Background & Aims

The exact underlying pathophysiological mechanism for Complex Regional Pain Syndrome (CRPS) has been under debate in recent years. In fact, previous work identified potential CRPS subtypes, which were characterized as “cold” and “warm” (Bruehl et al., 2016) or peripheral and central phenotypes (Dimova et al., 2020). Thus, the aim was to examine CRPS patients via a comprehensive somatosensory testing and thereby identify potential subgroups.

Methods

In total, 612 patients (age: 51.8 [±13.5], female: 441) with CRPS underwent Quantitative Sensory Testing according to the DFNS protocol (German Research Network on Neuropathic Pain). Thereby, 13 parameters including thermal and mechanical detection and pain thresholds were generated – indicating one distinct sensory profile for each participant.

Results

We identified three distinct sensory phenotypes. The largest group was characterized by hyperalgesia (n=387), a second group was characterized by loss of sensation (n=203). A third, small, but consistent group exhibited strong allodynia and hyperalgesia (n=22).

Conclusions

Here, we report a new way of stratifying patients with CRPS based on sensory phenotypes. The therapeutical implications for each subtype are unknown but still may add to a personalized pain treatment of CRPS in the future.

References

Bruehl S, Harden NR, Galer BS, Saltz S, Backonja M, Stanton-Hicks M. Complex regional pain syndrome: are there distinct subtypes and sequential stages of the syndrome? PAIN® 2002; 95: 119–124.

Dimova V, Herrnberger MS, Escolano-Lozano F, Rittner HL, Vlckova E, Sommer C, et al. Clinical phenotypes and classification algorithm for complex regional pain syndrome. Neurology 2020; 94: e357-e367.

Presenting Author

Julia Forstenpointner

Poster Authors

Julia Forstenpointner

MD

Division of Neurological Pain Research and Therapy, University Hospital Kiel

Lead Author

E-mail

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Complex Regional Pain Syndrome (CRPS)