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Review of complex regional pain syndrome and the role of the neuroimmune axis
- Source :
- Molecular Pain
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- Background Complex regional pain syndrome (CRPS) is a progressive and painful disease of the extremities that is characterized by continuous pain inconsistent with the initial trauma. CRPS is caused by a multi-mechanism process that involves both the peripheral and central nervous system, with a prominent role of inflammation in CRPS pathophysiology. This review examines what is currently known about the CRPS inflammatory and pain mechanisms, as well as the possible impact of neurostimulation therapies on the neuroimmune axis of CRPS. Study design A narrative review of preclinical and clinical studies provided an overview of the pain and inflammatory mechanisms in CRPS and addressed the effect of neurostimulation on immunomodulation. Methods A systematic literature search was conducted based on the PRISMA guidelines between September 2015 to September 2020. Data sources included relevant literature identified through searches of PubMed, Embase and the Cochrane Database of Systematic Reviews. Results Sixteen preclinical and eight clinical studies were reviewed. Preclinical studies identified different mechanisms of pain development in the acute and chronic CRPS phases. Several preclinical and clinical studies investigating inflammatory mechanisms, autoimmunity, and genetic profiles in CRPS, supported a role of neuroinflammation in the pathophysiology of CRPS. The immunomodulatory effects of neurostimulation therapy is still unclear, despite clinical improvement in the CRPS patients. Conclusions Increasing evidence supports a role for inflammation and neuroinflammation in CRPS pathophysiology. Preliminary neurostimulation findings, together with the role of (neuro)inflammation in CRPS, seems to provide a compelling rationale for its use in CRPS pain treatment. The possible immunomodulatory effects of neurostimulation opens new therapeutic possibilities, however further research is needed to gain a better understanding of the working mechanisms.
- Subjects :
- Neuroimmunomodulation
Pain
Inflammation
Disease
Review
Cellular and Molecular Neuroscience
medicine
Regional pain syndrome
Humans
Pain Management
pathophysiology
Spinal Cord Stimulation
business.industry
medicine.disease
Complex regional pain syndrome
Neuromodulation (medicine)
Pathophysiology
neuroimmunity
Anesthesiology and Pain Medicine
Anesthesia
dorsal root ganglion stimulation
neuromodulation
Molecular Medicine
medicine.symptom
business
Complex Regional Pain Syndromes
Subjects
Details
- Language :
- English
- ISSN :
- 17448069
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Molecular Pain
- Accession number :
- edsair.doi.dedup.....a81c52fc7750832dab8685792b43d386