Reflex mechanisms in CRPS-related dystonia

Reflex mechanisms in CRPS-related dystonia Complex Regional Pain Syndrome (CRPS) is a common, disabling and poorly understood disorder that is characterized by chronic pain, autonomic and trophic changes in an arm or leg. Although CRPS commonly develops after trauma (fracture, strain or surgery), the severity of the symptoms cannot be explained by the inciting trauma. Approximately 25% of the patients with CRPS develop fixed dystonia, a movement disorder associated with sustained muscle contractions that result in abnormal postures. TREND (Trauma RElated Neuronal Dysfunction), a consortium of Dutch medical and technical universities and industrial companies, integrates research on CRPS and aims to develop concepts on disease mechanisms that occur in response to tissue injury and methods for its assessment and treatment. The thesis describes research within TREND that focuses on the pathophysiology of CRPS-related dystonia from an engineering point of view. Although the mechanisms behind fixed dystonia are still elusive, the evidence implicating involvement of aberrant regulation of muscle force is compelling. A neuromuscular model with aberrant regulation of muscle force successfully mimicked dystonia while experiments demonstrated involvement of muscle force regulation in fixed dystonia. The research presented in the thesis elucidates the mechanisms behind fixed dystonia and may in time develop into a diagnostic tool that objectively quantifies fixed dystonia, expediting diagnosis and monitoring its progression.

W. Mugge

22-6-2011 12:30:00