Dissecting neuropathic from poststroke pain: the white matter within

Marcelo Delboni Lemos, Isabelle Faillenot, Leandro Tavares Lucato, Manoel Jacobsen Teixeira, Luciana Mendonça Barbosa, Eduardo Joaquim Lopes Alho, Adriana Bastos Conforto, Antonia Lilian de Lima Rodrigues, Ricardo Galhardoni, Valquíria Aparecida da Silva, Clarice Listik, Jefferson Rosi, Roland Peyron, Luis Garcia-Larrea, Daniel Ciampi de Andrade

Research output: Contribution to journalJournal articleResearchpeer-review

8 Citations (Scopus)

Abstract

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
Original languageEnglish
JournalPain
Volume163
Issue number4
Pages (from-to)765-778
ISSN0304-3959
DOIs
Publication statusPublished - 2021
Externally publishedYes

Keywords

  • Poststroke pain
  • Neuropathic pain
  • Stroke
  • Chronic pain
  • White matter

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