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White Matter Structure in Complex Regional Pain Syndrome: A High Angular Resolution and Fixel-Based Study
Audrey P Wang1,2, Michael Green2,3, Peter Humburg2,4
1Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia.
European Journal of Pain (London, England)
|December 29, 2025
Summary
Brain structure in complex regional pain syndrome (CRPS) shows no significant differences compared to healthy individuals. These findings suggest that white matter changes are unlikely to be clinically significant in CRPS, pointing towards functional alterations instead.
Area of Science:
- Neuroscience
- Medical Imaging
- Pain Research
Background:
- Complex Regional Pain Syndrome (CRPS) is often conceptualized as a sensory system disorder.
- Previous studies suggest brain structural and functional differences in CRPS patients, but findings are inconsistent.
Purpose of the Study:
- To investigate white matter structure differences in the brain between individuals with CRPS and healthy controls.
- To determine if white matter structural changes are associated with CRPS symptomology or opioid use.
Main Methods:
- Cross-sectional study analyzing high angular resolution diffusion imaging (HARDI) data.
- Employed a fixel-based analysis approach on brain white matter structure.
- Included 42 participants (CRPS patients and healthy controls).
Main Results:
- No significant differences in diffusion measures were found between CRPS patients and controls.
- Fibre density cross-section measures were statistically equivalent between the groups.
- CRPS symptomology and opioid use were not explained by detected white matter structural differences.
Conclusions:
- The study's large sample size and advanced methods increase confidence in the findings.
- Results challenge the notion of permanent brain structural changes hindering CRPS recovery.
- Functional neural changes, rather than white matter structural alterations, are likely key to CRPS deficits, suggesting movement-based therapies.
