Central post-stroke pain due to injury of the spinothalamic tract in patients with cerebral infarction： a diffusion tensor tractography imaging study

• Published in: Neural regeneration research Vol. 12; no. 12; pp. 2021 - 2024
• Main Authors: Jang, Sung, Lee, Jun, Yeo, Sang
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.12.2017; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea%Department of Neurology, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea%Department of Physical Therapy, College of Health Sciences, Dankook University, Chungnam, Republic of Korea; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Causes of; Complications and side effects; Development and progression; Females; Health aspects; Magnetic resonance imaging; Males; Methods; nerve regeneration; central post-stroke pain; cerebral infarction; spinothalamic tract; diffusion tensor imaging; neural regeneration; Observations; Pain; Pathogenesis; Patients; Somatosensory system; Spinal cord injuries; Stroke; Studies; diffusion tensor imaging; nerve regeneration; spinothalamic tract; neural regeneration; cerebral infarction; central post-stroke pain
• ISSN: 1673-5374; 1876-7958
• DOI: 10.4103/1673-5374.221159

Many studies using diffusion tensor tractography（DTT） have demonstrated that injury of the spinothalamic tract（STT） is the pathogenetic mechanism of central post-stroke pain（CPSP） in intracerebral hemorrhage; however, there is no DTT study reporting the pathogenetic mechanism of CPSP in cerebral infarction. In this study, we investigated injury of the STT in patients with CPSP following cerebral infarction, using DTT. Five patients with CPSP following cerebral infarction and eight age-and sex-matched healthy control subjects were recruited for this study. STT was examined using DTT. Among DTT parameters of the affected STT, fractional anisotropy and tract volume were decreased by more than two standard deviations in two patients（patients 1 and 2） and three patients（patients 3, 4, and 5）, respectively, compared with those of the control subjects, while mean diffusivity value was increased by more than two standard deviations in one patient（patient 2）. Regarding DTT configuration, all affected STTs passed through adjacent part of the infarct and three STTs showed narrowing. These findings suggest that injury of the STT might be a pathogenetic etiology of CPSP in patients with cerebral infarction.