Skip to main content

Advertisement

SpringerLink
Log in

Skin sympathetic function in complex regional pain syndrome type 1

  • Research Article
  • Published:
Clinical Autonomic Research Aims and scope Submit manuscript

Abstract

Purpose

Cutaneous sympathetic pathophysiology in complex regional pain syndrome type 1 (CRPS-1) is not yet completely understood. To evaluate cutaneous sympathetic dysfunction in CRPS-1, we evaluated sympathetic sweat response (SSwR) and skin vasomotor reflex (SkVR) in CRPS-1 patients.

Methods

We studied 10 CRPS-1 patients (age 41 ± 13 years; 5 females and 5 males; disease duration 20 ± 22 months) and 10 healthy subjects (age 44 ± 13 years; 3 females and 7 males). SkVRs and SSwRs to several sympathetic activating procedures were recorded on the palms of the CRPS-1 patients (affected side) and controls (right side).

Results

There were no significant differences in the baselines of sweat output and skin blood flow between the CRPS-1 and control groups. SSwR and SkVR amplitudes were significantly lower in the CRPS-1 group than in the control group. There was no significant correlation between disease duration and SSwR or SkVR amplitudes among the patients.

Conclusions

The reduced SSwRs and SkVRs in the affected limb of our CRPS-1 patients may reflect underlying damage to the sympathetic postganglionic fibres.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Oklander AL, Fields HL (2009) Is reflex sympathetic dystrophy/complex regional pain syndrome type I a small-fiber neuropathy? Ann Neurol 65:629–638. doi:10.1002/ana.21692

    Article  Google Scholar 

  2. Van der Laan L, Ter Laak HJ, Gabreels-Festen A, Gabreels F, Goris RJ (1998) Complex regional pain syndrome type I (RSD): pathology of skeletal muscle and peripheral nerve. Neurology 51:20–25

    Article  PubMed  Google Scholar 

  3. Albrecht PJ, Hines S, Eisenberg E, Pud D, Finlay DR, Connolly MK, Pare M, Davar G, Rice FL (2006) Pathologic alterations of cutaneous innervation and vasculature in affected limbs from patients with complex regional pain syndrome. Pain 120:244–266

    Article  PubMed  Google Scholar 

  4. Asahina M, Kikkawa Y, Suzuki A, Hattori T (2003) Cutaneous sympathetic function in patients with multiple system atrophy. Clin Auton Res 13:91–95

    Article  PubMed  Google Scholar 

  5. Akaogi Y, Asahina M, Yamanaka Y, Koyama Y, Hattori T (2009) Sudomotor, skin vasomotor, and cardiovascular reflexes in 3 clinical forms of Lewy body disease. Neurology 73:59–65. doi:10.1212/WNL.0b013e3181aae83c

    Article  CAS  PubMed  Google Scholar 

  6. Bruehl S, Harden RN, Galer BS, Saltz S, Bertram M, Backonia M, Gayles R, Rudin N, Bhugra MK, Stanton-Hicks M (1999) External validation of IASP diagnostic criteria for complex regional pain syndrome and proposed research diagnostic criteria. International Association for the Study of Pain. Pain 81:147–154

    Article  CAS  PubMed  Google Scholar 

  7. Birklein F, Sittl R, Spitzer A, Claus D, Neundorfer B, Handwerker HO (1997) Sudomotor function in sympathetic reflex dystrophy. Pain 69:49–54

    Article  CAS  PubMed  Google Scholar 

  8. Wasner G, Heckmann K, Maier C, Baron R (1999) Vascular abnormalities in acute reflex sympathetic dystrophy (CRPS-1): complete inhibition of sympathetic nerve activity with recovery. Arch Neurol 56:613–620

    Article  CAS  PubMed  Google Scholar 

  9. Harden RN, Duc TA, Williams TR, Coley D, Cate JC, Gracely RH (1994) Norepinephrine and epinephrine levels in affected versus unaffected limbs in sympathetically maintained pain. Clin J Pain 10:324–330

    Article  CAS  PubMed  Google Scholar 

  10. Birklein F, Schmelz M (2008) Neuropeptides, neurogenic inflammation and complex regional pain syndrome (CRPS). Neurosci Lett 437:199–202. doi:10.1016/j.neulet.2008.03.08

    Article  CAS  PubMed  Google Scholar 

  11. Birklein F, Schmelz M, Schifter S, Weber M (2001) The important role of neuropeptides in complex regional pain syndrome. Neurology 57:2179–2184

    Article  CAS  PubMed  Google Scholar 

  12. Marinus J, Moseley GL, Birklein F, Baron R, Maihofner C, Kingery WS, Van Hilten JJ (2011) Clinical features and pathophysiology of complex regional pain syndrome. Lancet Neurol 10:637–648

    Article  PubMed  Google Scholar 

  13. Schinkel C, Gaerter A, Zaspel J, Zedler S, Faist E, Schuermann M (2006) Inflammatory mediators are altered in the acute phase of posttraumatic complex regional pain syndrome. Clin J Pain 22:235–239

    Article  PubMed  Google Scholar 

  14. Clinchot DM, Lorch F (1996) Sympathetic skin response in patients with reflex sympathetic dystrophy. Am J Phys Med Rehabil 75:252–256

    Article  CAS  PubMed  Google Scholar 

  15. Drory VE, Korczyn AD (1995) The sympathetic skin response in reflex sympathetic dystrophy. J Neurol Sci 128:92–95

    Article  CAS  PubMed  Google Scholar 

  16. Rommel O, Tegenthoff M, Pern U, Strumpf M, Zenz M, Malin JP (1995) Sympathetic skin response in patients with reflex sympathetic dystrophy. Clin Auton Res 5:205–210

    Article  CAS  PubMed  Google Scholar 

  17. Lindh B, Pelto-Huikko M, Schalling M, Lundberg JM, Hokfelt T (1989) Substance P mRNA is present in a population of CGRP-immunoreactive cholinergic postganglionic sympathetic neurons of the cat: evidence from combined in situ hybridization and immunohistochemistry. Neurosci Lett 107:1–5

    Article  CAS  PubMed  Google Scholar 

  18. Ishida-Yamamoto A, Tohyama M (1990) Calcitonin gene-related peptide-like immunoreactive cells in the secretory portions of rat sweat glands. Cell Tissue Res 260:621–623

    Article  CAS  PubMed  Google Scholar 

  19. Zancanaro C, Mucignat-Caretta C, Merigo F, Osculati F (1999) Neuropeptide expression in the mouse vomeronasal organ during postnatal development. NeuroReport 10:2023–2027

    Article  CAS  PubMed  Google Scholar 

  20. Schlereth T, Dittmar JO, Seewald B, Birklein F (2006) Peripheral amplification of sweating-a role for calcitonin gene-related peptide. J Physiol 576:823–832

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Kumazawa K, Sobue G, Mitsuma T, Ogawa T (1994) Modulatory effects of calcitonin gene-related peptide and substance P on human cholinergic sweat secretion. Clin Autonomic Res 4:319–322

    Article  CAS  Google Scholar 

  22. Berg TJ, Levy DM, Reid G, Abraham RR (1995) The effects of vasoactive intestinal polypeptide and substance P on methacholine-induced sweating and vascular flare in diabetic neuropathy. Clin Auton Res 5:159–164

    Article  CAS  PubMed  Google Scholar 

  23. Vetrugno R, Liguori R, Cortelli P, Montagna P (2003) Sympathetic skin response. Basic mechanism and clinical applications. Clin Auton Res 13:256–270

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

No funding was obtained from outside the University.

Author information

Authors and Affiliations

  1. Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, 260-8670, Japan

    Anupama Poudel, Masato Asahina, Yoshikatsu Fujinuma, Yoshitaka Yamanaka, Akira Katagiri, Nobuyuki Araki, Shigeki Hirano & Satoshi Kuwabara

Authors
  1. Anupama Poudel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masato Asahina
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshikatsu Fujinuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshitaka Yamanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Akira Katagiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nobuyuki Araki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shigeki Hirano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Satoshi Kuwabara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masato Asahina.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study design was approved by the ethics committee of Chiba University, Graduate School of Medicine.

Informed consent

Written informed consent was obtained from all participants.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Poudel, A., Asahina, M., Fujinuma, Y. et al. Skin sympathetic function in complex regional pain syndrome type 1. Clin Auton Res 25, 367–371 (2015). https://doi.org/10.1007/s10286-015-0314-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10286-015-0314-x

Keywords

Search

Navigation