TY - JOUR
T1 - Dissecting neuropathic from poststroke pain: the white matter within
AU - Delboni Lemos, Marcelo
AU - Faillenot, Isabelle
AU - Tavares Lucato, Leandro
AU - Jacobsen Teixeira, Manoel
AU - Mendonça Barbosa, Luciana
AU - Joaquim Lopes Alho, Eduardo
AU - Bastos Conforto, Adriana
AU - Lilian de Lima Rodrigues, Antonia
AU - Galhardoni, Ricardo
AU - Aparecida da Silva, Valquíria
AU - Listik, Clarice
AU - Rosi, Jefferson
AU - Peyron, Roland
AU - Garcia-Larrea, Luis
AU - Ciampi de Andrade, Daniel
PY - 2021
Y1 - 2021
N2 - Poststroke pain (PSP) is a heterogeneous term encompassing both central neuropathic (ie, central poststroke pain [CPSP]) and nonneuropathic poststroke pain (CNNP) syndromes. Central poststroke pain is classically related to damage in the lateral brainstem, posterior thalamus, and parietoinsular areas, whereas the role of white matter connecting these structures is frequently ignored. In addition, the relationship between stroke topography and CNNP is not completely understood. In this study, we address these issues comparing stroke location in a CPSP group of 35 patients with 2 control groups: 27 patients with CNNP and 27 patients with stroke without pain. Brain MRI images were analyzed by 2 complementary approaches: an exploratory analysis using voxel-wise lesion symptom mapping, to detect significant voxels damaged in CPSP across the whole brain, and a hypothesis-driven, region of interest–based analysis, to replicate previously reported sites involved in CPSP. Odds ratio maps were also calculated to demonstrate the risk for CPSP in each damaged voxel. Our exploratory analysis showed that, besides known thalamic and parietoinsular areas, significant voxels carrying a high risk for CPSP were located in the white matter encompassing thalamoinsular connections (one-tailed threshold Z > 3.96, corrected P value
AB - Poststroke pain (PSP) is a heterogeneous term encompassing both central neuropathic (ie, central poststroke pain [CPSP]) and nonneuropathic poststroke pain (CNNP) syndromes. Central poststroke pain is classically related to damage in the lateral brainstem, posterior thalamus, and parietoinsular areas, whereas the role of white matter connecting these structures is frequently ignored. In addition, the relationship between stroke topography and CNNP is not completely understood. In this study, we address these issues comparing stroke location in a CPSP group of 35 patients with 2 control groups: 27 patients with CNNP and 27 patients with stroke without pain. Brain MRI images were analyzed by 2 complementary approaches: an exploratory analysis using voxel-wise lesion symptom mapping, to detect significant voxels damaged in CPSP across the whole brain, and a hypothesis-driven, region of interest–based analysis, to replicate previously reported sites involved in CPSP. Odds ratio maps were also calculated to demonstrate the risk for CPSP in each damaged voxel. Our exploratory analysis showed that, besides known thalamic and parietoinsular areas, significant voxels carrying a high risk for CPSP were located in the white matter encompassing thalamoinsular connections (one-tailed threshold Z > 3.96, corrected P value
KW - Poststroke pain
KW - Neuropathic pain
KW - Stroke
KW - Chronic pain
KW - White matter
U2 - 10.1097/j.pain.0000000000002427
DO - 10.1097/j.pain.0000000000002427
M3 - Journal article
SN - 0304-3959
VL - 163
SP - 765
EP - 778
JO - Pain
JF - Pain
IS - 4
ER -