Poststroke Pain

Abstract

Pain is common but often underrecognized after stroke. Poststroke pain (PSP) hinders recovery, impairs quality of life, and is associated with the psychological state of patients with stroke. The most common subtypes of PSP include central PSP, complex regional pain syndrome, shoulder pain, spasticity-related pain, and headache. The pathophysiologies of these PSP subtypes are not yet clearly understood, and PSP is refractory to conventional treatment in many patients. However, recent studies have proposed potential pathophysiologies of PSP subtypes, which may help prioritize therapies that target specific mechanisms.

The mechanism and effect of repetitive transcranial magnetic stimulation for post-stroke pain

“…Pain is one of the common sequelae after stroke and affects the quality of life. The incidence of post-stroke pain (PSP) is reported to be 10-45.8% (Yang and Chang, 2021;Zhang et al, 2021). PSP can manifest in many forms, including central PSP (CPSP), painful spasms, hemiplegia, tension headaches, and musculoskeletal pain (Delpont et al, 2018;Torres-Parada et al, 2020;Yang and Chang, 2021).…”

“…The incidence of post-stroke pain (PSP) is reported to be 10-45.8% (Yang and Chang, 2021;Zhang et al, 2021). PSP can manifest in many forms, including central PSP (CPSP), painful spasms, hemiplegia, tension headaches, and musculoskeletal pain (Delpont et al, 2018;Torres-Parada et al, 2020;Yang and Chang, 2021). CPSP is a neuropathic pain syndrome with challenging treatment due to vascular lesions of the somatosensory pathways in the brain (Boivie et al, 1989;Jang et al, 2019).…”

The Impact of Burst Motor Cortex Stimulation on Cardiovascular Autonomic Modulation in Chronic Pain: A Feasibility Study for a New Approach to Objectively Monitor Therapeutic Effects

“…Chronic pain of various origin (post-stroke, post-surgical, post-infection) affects approximately 30–45% of pain patients and is characterized by a broad clinical spectrum of pain phenotypes including, but not limited to, central post-stroke pain, complex regional pain syndrome, facial pain, extremity pain, back pain, and other pain disorders. Given the fact that these pain phenotypes derived from distinct and not well-understood pathophysiological pathways, clinical diagnosis and management of chronic pain appear to be challenging, thus slowing recovery in a considerable proportion of affected individuals [ 1 – 11 ]. In the case of failure and/or limited responsiveness to first-line pharmacological and behavioral therapies, central (transcranial magnetic stimulation (TMS), transcranial direct current stimulation, transcranial alternating stimulation, motor cortex stimulation (MCS), deep brain stimulation (DBS), and peripheral neurostimulation therapies [vagal nerve stimulation, peripheral nerve stimulation (PFS), spinal cord stimulation (SCS)] have been applied adjunctively to promote pain relief under these challenging circumstances, yielding response rates ranging from 25 to 45% [ 12 – 22 ].…”

Research Hotspots and Frontiers in Post Stroke Pain: A Bibliometric Analysis Study

“…Pain is a common complication of stroke, reported in 10-45.8% of patients with stroke (Yang and Chang, 2021;Zhang et al, 2021a). Pain after stroke can hinder the progress of rehabilitation and decrease the quality of life in stroke survivors (Payton and Soundy, 2020;Wang and Liu, 2021;Zhang et al, 2021b).…”

“…Pain is often missed clinically due to a low disclosure rate. The main subtypes of pain after stroke include central post-stroke pain (CPSP), complex regional pain syndrome (CRPS), shoulder pain, and spasticity-related pain (Delpont et al, 2018;Torres-Parada et al, 2020;Yang and Chang, 2021). Many patients persistently experience at least one subtype.…”