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Mechanical hyperalgesia in complex regional pain syndrome: A role for TNF-?

From the Departments of Neurology (Drs. Maihöfner and Neundörfer) and Physiology and Experimental Pathophysiology (Drs. Maihöfner and Handwerker), University of Erlangen-Nuremberg, Erlangen, Germany; and Department of Neurology (Dr. Birklein), University of Mainz, Mainz, Germany.

Plasma concentrations of soluble tumor necrosis factor (TNF-) receptor type I (sTNF-RI) were assessed in two complex regional pain syndrome (CRPS) patient groups (n = 30 and n = 16) and healthy controls (n = 25). Patients with CRPS and mechanical hyperalgesia had higher levels of sTNF-RI (1,661.8 ± 146.8 pg/mL) compared with those with CRPS with identical clinical appearance but without hyperalgesia (1,155.9 ± 56.3 pg/mL) and controls (1,239.5 ± 42.9 pg/mL). This study suggests involvement of TNF- in mechanical hyperalgesia of CRPS.

Supported by the German Research Network Neuropathic Pain Syndromes (German Federal Ministry of Education and Research, BMBF) and the German Research Foundation (Bi 579/1).

Received November 4, 2004. Accepted in final form April 7, 2005.

Address correspondence and reprint request to Dr. Christian Maihöfner, Institute for Physiology and Experimental Pathophysiology, University of Erlangen-Nuremberg, Universitätsstrasse 17, D-91054 Erlangen, Germany; e-mail: maihoefner{at}physiologie1.uni-erlangen.de

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