Abstract
The objective of this study is to investigate the endothelial function in complex regional pain syndrome. A total of 21 patients with CRPS and 15 healthy controls were enrolled. The mean age of patients was 22 ± 4.9 years and the mean duration of the disease was 5.9 ± 2.5 months. Flow-mediated vasodilatation (FMD) technique was performed for evaluating the endothelial function. Parameters were the waveforms obtained and the increase in diameter and blood flow of the brachial artery, which were expressed as the percent change from baseline. The differences of the waveforms obtained in the affected limbs in comparison to non-affected limbs and to controls were statistically significant. We observed a trend of greater percent dilating responses in the affected limbs; however, the differences showed no statistical significance. In macrovascular evaluation, the endothelial function seems to be impaired in the earlier stage of the disease.
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Okudan B, Celik C (2006) Determination of inflammation of reflex sympathetic dystrophy at early stages with Tc99 m HIG scintigraphy: preliminary results. Rheumatol Int 26(5):404–408
Schürmann M, Zaspel J, Gradl G, Wipfel A, Christ F (2001) Assessment of the peripheral microcirculation using computer-assisted venous congestion plethysmography in post-traumatic complex regional pain syndrome type I. J Vasc Res 38:453–461
Matsumura H, Jimbo Y, Watanabe K (1996) Haemodynamic changes in early phase reflex sympathetic dystrophy. Scand J Plast Reconstr Surg Hand Surg 30:133–138
Van der Laan L, ter Laak HJ, Gabreels-Festen A, Gabreels F, Goris RJA (1998) Complex regional pain syndrome type I (RSD) pathology of skeletal muscle and peripheral nerve. Neurology 51:20–25
Gradl G, Gaida S, Finke B, Gierer P, Mittlmeier T, Vollmar B (2006) Exaggeration of tissue trauma induces signs and symptoms of acute CRPS I, however displays distinct differences to experimental CRPS II. Neurosci Lett 402:267–272
Blair SJ, Chinthagada M, Hoppenstehdt D, Kijowski R, Fareed J (1998) Role of neuropeptides in the pathogenesis of reflex sympathetic dystrophy. Acta Orthop Belg 64:448–451
Daeman MARC, Kurvers HAJM, Kitslaar PJEHM, Slaaf DW, Bullens PHJ, van den Wildenberg FAJM (1998) Neurogenic inflammation in an animal model of neuropathic pain. Neurol Res 20:41–45
Goris RJ (2002) Reflex sympathetic dystrophy: model of severe regional inflammatory response syndrome. World J Surg 22:197–202
Oyen WJ, Arntz IE, Classens RM (1993) Reflex sympathetic dystrophy of the hand: an excessive inflammatory response? Pain 55:151–157
Gorodkin R, Moore T, Herrick A (2004) Assessment of endothelial function in complex regional pain syndrome type I using iontophoresis and laser doppler imaging. Rheumatology 43:727–730
Schattschneider J, Hartung K, Stengel M, Ludwig J, Binder A, Wasner G, Baron R (2006) Endothelial dysfunction in cold type complex regional pain syndrome. Neurology 67:673–675
Bruehl S, Harden RN, Galer BS, Saltz S, Bertram M, Backonja 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(1–2):147–154
Maltz JS, Budinger TF (2005) Evaluation of arterial endothelial function using transit times of artificially induced pulses. Physiol Meas 26:293–307
Coretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, Deanfield J, Drexler H, Gerhard-Herman M, Herrington D, Vallance P, Vita J, Vogel R (2002) Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery. J Am Coll Cardiol 39(2):257–265
Sorensen KE, Celermajer DS, Spiegelhalter DJ, Georgakopoulos D, Robinson J, Thomas O, Daenfield JE (1995) Noninvasive measurement of human endothelium dependent arterial responses: accuracy and reproducibility. Br Heart J 74:247–253
Joannides R, Haefeli WE, Linder L, Richard V, Bakkali EH, Thuillez C, Luscher TF (1995) Nitric oxide is responsible for flow-dependent dilatation of human peripheral conduit arteries in vivo. Circulation 91:1314–1319
Lieberman EH, Gerhard MD, Uehata A, Selwyn AP, Ganz P, Yeung AC, Creager MA (1996) Flow-induced vasodilation of the human brachial artery is impaired in patients 40 years of age with coronary artery disease. Am J Cardiol 78:1210–1214
Joannides R, Richard V, Haefeli WE, Benoist A, Linder L, Luscher TF, Thuillez C (1997) Role of nitric oxide in the regulation of the mechanical properties of peripheral conduit arteries in humans. Hypertension 30:1465–1470
Shoemaker JK, Pozeg ZI, Hughson RL (1996) Forearm blood flow by Doppler ultrasound during rest and exercise: tests of day-to-day repeatability. Med Sci Sports Exerc 28:1144–1149
Rosiello R, Mahler D, Ward J (1987) Cardiovascular responses to rowing. Med Sci Sports Exerc 19:239–245
Legarth J, Nolsoe C (1990) Doppler blood velocity waveforms and the relation to peripheral resistance in the brachial artery. J Ultrasound Med 9:449–453
Baxter BT, Blackburn D, Payne K, Pearce WH, Yao JS (1990) Noninvasive evaluation of the upper extremity. Surg Clin North Am 1:87–97
Celermajer DS, Sorensen KE, Gooch VM et al (1992) Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 340:1111–1115
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Duman, I., Sanal, H.T., Dincer, K. et al. Assessment of endothelial function in complex regional pain syndrome type I. Rheumatol Int 28, 329–333 (2008). https://doi.org/10.1007/s00296-007-0451-1
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DOI: https://doi.org/10.1007/s00296-007-0451-1