Cited by 94Pain Management and TreatmentPsychosomatic Disorders and Their TreatmentsFibromyalgia and Chronic Fatigue Syndrome Research

Complex regional pain syndrome and functional neurological disorders—Time for reconciliation

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Popkirov, Stoyan, Hoeritzauer, Ingrid, Colvin, Lesley, Carson, Alan J, Stone, Jon·2019·Journal of Neurology, Neurosurgery & Psychiatry

Abstract

There have been many articles highlighting differences and similarities between complex regional pain syndrome (CRPS) and functional neurological disorders (FND) but until now the discussions have often been adversarial with an erroneous focus on malingering and a view of FND as ‘all in the mind’. However, understanding of the nature, frequency and treatment of FND has changed dramatically in the last 10–15 years. FND is no longer assumed to be only the result of ‘conversion’ of psychological conflict but is understood as a complex interplay between physiological stimulus, expectation, learning and attention mediated through a Bayesian framework, with biopsychosocial predisposing, triggering and perpetuating inputs. Building on this new ‘whole brain’ perspective of FND, we reframe the debate about the ‘psychological versus physical’ basis of CRPS. We recognise how CRPS research may inform mechanistic understanding of FND and conversely, how advances in FND, especially treatment, have implications for improving understanding and management of CRPS.

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  • High arousal states, which are associated with increased muscle tension and chronic pain disorders, may also activate some of the motor programmes recruited in functional dystonia.

    “High arousal states-that are associated with increased muscle tension and chronic pain disorders-may also activate some of the motor programmes recruited in functional dystonia.175”

    From A new science of emotion: implications for functional neurological disorder (2022) · cites this paper as [175]

    In “The overlaps between CRPS and sensorimotor FND” (page unavailable), the paper says that pain can produce muscle stiffening and that such movement adaptations can become entrenched; it also links functional dystonia with regional pain. It does not say that high-arousal states activate motor programmes recruited in functional dystonia. (LLM, conf=0.82)

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Research works printed but not linked: 7

  1. [18]18. Peckham EL, Hallett M. Psychogenic movement disorders. NeurolClin 2009;27:801-19, vii.
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Authors
Popkirov, S., Hoeritzauer, I., Colvin, L., Carson, A. J., & Stone, J.
Affiliations
  • Universitätsklinikum Knappschaftskrankenhaus Bochum (DE)
  • NHS Lothian (GB)
  • University of Dundee (GB)
Corresponding author
Stone, Jon
Venue
Journal of Neurology, Neurosurgery & Psychiatry
Publisher
BMJ
Published
2018-10-24
Volume
90
Issue
5
Pages
608-614
ISSN
  • 0022-3050 (ISSN-L)
  • 1468-330X
OpenAlex
W2898249983
Cited by
94
References
56
Citations by year
2026: 6 · 2025: 10 · 2024: 16 · 2023: 5 · 2022: 19 · 2021: 10 · 2020: 20 · 2019: 8
FWCI
2.34
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (submittedVersion, other-oa)
  • HighWire Press Open Archive (submittedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
Funders
  • NHS Health Scotland
  • Patrick Berthoud Charitable Trust
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords
complex regional pain syndrome, conversion disorder, malingering, Bayesian framework, biopsychosocial model, CRPS treatment
MeSH terms
Diagnosis, Differential, Humans, Nervous System Diseases, Complex Regional Pain Syndromes

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