Dissecting central post-stroke pain: a controlled symptom-psychophysical characterization
Carregando...
Citações na Scopus
9
Tipo de produção
article
Data de publicação
2022
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS
Citação
BRAIN COMMUNICATIONS, v.4, n.3, article ID fcac090, 16p, 2022
Resumo
Dissection of distinct post-stroke pain syndromes evidenced that the neuropathic pain inventory, the presence of cold thermal deficit and the finding of allodynia on bedside examination, explained 77% of the occurrence of neuropathic central post-stroke pain, a new finding that has clear diagnostic potential. Central post-stroke pain affects up to 12% of stroke survivors and is notoriously refractory to treatment. However, stroke patients often suffer from other types of pain of non-neuropathic nature (musculoskeletal, inflammatory, complex regional) and no head-to-head comparison of their respective clinical and somatosensory profiles has been performed so far. We compared 39 patients with definite central neuropathic post-stroke pain with two matched control groups: 32 patients with exclusively non-neuropathic pain developed after stroke and 31 stroke patients not complaining of pain. Patients underwent deep phenotyping via a comprehensive assessment including clinical exam, questionnaires and quantitative sensory testing to dissect central post-stroke pain from chronic pain in general and stroke. While central post-stroke pain was mostly located in the face and limbs, non-neuropathic pain was predominantly axial and located in neck, shoulders and knees (P < 0.05). Neuropathic Pain Symptom Inventory clusters burning (82.1%, n = 32, P < 0.001), tingling (66.7%, n = 26, P < 0.001) and evoked by cold (64.1%, n = 25, P < 0.001) occurred more frequently in central post-stroke pain. Hyperpathia, thermal and mechanical allodynia also occurred more commonly in this group (P < 0.001), which also presented higher levels of deafferentation (P < 0.012) with more asymmetric cold and warm detection thresholds compared with controls. In particular, cold hypoesthesia (considered when the threshold of the affected side was <41% of the contralateral threshold) odds ratio (OR) was 12 (95% CI: 3.8-41.6) for neuropathic pain. Additionally, cold detection threshold/warm detection threshold ratio correlated with the presence of neuropathic pain (rho = -0.4, P < 0.001). Correlations were found between specific neuropathic pain symptom clusters and quantitative sensory testing: paroxysmal pain with cold (rho = -0.4; P = 0.008) and heat pain thresholds (rho = 0.5; P = 0.003), burning pain with mechanical detection (rho = -0.4; P = 0.015) and mechanical pain thresholds (rho = -0.4, P < 0.013), evoked pain with mechanical pain threshold (rho = -0.3; P = 0.047). Logistic regression showed that the combination of cold hypoesthesia on quantitative sensory testing, the Neuropathic Pain Symptom Inventory, and the allodynia intensity on bedside examination explained 77% of the occurrence of neuropathic pain. These findings provide insights into the clinical-psychophysics relationships in central post-stroke pain and may assist more precise distinction of neuropathic from non-neuropathic post-stroke pain in clinical practice and in future trials.
Palavras-chave
central post-stroke pain, post-stroke pain, neuropathic pain phenotyping, central neuropathic pain, quantitative sensory testing
Referências
- ADAMS HP, 1993, STROKE, V24, P35, DOI 10.1161/01.STR.24.1.35
- Aparecida da Silva V., 2018, Neurophysiol Clin, V48, P287
- Attal N, 2008, PAIN, V138, P343, DOI 10.1016/j.pain.2008.01.006
- Attal N, 2002, NEUROLOGY, V58, P554, DOI 10.1212/WNL.58.4.554
- de Oliveira RAA, 2020, ARQ NEURO-PSIQUIAT, V78, P741, DOI [10.1590/0004-282X20200166, 10.1590/0004-282x20200166]
- de Oliveira RAA, 2014, J PAIN, V15, P1271, DOI 10.1016/j.jpain.2014.09.009
- de Oliveira RAA, 2012, BMC NEUROL, V12, DOI 10.1186/1471-2377-12-89
- Baptista AF., 2019, PAIN REP, V4, P1
- Baron R, 2017, PAIN, V158, P261, DOI 10.1097/j.pain.0000000000000753
- Bender R, 2001, J CLIN EPIDEMIOL, V54, P343, DOI 10.1016/S0895-4356(00)00314-0
- BERIC A, 1988, PAIN, V34, P109, DOI 10.1016/0304-3959(88)90155-8
- HOLMGREN H, 1990, PAIN, V40, P43, DOI 10.1016/0304-3959(90)91049-O
- Hosomi K, 2013, PAIN, V154, P1352, DOI 10.1016/j.pain.2013.04.017
- Indredavik B, 2008, STROKE, V39, P414, DOI 10.1161/STROKEAHA.107.489294
- JENSEN TS, 1991, ACTA NEUROL SCAND, V84, P326, DOI 10.1111/j.1600-0404.1991.tb04963.x
- Kadono Y, 2021, SCI REP-UK, V11, DOI 10.1038/s41598-021-85409-w
- Kalita J, 2011, PAIN MED, V12, P282, DOI 10.1111/j.1526-4637.2010.01046.x
- KATZ RT, 1992, ARCH PHYS MED REHAB, V73, P339, DOI 10.1016/0003-9993(92)90007-J
- Kern D, 2008, PAIN, V135, P291, DOI 10.1016/j.pain.2007.12.001
- Klit H, 2014, PAIN, V155, P2699, DOI 10.1016/j.pain.2014.09.037
- Klit H, 2011, PLOS ONE, V6, DOI 10.1371/journal.pone.0027607
- MacGowan DJL, 1997, NEUROLOGY, V49, P120, DOI 10.1212/WNL.49.1.120
- Klit H, 2011, PAIN, V152, P818, DOI 10.1016/j.pain.2010.12.030
- Klit H, 2009, LANCET NEUROL, V8, P857, DOI 10.1016/S1474-4422(09)70176-0
- Kong KH, 2004, ARCH PHYS MED REHAB, V85, P35, DOI 10.1016/S0003-9993(03)00369-1
- Krause T, 2016, PAIN, V157, P194, DOI 10.1097/j.pain.0000000000000354
- Kuptniratsaikul V, 2009, AM J PHYS MED REHAB, V88, P92, DOI 10.1097/PHM.0b013e3181909d5f
- Lefaucheur JP, 2006, NEUROLOGY, V67, P1568, DOI 10.1212/01.wnl.0000242731.10074.3c
- LEIJON G, 1989, PAIN, V36, P13, DOI 10.1016/0304-3959(89)90107-3
- Leijon G., 1990, PAIN, V41, pS468
- Lemos MD, 2022, PAIN, V163, P765, DOI 10.1097/j.pain.0000000000002427
- Leone C, 2019, PAIN, V160, P1967, DOI 10.1097/j.pain.0000000000001584
- MAHONEY F I, 1965, Md State Med J, V14, P61
- Li Q, 2015, NEUROIMAGE-CLIN, V8, P526, DOI 10.1016/j.nicl.2014.08.017
- Lopes LCG, 2018, EUR J PAIN, V22, P72, DOI 10.1002/ejp.1091
- MELZACK R, 1987, PAIN, V30, P191, DOI 10.1016/0304-3959(87)91074-8
- Moisset X, 2020, REV NEUROL-FRANCE, V176, P325, DOI 10.1016/j.neurol.2020.01.361
- Giordano PCM, 2012, REV LAT-AM ENFERM, V20, P76, DOI 10.1590/S0104-11692012000100011
- Nagasaka K, 2020, EXP NEUROL, V323, DOI 10.1016/j.expneurol.2019.113096
- Okifuji A, 1997, J RHEUMATOL, V24, P377
- Osterberg A, 2010, EUR J PAIN, V14, P104, DOI 10.1016/j.ejpain.2009.03.003
- Otto M, 2003, PAIN, V101, P187, DOI 10.1016/S0304-3959(02)00313-5
- Pai MYB, 2021, PAIN REP, V6, DOI 10.1097/PR9.0000000000000939
- Tang SC, 2019, STROKE, V50, P2851, DOI 10.1161/STROKEAHA.119.025692
- Pedler Ashley, 2010, J Physiother, V56, P137, DOI 10.1016/S1836-9553(10)70047-3
- Raicher I, 2018, PAIN REP, V3, DOI 10.1097/PR9.0000000000000638
- RANKIN J, 1957, Scott Med J, V2, P200
- Reimer M, 2020, PAIN REP, V5, DOI 10.1097/PR9.0000000000000820
- Rolke R, 2006, PAIN, V123, P231, DOI 10.1016/j.pain.2006.01.041
- Santos JG, 2010, J PAIN, V11, P484, DOI 10.1016/j.jpain.2009.09.014
- Ferreira KAS, 2013, PAIN MANAG NURS, V14, P210, DOI 10.1016/j.pmn.2011.04.006
- Simons DG., 1998, TRAVELL SIMONS SIMON, V2nd
- Sinay VJ, 2003, CEPHALALGIA, V23, P541, DOI 10.1046/j.1468-2982.2003.00581.x
- Sommer C, 2011, BMC NEUROL, V11, DOI 10.1186/1471-2377-11-104
- Treede RD, 2008, NEUROLOGY, V70, P1630, DOI 10.1212/01.wnl.0000282763.29778.59
- Svendsen KB, 2005, PAIN, V114, P473, DOI 10.1016/j.pain.2005.01.015
- Takami K, 2011, J PHARM PHARMACOL, V63, P452, DOI 10.1111/j.2042-7158.2010.01231.x
- Truini A, 2009, PAIN, V145, P105, DOI 10.1016/j.pain.2009.05.023
- Truini A, 2016, PAIN, V157, pS53, DOI 10.1097/j.pain.0000000000000367
- Truini A, 2012, PAIN, V153, P2048, DOI 10.1016/j.pain.2012.05.024
- Urban PP, 2010, STROKE, V41, P2016, DOI 10.1161/STROKEAHA.110.581991
- Valerio F, 2020, EUR J PAIN, V24, P1548, DOI 10.1002/ejp.1608
- Vartiainen N, 2016, BRAIN, V139, P708, DOI 10.1093/brain/awv389
- VESTERGAARD K, 1995, PAIN, V61, P177, DOI 10.1016/0304-3959(94)00140-A
- Vollert J, 2017, PAIN, V158, P1446, DOI 10.1097/j.pain.0000000000000935
- Beric A, 1998, NEUROL CLIN, V16, P899, DOI 10.1016/S0733-8619(05)70104-3
- Vollert J, 2016, PAIN, V157, P1810, DOI 10.1097/j.pain.0000000000000588
- Ware JE, 1996, MED CARE, V34, P220, DOI 10.1097/00005650-199603000-00003
- Widar M, 2002, J REHABIL MED, V34, P165, DOI 10.1080/16501970213237
- Widar M, 2002, SCAND J CARING SCI, V16, P302, DOI 10.1046/j.1471-6712.2002.00090.x
- Widerstrom-Noga E, 2016, J NEUROTRAUM, V33, P482, DOI 10.1089/neu.2015.4040
- Wissel J, 2010, J NEUROL, V257, P1067, DOI 10.1007/s00415-010-5463-1
- Yamamoto T, 1997, PAIN, V72, P5, DOI 10.1016/S0304-3959(97)00028-6
- Yang F, 2014, NEUROSCI BULL, V30, P887, DOI 10.1007/s12264-014-1477-5
- Zeilig G, 2012, BRAIN, V135, P418, DOI 10.1093/brain/awr270
- Zhang XL, 2018, STEREOT FUNCT NEUROS, V96, P239, DOI 10.1159/000492056
- BOIVIE J, 1989, PAIN, V37, P173, DOI 10.1016/0304-3959(89)90128-0
- ZIGMOND AS, 1983, ACTA PSYCHIAT SCAND, V67, P361, DOI 10.1111/j.1600-0447.1983.tb09716.x
- Zorowitz Richard D, 2005, Top Stroke Rehabil, V12, P11, DOI 10.1310/EWCY-LJ68-LHE0-54AF
- Boivie J, 2003, EUR J PAIN, V7, P339, DOI 10.1016/S1090-3801(03)00046-6
- Bouhassira D, 2005, PAIN, V114, P160, DOI 10.1016/j.pain.2004.12.014
- Bouhassira D, 2005, PAIN, V114, P29, DOI 10.1016/j.pain.2004.12.010
- Bouhassira D, 2004, PAIN, V108, P248, DOI 10.1016/j.pain.2003.12.024
- Bouhassira D, 2021, PAIN, V162, P1038, DOI 10.1097/j.pain.0000000000002130
- BOWSHER D, 1995, POSTGRAD MED J, V71, P598, DOI 10.1136/pgmj.71.840.598
- Bowsher D, 1996, J NEUROL NEUROSUR PS, V61, P62, DOI 10.1136/jnnp.61.1.62
- Bowsher D, 1998, NEUROLOGY, V51, P1352, DOI 10.1212/WNL.51.5.1352
- Bowsher D, 2005, J PAIN, V6, P736, DOI 10.1016/j.jpain.2005.06.009
- Bowsher D, 2005, EUR NEUROL, V54, P14, DOI 10.1159/000086884
- Castro Martha Moreira Cavalcante, 2006, Rev. Bras. Anestesiol., V56, P470, DOI 10.1590/S0034-70942006000500005
- Choi-Kwon S, 2017, ACTA NEUROL SCAND, V135, P419, DOI 10.1111/ane.12617
- Ciaramitaro P, 2017, PAIN MED, V18, P2428, DOI 10.1093/pm/pnw360
- Cleeland C. S., 1994, Annals Academy of Medicine Singapore, V23, P129
- Cury RG, 2016, PAIN, V157, P2758, DOI 10.1097/j.pain.0000000000000697
- Cury RG, 2014, NEUROLOGY, V83, P1403, DOI 10.1212/WNL.0000000000000887
- dash.iwh.on.ca, DASH OUTCOME MEASURE
- De Andrade DC, 2017, ONCOLOGIST, V22, P1154, DOI 10.1634/theoncologist.2017-0235
- de Andrade DC, 2011, HEALTH QUAL LIFE OUT, V9, DOI 10.1186/1477-7525-9-107
- De Vloo P, 2017, PAIN, V158, P17, DOI 10.1097/j.pain.0000000000000722
- Defrin R, 2002, BRAIN, V125, P501, DOI 10.1093/brain/awf055
- Demant DT, 2015, PAIN, V156, P2234, DOI 10.1097/j.pain.0000000000000266
- Demant DT, 2014, PAIN, V155, P2263, DOI 10.1016/j.pain.2014.08.014
- Dongyang L, 2021, NEUROPHYSIOL CLIN, V51, P291, DOI 10.1016/j.neucli.2021.06.003
- Ducreux D, 2006, BRAIN, V129, P963, DOI 10.1093/brain/awl016
- Ferreira KA, 2011, SUPPORT CARE CANCER, V19, P505, DOI 10.1007/s00520-010-0844-7
- Finnerup NB, 2015, LANCET NEUROL, V14, P162, DOI 10.1016/S1474-4422(14)70251-0
- FISCHER AA, 1987, PAIN, V30, P115, DOI 10.1016/0304-3959(87)90089-3
- Fitzek S, 2001, ANN NEUROL, V49, P493
- Flor H, 2016, PAIN PHYSICIAN, V19, P507
- Freeman R, 2014, PAIN, V155, P367, DOI 10.1016/j.pain.2013.10.023
- Galhardoni GR, 2019, NEUROLOGY, V92, pE2165, DOI 10.1212/WNL.0000000000007396
- Garcia-Larrea L, 2012, NEUROPHYSIOL CLIN, V42, P299, DOI 10.1016/j.neucli.2012.06.001
- Garcia-Larrea L, 2013, PAIN, V154, pS29, DOI 10.1016/j.pain.2013.09.001
- Garcia-Larrea L, 2010, BRAIN, V133, P2528, DOI 10.1093/brain/awq220
- Giordano PCM., 2009, THESIS U CAMPINAS
- Greenspan JD, 2004, PAIN, V109, P357, DOI 10.1016/S0304-3959(04)00068-5
- Guimaraes, 2004, REV BRAS NEUROL, V40, P5
- Gummesson C., 2006, BMC Musculoskelet Disord, V7, P1
- Hasan M, 2014, NEUROMODULATION, V17, P731, DOI 10.1111/ner.12198
- Hatem SM, 2010, BRAIN, V133, P3409, DOI 10.1093/brain/awq244
- Helme RD, 2018, PAIN, V159, P1005, DOI 10.1097/j.pain.0000000000001149
- Hettiarachchi C, 2011, J REHABIL MED, V43, P197, DOI 10.2340/16501977-0648
Coleções
Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - HC/IOT
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/15
Carregar mais Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - HC/IOT
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/15