Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

January 01, 2013; 80 (1) Views & Reviews

Inflammation in complex regional pain syndrome

A systematic review and meta-analysis

Luke Parkitny, James H. McAuley, Flavia Di Pietro, Tasha R. Stanton, Neil E. O’Connell, Johan Marinus, Jacobus J. van Hilten, G. Lorimer Moseley
First published December 24, 2012, DOI: https://doi.org/10.1212/WNL.0b013e31827b1aa1
Luke Parkitny
From Neuroscience Research Australia (L.P., J.H.M., F.D.P., T.R.S.) and Prince of Wales Clinical School (L.P., F.D.P.), University of New South Wales, Sydney; Sansom Institute for Health Research (T.R.S., G.L.M.), University of South Australia, Adelaide, Australia; Centre for Research in Rehabilitation (N.E.O), Brunel University, Uxbridge, UK; Department of Neurology (J.M., J.J.v.H.), Leiden University Medical Center, Leiden, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
James H. McAuley
From Neuroscience Research Australia (L.P., J.H.M., F.D.P., T.R.S.) and Prince of Wales Clinical School (L.P., F.D.P.), University of New South Wales, Sydney; Sansom Institute for Health Research (T.R.S., G.L.M.), University of South Australia, Adelaide, Australia; Centre for Research in Rehabilitation (N.E.O), Brunel University, Uxbridge, UK; Department of Neurology (J.M., J.J.v.H.), Leiden University Medical Center, Leiden, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Flavia Di Pietro
From Neuroscience Research Australia (L.P., J.H.M., F.D.P., T.R.S.) and Prince of Wales Clinical School (L.P., F.D.P.), University of New South Wales, Sydney; Sansom Institute for Health Research (T.R.S., G.L.M.), University of South Australia, Adelaide, Australia; Centre for Research in Rehabilitation (N.E.O), Brunel University, Uxbridge, UK; Department of Neurology (J.M., J.J.v.H.), Leiden University Medical Center, Leiden, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tasha R. Stanton
From Neuroscience Research Australia (L.P., J.H.M., F.D.P., T.R.S.) and Prince of Wales Clinical School (L.P., F.D.P.), University of New South Wales, Sydney; Sansom Institute for Health Research (T.R.S., G.L.M.), University of South Australia, Adelaide, Australia; Centre for Research in Rehabilitation (N.E.O), Brunel University, Uxbridge, UK; Department of Neurology (J.M., J.J.v.H.), Leiden University Medical Center, Leiden, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Neil E. O’Connell
From Neuroscience Research Australia (L.P., J.H.M., F.D.P., T.R.S.) and Prince of Wales Clinical School (L.P., F.D.P.), University of New South Wales, Sydney; Sansom Institute for Health Research (T.R.S., G.L.M.), University of South Australia, Adelaide, Australia; Centre for Research in Rehabilitation (N.E.O), Brunel University, Uxbridge, UK; Department of Neurology (J.M., J.J.v.H.), Leiden University Medical Center, Leiden, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Johan Marinus
From Neuroscience Research Australia (L.P., J.H.M., F.D.P., T.R.S.) and Prince of Wales Clinical School (L.P., F.D.P.), University of New South Wales, Sydney; Sansom Institute for Health Research (T.R.S., G.L.M.), University of South Australia, Adelaide, Australia; Centre for Research in Rehabilitation (N.E.O), Brunel University, Uxbridge, UK; Department of Neurology (J.M., J.J.v.H.), Leiden University Medical Center, Leiden, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jacobus J. van Hilten
From Neuroscience Research Australia (L.P., J.H.M., F.D.P., T.R.S.) and Prince of Wales Clinical School (L.P., F.D.P.), University of New South Wales, Sydney; Sansom Institute for Health Research (T.R.S., G.L.M.), University of South Australia, Adelaide, Australia; Centre for Research in Rehabilitation (N.E.O), Brunel University, Uxbridge, UK; Department of Neurology (J.M., J.J.v.H.), Leiden University Medical Center, Leiden, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
G. Lorimer Moseley
From Neuroscience Research Australia (L.P., J.H.M., F.D.P., T.R.S.) and Prince of Wales Clinical School (L.P., F.D.P.), University of New South Wales, Sydney; Sansom Institute for Health Research (T.R.S., G.L.M.), University of South Australia, Adelaide, Australia; Centre for Research in Rehabilitation (N.E.O), Brunel University, Uxbridge, UK; Department of Neurology (J.M., J.J.v.H.), Leiden University Medical Center, Leiden, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Inflammation in complex regional pain syndrome
A systematic review and meta-analysis
Luke Parkitny, James H. McAuley, Flavia Di Pietro, Tasha R. Stanton, Neil E. O’Connell, Johan Marinus, Jacobus J. van Hilten, G. Lorimer Moseley
Neurology Jan 2013, 80 (1) 106-117; DOI: 10.1212/WNL.0b013e31827b1aa1

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
2903

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

ABSTRACT

Objectives: We conducted a systematic review of the literature with meta-analysis to determine whether complex regional pain syndrome (CRPS) is associated with a specific inflammatory profile and whether this is dependent on the duration of the condition.

Methods: Comprehensive searches of the literature using MEDLINE, Embase, Scopus, Web of Science, and reference lists from published reviews identified articles that measured inflammatory factors in CRPS. Two independent investigators screened titles and abstracts, and performed data extraction and risk of bias assessments. Studies were subgrouped by medium (blood, blister fluid, and CSF) and duration (acute and chronic CRPS). Where possible, meta-analyses of inflammatory factor concentrations were performed and pooled effect sizes were calculated using random-effects models.

Results: Twenty-two studies were included in the systematic review and 15 in the meta-analysis. In acute CRPS, the concentrations of interleukin (IL)-8 and soluble tumor necrosis factor receptors I (sTNF-RI) and II (sTNF-RII) were significantly increased in blood. In chronic CRPS, significant increases were found in 1) TNFα, bradykinin, sIL-1RI, IL-1Ra, IL-2, sIL-2Ra, IL-4, IL-7, interferon-γ, monocyte chemoattractant protein-1 (MCP-1), and sRAGE (soluble receptor for advanced glycation end products) in blood; 2) IL-1Ra, MCP-1, MIP-1β, and IL-6 in blister fluid; and 3) IL-1β and IL-6 in CSF. Chronic CRPS was also associated with significantly decreased 1) substance P, sE-selectin, sL-selectin, sP-selectin, and sGP130 in blood; and 2) soluble intercellular adhesion molecule-1 (sICAM-1) in CSF. Most studies failed to meet 3 or more of our quality criteria.

Conclusion: CRPS is associated with the presence of a proinflammatory state in the blood, blister fluid, and CSF. Different inflammatory profiles were found for acute and chronic cases.

GLOSSARY

CI=
confidence interval;
CGRP=
calcitonin gene-relaxed peptide;
CRPS=
complex regional pain syndrome;
ET-1=
endothelin-1;
IL=
interleukin;
IP-10=
interferon-inducible protein-10;
MCP-1=
monocyte chemoattractant protein-1;
NPY=
neuropeptide Y;
PGE2=
prostaglandin E2;
SP=
substance P;
sTNF-R=
soluble tumor necrosis factor receptor;
TNF=
tumor necrosis factor

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at www.neurology.org

  • Received May 16, 2012.
  • Accepted August 9, 2012.
  • © 2012 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Disputes & Debates: Rapid online correspondence

No comments have been published for this article.
Comment

NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.

  • Stay timely. Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • 200 words maximum.
  • 5 references maximum. Reference 1 must be the article on which you are commenting.
  • 5 authors maximum. Exception: replies can include all original authors of the article.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Disputes & Debates Submission Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • ABSTRACT
    • GLOSSARY
    • METHODS
    • RESULTS
    • DISCUSSION
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • APPENDIX
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
Advertisement

Related Articles

  • Warfarin treatment and thrombolysisHow to persuade procrastinators?
  • tPA and warfarinTime to move forward
  • Neighborhood socioeconomic status and stroke mortalityDisentangling individual and area effects
  • The border-land of epilepsy—Revisited
  • Diagnostic shifts in ALS?From clinical specter to imaging spectra
  • Biomarkers for PDHow can we approach complexity?
  • Whole-brain magnetic resonance spectroscopic imaging measures are related to disability in ALS
  • Olfaction and imaging biomarkers in premotor LRRK2 G2019S-associated Parkinson disease

Topics Discussed

  • All Pain
  • All Immunology
  • Neuropathic pain

Alert Me

  • Alert me when eletters are published
Neurology: 96 (15)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2021 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise