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Please use this identifier to cite or link to this item: http://hdl.handle.net/11055/654
Title: A new hypothesis for the pathophysiology of complex regional pain syndrome
Authors: Russo, Marc
Georgius, Peter
Santarelli, Danielle M
ANZCA/FPM Author: Georgius, P
Russo, M
Keywords: complex regional pain syndrome
Issue Date: Oct-2018
Citation: 119:41-53
Abstract: Complex Regional Pain Syndrome (CRPS) has defied a clear unified pathological explanation to date. Not surprisingly, treatments for the condition are limited in number, efficacy and their ability to enact a cure. Whilst many observations have been made of physiological abnormalities, how these explain the condition and who does and doesn’t develop CRPS remains unclear. We propose a new overarching hypothesis to explain the condition that invokes four dynamically changing and interacting components of tissue trauma, pathological pain processing, autonomic dysfunction (both peripheral and central) and immune dysfunction, primarily involving excessive and pathological activation of dendritic cells following trauma or atrophy. We outline pathophysiological changes that may initiate a cascade of events involving dendritic cells and the cholinergic anti-inflammatory pathway resulting in the condition, and the changes that maintain the condition into its chronic phase. This hypothesis should provide fertile ground for further investigations and development of new treatments that holistically address the nature of the disorder along its developmental continuum.
URI: http://hdl.handle.net/11055/654
DOI: 10.1016/j.mehy.2018.07.026
ORCID: 0000-0001-7364-9917
ISSN: 0306-9877
Journal Title: Medical Hypotheses
Type: Journal Article
Affiliates: Hunter Pain Clinic, Broadmeadow, NSW, Australia
Pain Rehab, Noosa Heads, QLD, Australia
Study/Trial: Narrative Reviews
Appears in Collections:Scholarly and Clinical

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