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In this issue of Neurology®, Klega et al.1 evaluated opioid receptor binding potential (OR-BP) in a small group of subjects with complex regional pain syndrome (CRPS) compared to a matched control group, utilizing PET scanning.
CRPS remains a puzzling condition. Its devastating nature, enigmatic pathophysiology, and lack of efficient treatment have resulted in over 4,000 published articles, while extensive research continues. It is unclear whether CRPS pathophysiology is based on central or peripheral pathologic alterations, or both; understanding this may facilitate development of a proper therapy.
Although pathophysiologic understanding has improved, not every aspect of this challenging neuropathic pain syndrome has been explored. Typical symptoms of CRPS are sensory, motor, and autonomic dysfunctions. In most cases, CRPS occurs after a fracture, limb trauma, or lesion of the peripheral nervous system or CNS. Sometimes, symptoms develop without any trauma. Three major mechanisms are currently postulated: enhanced peripheral neurogenic inflammation, dysfunction of the sympathetic nervous system, and structural reorganization in the CNS. Moreover, a genetic predisposition may explain increased vulnerability. The possible role of oxidative stress in CRPS pathophysiology has gained further attention in …
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