BACKGROUND AND PURPOSE:Chronic pain syndromes are reported to be common after stroke, but most previous epidemiological studies have generally included small cohorts of patients with relatively short-term follow-up. In a large cohort with ischemic stroke (Prevention Regimen for Effectively avoiding Second Stroke [PRoFESS] trial), we determined the prevalence, risk factors, and clinical consequence of new poststroke pain syndromes. METHODS: Within the PRoFESS trial (mean follow-up 2.5 years), a standardized chronic pain questionnaire was administered (at the penultimate follow-up visit) to all participants who reported chronic pain since their stroke and did not have a history of chronic pain before their index stroke. Multivariable logistic regression analyses were used to determine risk factors for poststroke pain (and pain subtypes), and the association between poststroke pain and cognitive (≥ 3 reduction in Mini-Mental State Examination score) and functional decline (≥ 1 increase in m-Rankin). RESULTS:In total, 15 754 participants were included; of which 1665 participants (10.6%) reported new chronic poststroke pain, and included 431 participants (2.7%) with central poststroke pain, 238 (1.5%) with peripheral neuropathic pain, 208 (1.3%) with pain from spasticity, and 136 participants (0.9%) with pain from shoulder subluxation. More than 1 pain subtype was reported in 86 participants (0.6%). Predictors of poststroke pain included increased stroke severity, female sex, alcohol intake, statin use, depressive symptoms, diabetes mellitus, antithrombotic regimen, and peripheral vascular disease. A new chronic pain syndrome was associated with greater dependence (odds ratio, 2.16; 95% confidence interval, 1.82-2.56). Peripheral neuropathy and pain from spasticity/shoulder subluxation were associated with cognitive decline. CONCLUSIONS:Chronic pain syndromes are common after ischemic stroke and are associated with increased functional dependence and cognitive decline.
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BACKGROUND AND PURPOSE:Chronic pain syndromes are reported to be common after stroke, but most previous epidemiological studies have generally included small cohorts of patients with relatively short-term follow-up. In a large cohort with ischemic stroke (Prevention Regimen for Effectively avoiding Second Stroke [PRoFESS] trial), we determined the prevalence, risk factors, and clinical consequence of new poststroke pain syndromes. METHODS: Within the PRoFESS trial (mean follow-up 2.5 years), a standardized chronic pain questionnaire was administered (at the penultimate follow-up visit) to all participants who reported chronic pain since their stroke and did not have a history of chronic pain before their index stroke. Multivariable logistic regression analyses were used to determine risk factors for poststroke pain (and pain subtypes), and the association between poststroke pain and cognitive (≥ 3 reduction in Mini-Mental State Examination score) and functional decline (≥ 1 increase in m-Rankin). RESULTS: In total, 15 754 participants were included; of which 1665 participants (10.6%) reported new chronic poststroke pain, and included 431 participants (2.7%) with central poststroke pain, 238 (1.5%) with peripheral neuropathic pain, 208 (1.3%) with pain from spasticity, and 136 participants (0.9%) with pain from shoulder subluxation. More than 1 pain subtype was reported in 86 participants (0.6%). Predictors of poststroke pain included increased stroke severity, female sex, alcohol intake, statin use, depressive symptoms, diabetes mellitus, antithrombotic regimen, and peripheral vascular disease. A new chronic pain syndrome was associated with greater dependence (odds ratio, 2.16; 95% confidence interval, 1.82-2.56). Peripheral neuropathy and pain from spasticity/shoulder subluxation were associated with cognitive decline. CONCLUSIONS:Chronic pain syndromes are common after ischemic stroke and are associated with increased functional dependence and cognitive decline.
Authors: Alyson R Plecash; Amokrane Chebini; Alvin Ip; Joshua J Lai; Andrew A Mattar; Jason Randhawa; Thalia S Field Journal: Curr Neurol Neurosci Rep Date: 2019-11-13 Impact factor: 5.081
Authors: Sohail M Mulla; D Norman Buckley; Dwight E Moulin; Rachel Couban; Zain Izhar; Arnav Agarwal; Akbar Panju; Li Wang; Sun Makosso Kallyth; Alparslan Turan; Victor M Montori; Daniel I Sessler; Lehana Thabane; Gordon H Guyatt; Jason W Busse Journal: BMJ Open Date: 2014-11-20 Impact factor: 2.692
Authors: Max M Klein; Roi Treister; Tommi Raij; Alvaro Pascual-Leone; Lawrence Park; Turo Nurmikko; Fred Lenz; Jean-Pascal Lefaucheur; Magdalena Lang; Mark Hallett; Michael Fox; Merit Cudkowicz; Ann Costello; Daniel B Carr; Samar S Ayache; Anne Louise Oaklander Journal: Pain Date: 2015-09 Impact factor: 7.926
Authors: Gianluca Castelnuovo; Emanuele M Giusti; Gian Mauro Manzoni; Donatella Saviola; Arianna Gatti; Samantha Gabrielli; Marco Lacerenza; Giada Pietrabissa; Roberto Cattivelli; Chiara A M Spatola; Stefania Corti; Margherita Novelli; Valentina Villa; Andrea Cottini; Carlo Lai; Francesco Pagnini; Lorys Castelli; Mario Tavola; Riccardo Torta; Marco Arreghini; Loredana Zanini; Amelia Brunani; Paolo Capodaglio; Guido E D'Aniello; Federica Scarpina; Andrea Brioschi; Lorenzo Priano; Alessandro Mauro; Giuseppe Riva; Claudia Repetto; Camillo Regalia; Enrico Molinari; Paolo Notaro; Stefano Paolucci; Giorgio Sandrini; Susan G Simpson; Brenda Wiederhold; Stefano Tamburin Journal: Front Psychol Date: 2016-04-19