• To investigate if FD in CRPS is associated with specific structural and functional changes of the brain.• If so, to find out which of these changes are specific for FD in CRPS, i.e., independent regardless the clinical setting (pain versus…
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Gray matter volume
Anisotropy white matter
gray-white matter connectivity
activity brain areas
Secondary outcome
Pain scores
Psychiological score
Dystonia score
Background summary
Complex Regional Pain Syndrome (CRPS) is a very disabling syndrom with an
incidence of 26 per 100,000 people in the Netherlands, more common in women
than in men. Ninety percent of the patients develop symptoms after peripheral
trauma. Patients complain of constant severe pain that is aggravated when in
contact with non-painful stimuli (allodynia). Other symptoms develop such as
fluctuations in color and temperature, changes in nail and hair growth and
movement disorders like fixed dystonia (FD).
FD is common in CRPS and develops in 20% of patients. It is characterized by a
flexed and inversed state of the affected limb. The symptoms may arise soon
after CRPS started but can also develop months or years later. This is one of
the major reasons for the ongoing discussion on the etiology of this condition
and the relationship with CRPS. Many researchers think that this form of
dystonia is of psychological origin and is not maintained by a biological
substrate.
Indications for an underlying biological substrate are found in some imaging
studies in CRPS patients focussing on structural and functional changes and
recent research focussing on cortical disinhibition in patients with FD
These studies highlight prominent changes in sensorymotor supraspinal circuitry
in both CRPS and FD patients. Until now, no differentiation has been made
between these two syndromes in terms of structural and functional differences
seen in the brain. Therefore we will compare patients with CRPS with and
without FD, FD without CRPS and controls on the following parameters: Cortical
plasticity expressed by gray and white matter volume change using Voxel Based
Morphometry (VBM), white matter directionality and connectivity using Diffusor
Tensor Imaging (DTI), brain activity in rest using resting state fMRI (rfMRI)
and heat pulse evoked fMRI
Study objective
• To investigate if FD in CRPS is associated with specific structural and
functional changes of the brain.
• If so, to find out which of these changes are specific for FD in CRPS, i.e.,
independent regardless the clinical setting (pain versus spontaneous onset) in
which FD has developed.
Study design
case-controled
Study burden and risks
none
Albinusdreef 2
2333 za Leiden
NL
Albinusdreef 2
2333 za Leiden
NL
Listed location countries
Age
Inclusion criteria
3 groups:
1: CRPS with fixed dystonia. fulfil 'Budapest criteria' CRPS. Fixed dystonia in one or more upper limbs
2: CRPS without dystonia: fulfil Budapest criteria'. 3: Fixed dystonia in one or more upper limbs
Exclusion criteria
all: <18 years old. Positive scan-exclusion criteria, disease or lesions in central nervous system, psychiatric history
group:
1: mobile dystonia, genetic form of dystonia, symptoms in lower limbs, drug delivery pump
2: dystonia, symptoms in lower limbs, drug delivery pump
3:CRPS
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL34614.058.11 |