A study of diffusion tensor imaging in central post-stroke pain: Traveling beyond the pain pathways
Introduction: Central post-stroke pain (CPSP), seen in the aftermath of a stroke, is an underdiagnosed entity but quite a disabling complication. All the postulated theories regarding the pathogenesis of CPSP point to its origin in the central pain pathways. However, this study attempts to demonstra...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Annals of Indian Academy of Neurology |
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| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2023;volume=26;issue=6;spage=889;epage=894;aulast=Porey |
| _version_ | 1797352316817375232 |
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| author | Camelia Porey Suprava Naik Sanjeev Kumar Bhoi Menka Jha Priyanka Samal |
| author_facet | Camelia Porey Suprava Naik Sanjeev Kumar Bhoi Menka Jha Priyanka Samal |
| author_sort | Camelia Porey |
| collection | DOAJ |
| description | Introduction: Central post-stroke pain (CPSP), seen in the aftermath of a stroke, is an underdiagnosed entity but quite a disabling complication. All the postulated theories regarding the pathogenesis of CPSP point to its origin in the central pain pathways. However, this study attempts to demonstrate the role of other contributing areas in the generation of CPSP. Materials and Methods: In this single-center tertiary care hospital-based study, 24 patients with both ischemic and hemorrhagic strokes of variable durations were recruited, and Magnetic Resonance Imaging (MRI) imaging with diffusion tensor imaging (DTI) acquisition was done. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the spinothalamic tract (STT), corticospinal tract (CST), superior thalamic radiation (STR), basal ganglia (BG), and primary somatosensory cortex (SSC) were compared between normal and abnormal sides and also in extrathalamic lesions separately. Results: Significant differences with lower FA were noted in STT, CST, STR, and SSC and higher ADC values in BG, STR, CST, and SSC on comparison between the normal and lesion sides. On individual sub-analysis, ischemic stroke had significant changes in the FA value of CST and the ADC value of STR and CST, while hemorrhagic stroke had significant changes in the FA and ADC values of STR and SSC, as well as the FA value of STT. In the analysis of the extrathalamic strokes, significance persisted in all the studied parameters except the BG. The CST abnormalities were evident even in patients with clinical motor improvement. On multivariate analysis, visual analogue scale score severity was correlated with thalamic lesions. Conclusion: Contrary to the belief that STT is solely responsible for CPSP, the role of CST, STR, BG, and SSC as contributing areas is evident from this study and may be more well established if studied in a larger population. |
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| format | Article |
| id | doaj.art-c881a85832774a748a223fdc77f1a50d |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-03-08T13:13:37Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-c881a85832774a748a223fdc77f1a50d2024-01-18T10:33:01ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492023-01-0126688989410.4103/aian.aian_378_23A study of diffusion tensor imaging in central post-stroke pain: Traveling beyond the pain pathwaysCamelia PoreySuprava NaikSanjeev Kumar BhoiMenka JhaPriyanka SamalIntroduction: Central post-stroke pain (CPSP), seen in the aftermath of a stroke, is an underdiagnosed entity but quite a disabling complication. All the postulated theories regarding the pathogenesis of CPSP point to its origin in the central pain pathways. However, this study attempts to demonstrate the role of other contributing areas in the generation of CPSP. Materials and Methods: In this single-center tertiary care hospital-based study, 24 patients with both ischemic and hemorrhagic strokes of variable durations were recruited, and Magnetic Resonance Imaging (MRI) imaging with diffusion tensor imaging (DTI) acquisition was done. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the spinothalamic tract (STT), corticospinal tract (CST), superior thalamic radiation (STR), basal ganglia (BG), and primary somatosensory cortex (SSC) were compared between normal and abnormal sides and also in extrathalamic lesions separately. Results: Significant differences with lower FA were noted in STT, CST, STR, and SSC and higher ADC values in BG, STR, CST, and SSC on comparison between the normal and lesion sides. On individual sub-analysis, ischemic stroke had significant changes in the FA value of CST and the ADC value of STR and CST, while hemorrhagic stroke had significant changes in the FA and ADC values of STR and SSC, as well as the FA value of STT. In the analysis of the extrathalamic strokes, significance persisted in all the studied parameters except the BG. The CST abnormalities were evident even in patients with clinical motor improvement. On multivariate analysis, visual analogue scale score severity was correlated with thalamic lesions. Conclusion: Contrary to the belief that STT is solely responsible for CPSP, the role of CST, STR, BG, and SSC as contributing areas is evident from this study and may be more well established if studied in a larger population.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2023;volume=26;issue=6;spage=889;epage=894;aulast=Poreyapparent diffusion coefficientcorticospinal tractextrathalamic strokefractional anisotropysomatosensory cortexsuperior thalamic radiation |
| spellingShingle | Camelia Porey Suprava Naik Sanjeev Kumar Bhoi Menka Jha Priyanka Samal A study of diffusion tensor imaging in central post-stroke pain: Traveling beyond the pain pathways Annals of Indian Academy of Neurology apparent diffusion coefficient corticospinal tract extrathalamic stroke fractional anisotropy somatosensory cortex superior thalamic radiation |
| title | A study of diffusion tensor imaging in central post-stroke pain: Traveling beyond the pain pathways |
| title_full | A study of diffusion tensor imaging in central post-stroke pain: Traveling beyond the pain pathways |
| title_fullStr | A study of diffusion tensor imaging in central post-stroke pain: Traveling beyond the pain pathways |
| title_full_unstemmed | A study of diffusion tensor imaging in central post-stroke pain: Traveling beyond the pain pathways |
| title_short | A study of diffusion tensor imaging in central post-stroke pain: Traveling beyond the pain pathways |
| title_sort | study of diffusion tensor imaging in central post stroke pain traveling beyond the pain pathways |
| topic | apparent diffusion coefficient corticospinal tract extrathalamic stroke fractional anisotropy somatosensory cortex superior thalamic radiation |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2023;volume=26;issue=6;spage=889;epage=894;aulast=Porey |
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