Microneurography in complex regional pain syndrome
Research type
Research Study
Full title
Investigation of afferent activity using microneurography in complex regional pain syndrome - is there evidence of hyper-reactivity?
IRAS ID
216441
Contact name
Andrew Marshall
Contact email
Sponsor organisation
Salford Royal Foundation Trust
Duration of Study in the UK
1 years, 6 months, 0 days
Research summary
Complex regional pain syndrome (CRPS) is an extremely painful condition that is difficult to treat and causes significant morbidity as well as socio-economic burden. CRPS results in a painful extremity often preceded by a minor injury. The causes of CRPS and the mechanisms underlying the pain are unclear. One hypothesis is that an abnormal immune reaction (auto-immune reaction) targets the tissues involved in the minor injury resulting in the production of antibodies that attach to the sensory nerves that convey information regarding touch, pain and temperature to the spinal cord and henceforth brain. This would result in abnormal over-activity in these sensory nerve fibres. Recent evidence in rodents suggests that such antibodies do cause over-activity in sensory nerve fibres but it is not known whether this is the case in patients with CRPS.
By using microneurography, a minimally invasive technique that can record directly from individual sensory nerve fibres, we will assess well-characterised patients with CRPS to see if their sensory nerve fibres exhibit over-activity or abnormal patterns of activity. The sensory nerve activity patterns will be compared to an established ‘library’ of nerve activity already collected in healthy subjects.
We aim to recruit 10 patients with CRPS into the study over a period of 12-18 months. Patients will attend for at least one recording session lasting 2-4 hours in the Clinical Neurophysiology Department at Salford Royal Hospital. Well-motivated patients may attend for additional recording sessions so that nerve activity can be compared before and after their planned immune treatment and/or with activity in their unaffected limbs.Knowledge of the causes of CRPS and the mechanisms by which neural activity gives rise to the pain associated with the condition is of significant importance and may lead to the development of better therapies.
REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
17/NW/0424
Date of REC Opinion
14 Sep 2017
REC opinion
Further Information Favourable Opinion