Sensory modulation dysfunction is associated with Complex Regional Pain Syndrome

PLoS One. 2018 Aug 9;13(8):e0201354. doi: 10.1371/journal.pone.0201354. eCollection 2018.

Abstract

Objective: Complex Regional Pain Syndrome (CRPS), a chronic pain condition, develops mainly after limb trauma and severely inhibits function. While early diagnosis is essential, factors for CRPS onset are elusive. Therefore, identifying those at risk is crucial. Sensory modulation dysfunction (SMD), affects the capacity to regulate responses to sensory input in a graded and adaptive manner and was found associated with hyperalgesia in otherwise healthy individuals, suggestive of altered pain processing.

Aim: To test SMD as a potential risk factor for CRPS.

Methods: In this cross-sectional study, forty-four individuals with CRPS (29.9±11 years, 27 men) and 204 healthy controls (27.4±3.7 years, 105 men) completed the Sensory Responsiveness Questionnaire-Intensity Scale (SRQ-IS). A physician conducted the CRPS Severity Score (CSS), testing individuals with CRPS.

Results: Thirty-four percent of the individuals with CRPS and twelve percent of the healthy individuals were identified to have SMD (χ2 (1) = 11.95; p<0.001). Logistic regression modeling revealed that the risk of CRPS is 2.68 and 8.21 times higher in individuals with sensory over- and sensory under-responsiveness, respectively, compared to non-SMD individuals (p = 0.03 and p = 0.01, respectively).

Conclusions: SMD, particularly sensory under-responsiveness, might serve as a potential risk factor for CRPS and therefore screening for SMD is recommended. This study provides the risk index probability clinical tool a simple evaluation to be applied by clinicians in order to identify those at risk for CRPS immediately after injury. Further research is needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arm Injuries / complications*
  • Chronic Disease / epidemiology
  • Complex Regional Pain Syndromes / diagnosis
  • Complex Regional Pain Syndromes / epidemiology*
  • Complex Regional Pain Syndromes / etiology
  • Complex Regional Pain Syndromes / prevention & control
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hyperalgesia / diagnosis
  • Hyperalgesia / epidemiology*
  • Hyperalgesia / etiology
  • Hyperalgesia / prevention & control
  • Leg Injuries / complications*
  • Male
  • Pain Measurement
  • Risk Factors
  • Sensation Disorders / complications
  • Sensation Disorders / diagnosis
  • Sensation Disorders / epidemiology*
  • Severity of Illness Index
  • Somatosensory Disorders
  • Young Adult

Grants and funding

The commercial company, BioStats Statistical Consulting ltd, Modiin, Israel (https://www.ldbiostats.com/), provided financial support in the form of salary to Lisa Deutsch. The funders did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.