AUTHOR=Zangrandi Andrea , Allen Demers Fannie , Schneider Cyril 

TITLE=Complex Regional Pain Syndrome. A Comprehensive Review on Neuroplastic Changes Supporting the Use of Non-invasive Neurostimulation in Clinical Settings

JOURNAL=Frontiers in Pain Research

VOLUME=Volume 2 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2021.732343

DOI=10.3389/fpain.2021.732343

ISSN=2673-561X

ABSTRACT=Background: The complex regional pain syndrome (CRPS) is a rare debilitating disorder characterized by severe pain affecting one or more limbs. CRPS presents a complex multifactorial physiopathology. The peripheral and sensorimotor abnormalities reflect maladaptive changes of the central nervous system. These changes of volume, connectivity, activation, metabolism, etc. could be keys to understand chronicization, refractoriness to conventional treatment and develop more efficient treatments.
Objective: This review discusses the use of nonpharmacological noninvasive neurostimulation techniques in CRPS, in regards of CRPS physiopathology, brain changes underlying chronicization, conventional approaches to treat CRPS, current evidence and mechanisms of action of peripheral and brain stimulation.
Conclusion: Future work is warranted to foster the evidence of the efficacy of noninvasive neurostimulation in CRPS. It seems that the approach has to be individualized owing to the integrity of brain and corticospinal function. Noninvasive neurostimulation of brain or of nerve / muscles / spinal roots, alone or in combination with conventional therapy, represents a fertile ground to develop more efficient approaches for pain management in CRPS.