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Correlation between changes in regional cerebral blood flow and pain relief in complex regional pain syndrome type 1.

Publication ,  Journal Article
Wu, C-T; Fan, Y-M; Sun, C-M; Borel, CO; Yeh, C-C; Yang, C-P; Wong, C-S
Published in: Clin Nucl Med
June 2006

OBJECTIVE: Analyzing changes in regional cerebral blood flow (rCBF) with SPECT in complex regional pain syndrome type 1 (CRPS 1), formerly known as reflex sympathetic dystrophy, is an optimal method for evaluating effective pain relief. We attempted to investigate the correlation of changes in rCBF with pain relief during treatments of sympathetic blockade and multimodal epidural pain control. CASE REPORT: We describe a patient with severe CRPS 1 in whom conventional treatment failed to relieve the pain. Combined repeated lumbar sympathetic blocks and long-term epidural morphine, bupivacaine, and ketamine administration provided satisfactory pain relief and functional activity recovery. Six normal control subjects having one Tc-99m HMPAO scan each and the patient with CRPS having 3 Tc-99m HMPAO scans (once before treatment and twice at 4 months and 6 months after treatment, respectively). The patient with CRPS showed lower rCBF than normal controls in the left thalamus and higher rCBF than normal controls in the right parietal lobe and left frontal lobe. After subsequent treatment, the subtraction images showed increased rCBF in the left thalamus and decreased rCBF in the right parietal and left frontal lobes. CONCLUSIONS: Tc-99m HMPAO SPECT showed a relationship of rCBF in the thalamus, parietal lobe, and frontal lobe with pain relief. rCBF alterations may provide an indicator for the quality of pain management for neuropathic pains. Subtraction analysis between pre- and posttreatment, by using statistical parametric mapping (version 2), can be used as an objective indicator for the effectiveness of therapy.

Duke Scholars

Published In

Clin Nucl Med

DOI

ISSN

0363-9762

Publication Date

June 2006

Volume

31

Issue

6

Start / End Page

317 / 320

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, Emission-Computed, Single-Photon
  • Technetium Tc 99m Exametazime
  • Statistics as Topic
  • Reflex Sympathetic Dystrophy
  • Radiopharmaceuticals
  • Prognosis
  • Pain Measurement
  • Nuclear Medicine & Medical Imaging
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wu, C.-T., Fan, Y.-M., Sun, C.-M., Borel, C. O., Yeh, C.-C., Yang, C.-P., & Wong, C.-S. (2006). Correlation between changes in regional cerebral blood flow and pain relief in complex regional pain syndrome type 1. Clin Nucl Med, 31(6), 317–320. https://doi.org/10.1097/01.rlu.0000218538.06832.69
Wu, Ching-Tang, Yu-Ming Fan, Chen-Ming Sun, Cecil O. Borel, Chun-Chang Yeh, Chih-Ping Yang, and Chih-Shung Wong. “Correlation between changes in regional cerebral blood flow and pain relief in complex regional pain syndrome type 1.Clin Nucl Med 31, no. 6 (June 2006): 317–20. https://doi.org/10.1097/01.rlu.0000218538.06832.69.
Wu C-T, Fan Y-M, Sun C-M, Borel CO, Yeh C-C, Yang C-P, et al. Correlation between changes in regional cerebral blood flow and pain relief in complex regional pain syndrome type 1. Clin Nucl Med. 2006 Jun;31(6):317–20.
Wu, Ching-Tang, et al. “Correlation between changes in regional cerebral blood flow and pain relief in complex regional pain syndrome type 1.Clin Nucl Med, vol. 31, no. 6, June 2006, pp. 317–20. Pubmed, doi:10.1097/01.rlu.0000218538.06832.69.
Wu C-T, Fan Y-M, Sun C-M, Borel CO, Yeh C-C, Yang C-P, Wong C-S. Correlation between changes in regional cerebral blood flow and pain relief in complex regional pain syndrome type 1. Clin Nucl Med. 2006 Jun;31(6):317–320.

Published In

Clin Nucl Med

DOI

ISSN

0363-9762

Publication Date

June 2006

Volume

31

Issue

6

Start / End Page

317 / 320

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, Emission-Computed, Single-Photon
  • Technetium Tc 99m Exametazime
  • Statistics as Topic
  • Reflex Sympathetic Dystrophy
  • Radiopharmaceuticals
  • Prognosis
  • Pain Measurement
  • Nuclear Medicine & Medical Imaging
  • Male