RSD Research Grants!

The RSDSA Board of Directors has approved the following two research grants. We would like to extend a heartfelt thank-you to everyone who has donated to our research fund. Every donated dollar makes a difference!

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RSDSA Approves Two Research Grants for 2005

The Validation of Revised Diagnostic Criteria for CRPS Diagnostic Criteria for CRPS/RSD has been discussed and planned for years. Current criteria may over diagnose the condition, and may be of limited use in guiding treatment as their association with mechanisms believed to be involved in producing the condition are unknown. Although earlier research suggests the signs and symptoms of CRPS should be grouped into four relatively independent factors, only three are currently used in diagnosis leading to inadequate specificity and potentially, to over diagnosis. Revised CRPS/RSD diagnostic criteria have been proposed based on the four factors, which appear to have a better balance of diagnostic sensitivity and specificity than existing criteria, and this has been corroborated by an international consensus group meeting in Budapest last year.

These proposed criteria must be validated in order for the International Association of the Study of Pain (IASP) to adopt them. Moreover, the validation will lead to a more universal acceptance of the proposed changes, will encourage adoption of these criteria for clinical diagnosis, and will facilitate selection of more homogeneous research samples.

With a research grant, R. Norman Harden, MD, Director, Center for Pain Studies and Chronic Pain Care Center, Addison Chair, Rehabilitation Institute of Chicago, and Stephen Bruehl, PhD, Associate Professor of Anesthesiology at Vanderbilt University School of Medicine, will determine the validity of proposed diagnostic criteria using elements of a prospective correlational design and a case comparison design, and will use a coordinated multi-site data collection system. The sample will include a sequential series of 120 patients meeting current IASP criteria for CRPS/RSD and another group of 60 people with non-CRPS neuropathic pain (eg, diabetic neuropathy) diagnosed using independent criteria.

This study will further document the validity of these proposed diagnostic criteria by linking them with measures reflecting pain mechanisms believed to contribute to CRPS (e.g., central sensitization, catecholamine activity, inflammatory changes). Non-invasive Investigation of Human Brain Mechanisms Associated with the Development and Treatment of RSD will evaluate brain mechanisms involved in CRPS/RSD and their etiological importance.

The study will use functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to compare brain activity, firstly in patients just after an acute injury (wrist fracture), between patients who are at high risk of developing CRPS to those who are at a low risk of developing it, and secondly between those patients who do end up developing CRPS and those who don't. The main questions are; do brain mechanisms change before the development of CRPS? Do acute brain changes predict CRPS?

Are areas such as the thalamus, insula and amygdala important in development of CRPS?

This study will provide a greater understanding of how the brain is involved in CRPS, which should in turn lead to better prevention and treatment strategies.

The research team, Lorimer Moseley, PhD, Irene Tracey, DPhil and Simon Gandevia, DSc, are undertaking the work at Oxford University, England.