Abstract | OBJECTIVES: METHODS: All patients developed CRPS after traumatic injury to one upper extremity. To document changes during the study, levels of pain were measured after clenching the hand using a numeric pain intensity scale ranging from 0 (no pain) to 10 (maximum pain). Motor symptoms were documented for the fingers (fingertips to palm and fingernails to table) and the wrist (flexion/extension). Furthermore, the force was analyzed using a JAMAR-Dynamometer and a Pinchmeter. For assessment of central changes, functional magnetic resonance imaging and magnetoencephalography were used to further document the results of other experiments in 1 patient. Autonomic changes were photographed and pictures were compared before and after treatment with Memantine. RESULTS: Six months after treatment with Memantine, all patients showed a significant decrease in their levels of pain which coincided with an improvement in motor symptoms and autonomic changes. The functional magnetic resonance imaging and magnetoencephalography results provided evidence of cortical reorganization [changes in somatotopic maps in the primary somatosensory cortex (S1)]. These changes returned to a cortical pattern comparable to the unaffected side after treatment with Memantine. DISCUSSION: Based on these first results, the use of Memantine for treatment of CRPS seems promising and supports the hypothesis of a CNS contribution to the pathogenesis and maintenance of neuropathic pain syndromes.
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Authors | Nektarios Sinis, Niels Birbaumer, Sylvia Gustin, Anja Schwarz, Sabine Bredanger, Stephan Thomas Becker, Klaus Unertl, Hans-Eberhard Schaller, Max Haerle |
Journal | The Clinical journal of pain
(Clin J Pain)
2007 Mar-Apr
Vol. 23
Issue 3
Pg. 237-43
ISSN: 0749-8047 [Print] United States |
PMID | 17314583
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Excitatory Amino Acid Antagonists
- Memantine
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Topics |
- Adult
- Analysis of Variance
- Complex Regional Pain Syndromes
(drug therapy, pathology, physiopathology)
- Excitatory Amino Acid Antagonists
(therapeutic use)
- Female
- Follow-Up Studies
- Humans
- Magnetic Resonance Imaging
- Magnetoencephalography
(methods)
- Male
- Memantine
(therapeutic use)
- Middle Aged
- Motor Activity
(drug effects)
- Pain Measurement
- Time Factors
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