Measuring Behavior 2005: Niehof.html

Dynamic and static thermography and laser Doppler flow measurement in assessing Complex Regional Pain Syndrome type 1

S.P. Niehof

Pain treatment center, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands

Complex regional pain syndrome type 1 (CRPS1), is a chronic disease of unknown origin. The syndrome is thought to be a damaged nerve disorder that occurs in patients after trauma or surgery at the site of an injury, most often it expresses itself in extremities. It is quite certain that the damage in nerves of the sympathetic nervous system, which are responsible for blood flow and thus partially for tissue temperature, plays an important role in the development of chronic CRPS1. Furthermore, CRPS1 seems to resemble neurogenic in.ammation, which produces heat and sympathetic dysfunction.

Non-invasive indicators of sympathetic activity were measured using skin temperature and skin blood flow.

Laser Doppler is a feasible method although, until recently, only limited areas could be measured. Several reports on measurement of sympathetic using Videothermography and laser Doppler flow are available in the literature. The value of thermographic as a tool in screening of CRPS1 patients is currently being studied. Static left – right differences in temperature and in deviations in temperature/flow recovery after disturbances are measured using a heat-sensitive infrared camera system and laser Doppler flow. These disturbances are fixed on the sympathetic system by modulating skin temperature.

Observers were used to assess the discriminating value of thermographic pictures. We, in an earlier study described a promising calculation method to examine the difference between static videothermographic images of CRPS1 patients and healthy controls. A current study focuses on possible static thermographic differences between patients with a fracture whom do develop CRPS1 and those that don’t develop CRPS1.

A study in which the sympathetic system of patients was disturbed using total body cooling followed by total body heating revealed improved diagnosis and some dynamics of the disturbed sympathetic system in CRPS1 patients. Currently more research is done on patients groups and controls, in a setup where local disturbance are applied using thermographic and laser Doppler flow measurements as indicators of sympathetic activity.

Paper presented at Measuring Behavior 2005 , 5^th International Conference on Methods and Techniques in Behavioral Research, 30 August - 2 September 2005, Wageningen, The Netherlands.