Contralateral thalamic perfusion in patients with reflex sympathetic dystrophy syndrome

Fukumoto, Mitsutaka; Ushida, Takahiro; Zinchuk, Vadim S.; Yamamoto, Hiroshi; Shoji, Yasuhiro

doi:10.1016/s0140-6736(99)03746-0

Cited by 122 publications

(65 citation statements)

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“…Historically, hyperactivity of the sympathetic nervous system and changes in the peripheral nervous system were implicated; contemporary imaging studies also demonstrate the role of the central nervous system and local inflammation in this process. Alterations in thalamic perfusion have been found in CRPS patients [97]. These patients also display cortical sensory abnormalities [98].…”

Section: Common Post-stroke Pain Subtypesmentioning

confidence: 99%

Post Stroke Pain: Identification, Assessment, and Therapy

2015

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Background: Pain is a common complication after stroke and is associated with the presence of depression, cognitive dysfunction, and impaired quality of life. It remains underdiagnosed and undertreated, despite evidence that effective treatment of pain may improve function and quality of life. Summary: We provide an overview of the means for clinical assessment and risk factors for the development of post-stroke pain, then review the newest available literature regarding the commonest post-stroke pain syndromes, including central post-stroke pain, complex regional pain syndrome, musculoskeletal pain including shoulder subluxation, spasticity-related pain, and post-stroke headache, as well as the available epidemiology and current treatment options. Key Messages: In the best interests of optimizing quality of life and function after stroke, clinicians should be aware of pain as a common complication after stroke, identify those patients at highest risk, directly inquire as to the presence and characteristics of pain, and should be aware of the options for treatment for the various pain syndromes.

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Section: Common Post-stroke Pain Subtypesmentioning

confidence: 99%

Post Stroke Pain: Identification, Assessment, and Therapy

2015

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“…Thalamic activation is correlated with time since onset of the chronic pain, with hyperperfusion in shortterm and hypoperfusion in long-term chronic pain, indicating adaptive changes during the development of chronic pain. 60 Future studies examining patients with PTSD with and without chronic pain will be necessary to gain more insight into the role of the thalamus in developing chronic pain as part of a posttraumatic syndrome.…”

Section: Stress-induced Analgesiamentioning

confidence: 99%

Effects of trauma-related cues on pain processing in posttraumatic stress disorder: an fMRI investigation

Mickleborough

2011

J Psychiatry Neurosci

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Background: Imaging studies of pain processing in primary psychiatric disorders are just emerging. This study explored the neural correlates of stress-induced analgesia in individuals with posttraumatic stress disorder (PTSD). It combined functional magnetic resonance imaging (fMRI) and the traumatic script-driven imagery symptom provocation paradigm to examine the effects of trauma-related cues on pain perception in individuals with PTSD. Methods: The study included 17 patients with PTSD and 26 healthy, trauma-exposed controls. Participants received warm (nonpainful) or hot (painful) thermal stimuli after listening to a neutral or a traumatic script while they were undergoing an fMRI scan at a 4.0 T field strength. Results: Between-group analyses revealed that after exposure to the traumatic scripts, the blood oxygen level-dependent (BOLD) signal during pain perception was greater in the PTSD group than the control group in the head of the caudate. In the PTSD group, strong positive correlations resulted between BOLD signal and symptom severity in a number of brain regions previously implicated in stress-induced analgesia, such as the thalamus and the head of the caudate nucleus. Trait dissociation as measured by the Dissociative Experiences Scale correlated negatively with the right amygdala and the left putamen. Limitations: This study included heterogeneous traumatic experiences, a different proportion of military trauma in the PTSD versus the control group and medicated patients with PTSD. Conclusion: These data indicate that in patients with PTSD trauma recall will lead in a state-dependent manner to greater activation in brain regions implicated in stress-induced analgesia. Correlational analyses lend support to cortical hyperinhibition of the amygdala as a function of dissociation.

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“…The brain metabolic and bloodflow differences estimated by PET or SPECT reflect both inhibitory and excitatory synaptic activity. Therefore, decreased thalamic bloodflow in patients with CP might reflect decreased inhibitory synaptic activity, which may be related to loss of neurons, as suggested by the MR spectroscopy study reviewed above (Fukumoto et al, 1999). This decrease in bloodflow could occur despite the increased spontaneous thalamic firing rates, since spontaneous activity may not be reflected in metabolic or bloodflow imaging studies of the brain.…”

Section: Neuroimaging -Cognitive and Clinical Neuroscience 456mentioning

confidence: 99%

“…It is also possible these results are due to adaptive changes in the thalamus following the inciting lesion. For example, in patients with complex regional pain syndrome a SPECT study found increased thalamic bloodflow in patients with symptoms at 3 to 7 months after the injury, while decreased bloodflow occurred with long-term symptoms (24-36 months after) (Fukumoto et al, 1999). Finally, ongoing pain in patients with CP might be related to changes in the opiodergic intrinsic modulatory system.…”

Section: Neuroimaging -Cognitive and Clinical Neuroscience 456mentioning

confidence: 99%