PhD defence T.J.P. (Thomas) Mangnus

Brief summary on the aim of the doctoral thesis:

This dissertation illustrates how the management of CRPS should be personalized. Patients with CRPS suffer continuous pain and can experience sensory, vasomotor, sudomotor, motor and trophic symptoms in the affected extremity. The clinical presentation of CRPS can be very heterogeneous during the course of the syndrome, because several pathophysiological mechanisms play a role in CRPS. To optimize the treatment effect, the most prominent mechanisms at clinical presentation can be specifically targeted by pharmacotherapeutic options for CRPS. Unfortunately, there is no biomarker that can support the diagnosis or helps monitoring the severity of CRPS. To personalize the treatment for patients with CRPS distinct biomarkers are probably needed for the different pathophysiological mechanisms in CRPS. Intravenous esketamine treatment can be effective for CRPS patients. However, pain clinics work with heterogeneous treatment protocols and this underlines the importance of developing ketamine guidelines for chronic pain treatment. Further research that focusses on predictors of response to esketamine treatment is essential and encourages the shift towards a personalized management of CRPS.