PhD defence C. (Corinne) van den Berg

Below is a brief summary of the dissertation:

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition in which patients develop severe and persistent pain, usually after an injury or surgery. The pain is disproportionate to the initial trigger and is often accompanied by changes such as swelling, skin colour changes, temperature differences, and functional loss of the affected limb. The exact cause of CRPS is not yet fully understood, but multiple mechanisms are thought to be involved, including inflammation.

In this thesis, the contribution of these mechanisms to CRPS was investigated. The study focused on anti-inflammatory treatments, including prednisolone and infliximab. These treatments were effective in a subset of patients, but not in all cases. It was also examined whether the body’s stress system, the hypothalamic-pituitary-adrenal (HPA) axis, functions differently in CRPS. At the group level, no clear differences were found, although a small subgroup of patients showed an altered stress response. Finally, cognitive performance (such as memory and concentration) was assessed in patients with CRPS. Although cognitive complaints are frequently reported, no objective impairments were found on testing.

Together, these findings show that CRPS is a heterogeneous condition in which different mechanisms may contribute, and in which symptoms and treatment responses vary considerably between patient