{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:55:13Z","timestamp":1791464113058,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This investigation aimed to replicate phenotypes in pediatric complex regional pain syndrome (CRPS) previously identified in adult CRPS patients. The impact of an intensive pain therapeutic approach in pediatric CRPS was also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Neurological examination data were obtained from two samples of children with CRPS (cohort #1;\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200924 and cohort #2;\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200914). The structure among CRPS signs was analyzed on pooled data from cohorts #1 and 2 using hierarchical clustering. A phenotype score was quantified for patients and then submitted to unsupervised k\u2010means clustering. Patients in cohort #2 were enrolled in a 4\u20136\u2010week treatment program consisting of psychological, physical, and occupational therapy. Questionnaires about pain and mental and physical health were evaluated at treatment admission and discharge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A two\u2010cluster structure of CRPS signs could be replicated in the pediatric population. Cluster #1 includes skin color, temperature, and edema resembling peripheral inflammation (\u201cperipheral\u201d phenotype). Cluster #2 grouped together motor disorders, minor injury, glove\/stocking\u2010like sensory deficits, and allodynia (\u201ccentral\u201d phenotype). K\u2010means clustering also showed three phenotypes, \u201cperipheral\u201d (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200912), \u201ccentral\u201d (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200910), and \u201cmixed\u201d (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200917), similar to adults. The impact of treatment was revealed for pain affect, pain behavior, psychological distress, depression, pain catastrophizing levels, as well as physical activity and strength (Cohen's d\u2009=\u2009[0.8\u20131.3]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CRPS phenotypes reflecting major pathophysiological mechanisms of peripheral inflammation and central reorganization are identifiable in adult and pediatric patients, suggesting phenomenological features of the disease. An intensive interdisciplinary pain treatment approach was effective in reducing CRPS severity and restoring function in pediatric CRPS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papr.70157","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:46:29Z","timestamp":1778129189000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Phenotypes and the Effects of Interdisciplinary Pain Treatment in Pediatric Complex Regional Pain Syndrome"],"prefix":"10.1111","volume":"26","author":[{"given":"Violeta","family":"Dimova","sequence":"first","affiliation":[{"name":"Department of Neurology University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edin T.","family":"Randall","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Boston Children\u2019s Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjarne","family":"Schmalbach","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology University Medical Center of the Johannes Gutenberg\u2010University  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariesa","family":"Cay","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Maih\u00f6fner","sequence":"additional","affiliation":[{"name":"Department of Neurology General Hospital F\u00fcrth of the Friedrich\u2010Alexander University Erlangen\u2010N\u00fcrnberg  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Birklein","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2200-9826","authenticated-orcid":false,"given":"Navil","family":"Sethna","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaymin","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Psychiatry McLean Hospital, Harvard Medical School  Belmont Massachusetts 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