatment varies from patient to patient. When conservative approaches prove insufficient, gradual progression to invasive treatments based on the underlying subtype is recommended.
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Project description:BackgroundTreatment of complex regional pain syndrome type I (CRPS-I) is subject to discussion. The purpose of this study was to develop multidisciplinary guidelines for treatment of CRPS-I.MethodA multidisciplinary task force graded literature evaluating treatment effects for CRPS-I according to their strength of evidence, published between 1980 to June 2005. Treatment recommendations based on the literature findings were formulated and formally approved by all Dutch professional associations involved in CRPS-I treatment.ResultsFor pain treatment, the WHO analgesic ladder is advised with the exception of strong opioids. For neuropathic pain, anticonvulsants and tricyclic antidepressants may be considered. For inflammatory symptoms, free-radical scavengers (dimethylsulphoxide or acetylcysteine) are advised. To promote peripheral blood flow, vasodilatory medication may be considered. Percutaneous sympathetic blockades may be used to increase blood flow in case vasodilatory medication has insufficient effect. To decrease functional limitations, standardised physiotherapy and occupational therapy are advised. To prevent the occurrence of CRPS-I after wrist fractures, vitamin C is recommended. Adequate perioperative analgesia, limitation of operating time, limited use of tourniquet, and use of regional anaesthetic techniques are recommended for secondary prevention of CRPS-I.ConclusionsBased on the literature identified and the extent of evidence found for therapeutic interventions for CRPS-I, we conclude that further research is needed into each of the therapeutic modalities discussed in the guidelines.
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Project description:we successfully identified pain-related genes through genome-wide expression profiling in blood from CRPS patients. We found that 80 genes were differentially expressed between 4 CRPS patients (2 CRPS I and 2 CRPS II) and 5 controls (cut-off value: 1.5-fold change and p < 0.05). Most of those genes were associated with signal transduction, developmental processes, cell structure and motility, and immunity and defense. The expression levels of 12 genes selected from the microarray were confirmed in 24 CRPS patients and 18 controls by quantitative reverse transcription-polymerase chain reaction. We focused on matrix metalloproteinase 9 (MMP9) that showed statistically significant difference from controls and the highest relative fold change in CRPS II patients to controls by qPCR validation (6.4 ± 2.47 times and p = 0.001).
2013-06-06 | GSE47603 | GEO
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Project description:IntroductionPatients with complex regional pain syndrome (CRPS) often show disturbed bone metabolism, assessed using three-phase bone scintigraphy (TPBS). However, current methods lack automation and standardisation. Bone serum markers have been proposed as biomarkers, but their utility is unclear.ObjectivesThis study aimed to evaluate bone metabolism in CRPS using TPBS and bone serum markers.MethodsA deep learning model for automated segmentation quantified tracer enhancement in TPBS images. Serum markers analysed included alkaline phosphatase (AP), 25-OH vitamin D, osteoprotegerin, procollagen type I N-terminal propeptide (PINP), and β-C-terminal telopeptide, compared to 48 healthy controls (HC). The study included 114 patients with CRPS, 41 of whom underwent TPBS.ResultsOf the 41 patients with CRPS with TPBS, 39 (95.1%) displayed radiotracer enhancement in the bone phase across CRPS subtypes. Serum markers of 114 patients did not significantly differ between patients and HC, nor did they correlate with TPBS enhancement, except in warm CRPS. In these patients, TPBS accumulation in the metacarpophalangeal region correlated with PINP (Spearman ρ = 0.63, P = 0.038), and AP levels were elevated at 78 U/L (interquartile range 64-88) compared to cold CRPS at 66 U/L (51-77; P = 0.003) and HC at 60 U/L (53-69; P < 0.001).ConclusionAutomated TPBS quantification revealed widespread bone metabolism alterations, common in CRPS and detectable beyond qualitative assessment. Although most serum markers remained unchanged, patients with warm CRPS exhibited unique features, suggesting distinct pathophysiological profiles. Integrating novel image analysis with other biomarkers may enhance diagnostic precision and patient stratification for targeted therapies.
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2023-03-20 | E-MTAB-12829 | biostudies-arrayexpress
Project description:Complex regional pain syndrome (CRPS) is a chronic pain condition associating sensory, motor, trophic and autonomic symptoms in one limb. Cognitive difficulties have also been reported, affecting the patients' ability to mentally represent, perceive and use their affected limb. However, the nature of these deficits is still a matter of debate. Recent studies suggest that cognitive deficits are limited to body-related information and body perception, while not extending to external space. Here we challenge that statement, by using temporal order judgment (TOJ) tasks with tactile (i.e. body) or visual (i.e. extra-body) stimuli in patients with upper-limb CRPS. TOJ tasks allow characterizing cognitive biases to the advantage of one of the two sides of space. While the tactile TOJ tasks did not show any significant results, significant cognitive biases were observed in the visual TOJ tasks, affecting mostly the perception of visual stimuli occurring in the immediate vicinity of the affected limb. Our results clearly demonstrate the presence of visuospatial deficits in CRPS, corroborating the cortical contribution to the CRPS pathophysiology, and supporting the utility of developing rehabilitation techniques modifying visuospatial abilities to treat chronic pain.
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