Clinical Features

Canavero, Sergio; Bonicalzi, Vincenzo

doi:10.1007/978-3-319-56765-5_3

Cited by 2 publications

(2 citation statements)

References 124 publications

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“…This is consistent with previous reports of development of CPSP by 6 months of stroke onset. 31 Other reports suggest that almost a third of people have moderate to severe pain at 4 months poststroke and this decreases to 21% by 16 months. 32…”

Section: Discussionmentioning

confidence: 97%

Prevalence, Trajectory, and Predictors of Poststroke Pain: Retrospective Analysis of Pooled Clinical Trial Data Set

Ali,

Tibble,

Brady

et al. 2023

Stroke

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BACKGROUND: Poststroke pain remains underdiagnosed and inadequately managed. To inform the optimum time to initiate interventions, we examined prevalence, trajectory, and participant factors associated with poststroke pain. METHODS: Eligible studies from the VISTA (Virtual International Stroke Trials Archives) included an assessment of pain. Analyses of individual participant data examined demography, pain, mobility, independence, language, anxiety/depression, and vitality. Pain assessments were standardized to the European Quality of Life Scale (European Quality of Life 5 Dimensions 3 Level) pain domain, describing no, moderate, or extreme pain. We described pain prevalence, associations between participant characteristics, and pain using multivariable models. RESULTS: From 94 studies (n>48 000 individual participant data) in VISTA, 10 (n=10 002 individual participant data) included a pain assessment. Median age was 70.0 years (interquartile range [59.0–77.1]), 5560 (55.6%) were male, baseline stroke severity was National Institutes of Health Stroke Scale score 10 (interquartile range [7–15]). Reports of extreme pain ranged between 3% and 9.5% and were highest beyond 2 years poststroke (31/328 [9.5%]); pain trajectory varied by study. Poorer independence was significantly associated with presence of moderate or extreme pain (5 weeks–3 months odds ratio [OR], 1.5 [95% CI, 1.4–1.6]; 4–6 months OR, 1.7 [95% CI, 1.3–2.1]; >6 months OR, 1.5 [95% CI, 1.2–2.0]), and increased severity of pain (5 weeks–3 months: OR, 1.2 [95% CI, 1.1–1.2]; 4–6 months OR, 1.1 [95% CI, 1.1–1.2]; >6 months, OR, 1.2 [95% CI, 1.1–1.2]), after adjusting for covariates. Anxiety/depression and lower vitality were each associated with pain severity. CONCLUSIONS: Between 3% and 9.5% of participants reported extreme poststroke pain; the presence and severity of pain were independently associated with dependence at each time point. Future studies could determine whether and when interventions may reduce the prevalence and severity of poststroke pain.

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Section: Discussionmentioning

confidence: 97%

Prevalence, Trajectory, and Predictors of Poststroke Pain: Retrospective Analysis of Pooled Clinical Trial Data Set

Ali,

Tibble,

Brady

et al. 2023

Stroke

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“…[2] Thalamic pain is characterized by thermal paresthesia, ectopic pain, and persistent pain. [3] In previous reports on central pain cases, thalamic pain accounts for about 33% to 47%, [4] mostly occurs within 3 to 6 months after stroke, [5] and about 1% to 12% of stroke patients will experience thalamic pain within 1 year. [6] Risk factors for development of CPSP include young age, previous depression, current smoking, and increased baseline stroke severity, [7] Notably, studies have found that young stroke patients are twice as likely to develop CPSP.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture for thalamic pain after stroke: A systematic review and meta-analysis

Chen

2023

Medicine

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Objective: To evaluate the efficacy and safety of acupuncture on thalamic pain after stroke. Methods: The self-established database was searched from 8 Chinese and English databases to June 2022, and the randomized controlled trials articles on the comparative treatment of thalamic pain after stroke with acupuncture were included. That visual analog scale, present pain intensity score, pain rating index, the total efficiency, and adverse reactions were mainly used to evaluate the outcomes. Results: A total of 11 papers were included. Meta-analysis showed that acupuncture appeared to be more effective than drugs for treatment of thalamic pain, as assessed by the visual analog scale [mean difference (MD) = −1.06, 95% confidence interval (CI) (−1.20, −0.91), P < .00001], the present pain intensity score [MD = −0.27, 95% CI (−0.43, −0.11), P = .001], the pain rating index [MD = −1.02, 95% CI (−1.41, −0.63), P < .00001], and the total efficiency [risk ratio = 1.31, 95% CI (1.22,1.41), P < .00001]. Meta-analysis results show that there is no significant difference in safety between acupuncture and drug therapy [risk ratio = 0.50, 95% CI (0.30,0.84), P = .009]. Conclusion: Studies have shown that acupuncture in the treatment of thalamic pain is effective, and it does not prove to have a higher safety than drug treatment, therefore a large-scale multicenter randomized controlled trials study is needed to further prove.

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Clinical Features

Cited by 2 publications

References 124 publications

Prevalence, Trajectory, and Predictors of Poststroke Pain: Retrospective Analysis of Pooled Clinical Trial Data Set

Prevalence, Trajectory, and Predictors of Poststroke Pain: Retrospective Analysis of Pooled Clinical Trial Data Set

Acupuncture for thalamic pain after stroke: A systematic review and meta-analysis

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