Complex Regional Pain Syndromes in Children and Adolescents: Regional and Systemic Signs and Symptoms and Hemodynamic Response to Tilt Table Testing
OBJECTIVEComplex regional pain syndromes (CRPS) involve neuropathic limb pain and localized circulatory abnormalities. The authors hypothesized that (1) pediatric CRPS patients exhibit systemic autonomic symptoms and orthostatic and/or cardiac sympatho-vagal dysregulation and (2) their orthostatic r...
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| Veröffentlicht in: | The Clinical journal of pain 2006-05, Vol.22 (4), p.399-406 |
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| container_title | The Clinical journal of pain |
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| creator | Meier, Petra M Alexander, Mark E Sethna, Navil F De Jong-De Vos Van Steenwijk, Catharine C. E Zurakowski, David Berde, Charles B |
| description | OBJECTIVEComplex regional pain syndromes (CRPS) involve neuropathic limb pain and localized circulatory abnormalities. The authors hypothesized that (1) pediatric CRPS patients exhibit systemic autonomic symptoms and orthostatic and/or cardiac sympatho-vagal dysregulation and (2) their orthostatic regulation differs from healthy controls and pediatric patients with postural orthostatic tachycardia syndrome (POTS).
METHODSCRPS children and adolescents (n=20) underwent a 6-week trial of physical therapy and cognitive-behavioral treatment. Measures included pain and function scores, regional and systemic autonomic symptom profiles, heart rate and blood pressure with tilt, heart rate variability indices, and baroreflex gain. Systemic autonomic symptoms were recorded in 55 healthy pediatric controls. Tilt responses in CRPS patients were compared with those of 21 POTS patients and 39 healthy controls.
RESULTSCRPS patientsʼ regional autonomic symptoms, pain, and limb function improved over 6 weeks (P |
| doi_str_mv | 10.1097/01.ajp.0000192514.50955.d6 |
| format | Article |
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METHODSCRPS children and adolescents (n=20) underwent a 6-week trial of physical therapy and cognitive-behavioral treatment. Measures included pain and function scores, regional and systemic autonomic symptom profiles, heart rate and blood pressure with tilt, heart rate variability indices, and baroreflex gain. Systemic autonomic symptoms were recorded in 55 healthy pediatric controls. Tilt responses in CRPS patients were compared with those of 21 POTS patients and 39 healthy controls.
RESULTSCRPS patientsʼ regional autonomic symptoms, pain, and limb function improved over 6 weeks (P<0.01). At baseline CRPS patients reported more systemic autonomic symptoms than controls (P<0.05). Tilt table test showed orthostatic stability, but the mean heart rate increase with tilt was greater in CRPS patients than controls (P<0.001). POTS patients showed significant increases with tilt in mean heart rate and diastolic and systolic blood pressures compared with controls (P<0.001). There were significant increases in the mean systolic and diastolic blood pressures in POTS compared with CRPS patients but no difference in the mean heart rate between groups.
DISCUSSIONCRPS patients reported multiple regional and systemic autonomic symptoms that improved during the study course, and they experienced minimal and transient tilt table-induced hemodynamic changes compared with POTS patients but relatively similar to controls.</description><identifier>ISSN: 0749-8047</identifier><identifier>EISSN: 1536-5409</identifier><identifier>DOI: 10.1097/01.ajp.0000192514.50955.d6</identifier><identifier>PMID: 16691095</identifier><identifier>CODEN: CJPAEU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adolescent ; Analysis of Variance ; Autonomic Nervous System Diseases - etiology ; Biological and medical sciences ; Blood Pressure - physiology ; Child ; Complex Regional Pain Syndromes - classification ; Complex Regional Pain Syndromes - complications ; Complex Regional Pain Syndromes - physiopathology ; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction ; Female ; Fundamental and applied biological sciences. Psychology ; Heart Rate - physiology ; Hemodynamics - physiology ; Humans ; Male ; Medical sciences ; Nervous system (semeiology, syndromes) ; Nervous system as a whole ; Neurology ; Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors ; Tilt-Table Test ; Vertebrates: nervous system and sense organs</subject><ispartof>The Clinical journal of pain, 2006-05, Vol.22 (4), p.399-406</ispartof><rights>2006 Lippincott Williams & Wilkins, Inc.</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3352-cbfbe8982903a4db7d2dacf929f1933ac13f1b6b4659f32e5cab43f8561ff1043</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17761188$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16691095$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Meier, Petra M</creatorcontrib><creatorcontrib>Alexander, Mark E</creatorcontrib><creatorcontrib>Sethna, Navil F</creatorcontrib><creatorcontrib>De Jong-De Vos Van Steenwijk, Catharine C. E</creatorcontrib><creatorcontrib>Zurakowski, David</creatorcontrib><creatorcontrib>Berde, Charles B</creatorcontrib><title>Complex Regional Pain Syndromes in Children and Adolescents: Regional and Systemic Signs and Symptoms and Hemodynamic Response to Tilt Table Testing</title><title>The Clinical journal of pain</title><addtitle>Clin J Pain</addtitle><description>OBJECTIVEComplex regional pain syndromes (CRPS) involve neuropathic limb pain and localized circulatory abnormalities. The authors hypothesized that (1) pediatric CRPS patients exhibit systemic autonomic symptoms and orthostatic and/or cardiac sympatho-vagal dysregulation and (2) their orthostatic regulation differs from healthy controls and pediatric patients with postural orthostatic tachycardia syndrome (POTS).
METHODSCRPS children and adolescents (n=20) underwent a 6-week trial of physical therapy and cognitive-behavioral treatment. Measures included pain and function scores, regional and systemic autonomic symptom profiles, heart rate and blood pressure with tilt, heart rate variability indices, and baroreflex gain. Systemic autonomic symptoms were recorded in 55 healthy pediatric controls. Tilt responses in CRPS patients were compared with those of 21 POTS patients and 39 healthy controls.
RESULTSCRPS patientsʼ regional autonomic symptoms, pain, and limb function improved over 6 weeks (P<0.01). At baseline CRPS patients reported more systemic autonomic symptoms than controls (P<0.05). Tilt table test showed orthostatic stability, but the mean heart rate increase with tilt was greater in CRPS patients than controls (P<0.001). POTS patients showed significant increases with tilt in mean heart rate and diastolic and systolic blood pressures compared with controls (P<0.001). There were significant increases in the mean systolic and diastolic blood pressures in POTS compared with CRPS patients but no difference in the mean heart rate between groups.
DISCUSSIONCRPS patients reported multiple regional and systemic autonomic symptoms that improved during the study course, and they experienced minimal and transient tilt table-induced hemodynamic changes compared with POTS patients but relatively similar to controls.</description><subject>Adolescent</subject><subject>Analysis of Variance</subject><subject>Autonomic Nervous System Diseases - etiology</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure - physiology</subject><subject>Child</subject><subject>Complex Regional Pain Syndromes - classification</subject><subject>Complex Regional Pain Syndromes - complications</subject><subject>Complex Regional Pain Syndromes - physiopathology</subject><subject>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Heart Rate - physiology</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Nervous system as a whole</subject><subject>Neurology</subject><subject>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</subject><subject>Tilt-Table Test</subject><subject>Vertebrates: nervous system and sense organs</subject><issn>0749-8047</issn><issn>1536-5409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkd2O0zAQhSMEYsvCKyALCe4S7Pgn8d6tKmCRVgJty7XlxOPWi2OHONXS9-CBcbaV6htrxt-ZM9Ypig8EVwTL5jMmlX4cK5wPkTUnrOJYcl4Z8aJYEU5FyRmWL4sVbpgsW8yaq-JNSo8Z53WLXxdXRAiZR_FV8W8dh9HDX_QAOxeD9uindgFtjsFMcYCEcrHeO28mCEgHg25N9JB6CHO6uYiWl80xzTC4Hm3cLqRzaxjnOJyKOxiiOQa9IA-QxhgSoDmirfMz2urOA9pCml3YvS1eWe0TvDvf18Wvr1-267vy_se37-vb-7KnlNdl39kOWtnWElPNTNeY2ujeylpaIinVPaGWdKJjgktLa-C97hi1LRfEWoIZvS4-neaOU_xzyN5qcPlr3usA8ZCUaKRggrYZvDmB_RRTmsCqcXKDno6KYLVkojBRORN1yUQ9Z6KMyOL3Z5dDN4C5SM8hZODjGdCp195OOvQuXbimEYS0yxbsxD1FP8OUfvvDE0xqD9rP-2frmuO2rDEWmOeqXJap6X9CCaf8</recordid><startdate>200605</startdate><enddate>200605</enddate><creator>Meier, Petra M</creator><creator>Alexander, Mark E</creator><creator>Sethna, Navil F</creator><creator>De Jong-De Vos Van Steenwijk, Catharine C. E</creator><creator>Zurakowski, David</creator><creator>Berde, Charles B</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams and Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200605</creationdate><title>Complex Regional Pain Syndromes in Children and Adolescents: Regional and Systemic Signs and Symptoms and Hemodynamic Response to Tilt Table Testing</title><author>Meier, Petra M ; Alexander, Mark E ; Sethna, Navil F ; De Jong-De Vos Van Steenwijk, Catharine C. E ; Zurakowski, David ; Berde, Charles B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3352-cbfbe8982903a4db7d2dacf929f1933ac13f1b6b4659f32e5cab43f8561ff1043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Analysis of Variance</topic><topic>Autonomic Nervous System Diseases - etiology</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure - physiology</topic><topic>Child</topic><topic>Complex Regional Pain Syndromes - classification</topic><topic>Complex Regional Pain Syndromes - complications</topic><topic>Complex Regional Pain Syndromes - physiopathology</topic><topic>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Heart Rate - physiology</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Nervous system as a whole</topic><topic>Neurology</topic><topic>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</topic><topic>Tilt-Table Test</topic><topic>Vertebrates: nervous system and sense organs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Meier, Petra M</creatorcontrib><creatorcontrib>Alexander, Mark E</creatorcontrib><creatorcontrib>Sethna, Navil F</creatorcontrib><creatorcontrib>De Jong-De Vos Van Steenwijk, Catharine C. E</creatorcontrib><creatorcontrib>Zurakowski, David</creatorcontrib><creatorcontrib>Berde, Charles B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Clinical journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meier, Petra M</au><au>Alexander, Mark E</au><au>Sethna, Navil F</au><au>De Jong-De Vos Van Steenwijk, Catharine C. E</au><au>Zurakowski, David</au><au>Berde, Charles B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complex Regional Pain Syndromes in Children and Adolescents: Regional and Systemic Signs and Symptoms and Hemodynamic Response to Tilt Table Testing</atitle><jtitle>The Clinical journal of pain</jtitle><addtitle>Clin J Pain</addtitle><date>2006-05</date><risdate>2006</risdate><volume>22</volume><issue>4</issue><spage>399</spage><epage>406</epage><pages>399-406</pages><issn>0749-8047</issn><eissn>1536-5409</eissn><coden>CJPAEU</coden><abstract>OBJECTIVEComplex regional pain syndromes (CRPS) involve neuropathic limb pain and localized circulatory abnormalities. The authors hypothesized that (1) pediatric CRPS patients exhibit systemic autonomic symptoms and orthostatic and/or cardiac sympatho-vagal dysregulation and (2) their orthostatic regulation differs from healthy controls and pediatric patients with postural orthostatic tachycardia syndrome (POTS).
METHODSCRPS children and adolescents (n=20) underwent a 6-week trial of physical therapy and cognitive-behavioral treatment. Measures included pain and function scores, regional and systemic autonomic symptom profiles, heart rate and blood pressure with tilt, heart rate variability indices, and baroreflex gain. Systemic autonomic symptoms were recorded in 55 healthy pediatric controls. Tilt responses in CRPS patients were compared with those of 21 POTS patients and 39 healthy controls.
RESULTSCRPS patientsʼ regional autonomic symptoms, pain, and limb function improved over 6 weeks (P<0.01). At baseline CRPS patients reported more systemic autonomic symptoms than controls (P<0.05). Tilt table test showed orthostatic stability, but the mean heart rate increase with tilt was greater in CRPS patients than controls (P<0.001). POTS patients showed significant increases with tilt in mean heart rate and diastolic and systolic blood pressures compared with controls (P<0.001). There were significant increases in the mean systolic and diastolic blood pressures in POTS compared with CRPS patients but no difference in the mean heart rate between groups.
DISCUSSIONCRPS patients reported multiple regional and systemic autonomic symptoms that improved during the study course, and they experienced minimal and transient tilt table-induced hemodynamic changes compared with POTS patients but relatively similar to controls.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>16691095</pmid><doi>10.1097/01.ajp.0000192514.50955.d6</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Analysis of Variance Autonomic Nervous System Diseases - etiology Biological and medical sciences Blood Pressure - physiology Child Complex Regional Pain Syndromes - classification Complex Regional Pain Syndromes - complications Complex Regional Pain Syndromes - physiopathology Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction Female Fundamental and applied biological sciences. Psychology Heart Rate - physiology Hemodynamics - physiology Humans Male Medical sciences Nervous system (semeiology, syndromes) Nervous system as a whole Neurology Somesthesis and somesthetic pathways (proprioception, exteroception, nociception) interoception electrolocation. Sensory receptors Tilt-Table Test Vertebrates: nervous system and sense organs |
| title | Complex Regional Pain Syndromes in Children and Adolescents: Regional and Systemic Signs and Symptoms and Hemodynamic Response to Tilt Table Testing |
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