Injury of the spino-thalamo-cortical pathway is necessary for central post-stroke pain.
OBJECTIVE
We investigated the relationship between injury of the spino-thalamo-cortical pathway (STP) and central post-stroke pain (CPSP) in patients with intracerebral hemorrhage, using diffusion tensor tractography (DTT).


METHODS
30 consecutive chronic patients, in whom integrity of the STP and the medial lemnisco-thalamo-cortical pathway (MLP) were spared in both hemispheres, were recruited. We classified the patients into two groups according to the presence of the CPSP. DTTs were obtained using the FMRIB Software Library. Fractional anisotropy (FA), mean diffusivity (MD), and tract volume were measured. A laterality index (LI) was used to determine asymmetry of DTT parameters between the hemispheres.


RESULTS
The LI for tract volume of the STP in the CPSP group was lower than that of the non-CPSP group (p = 0.000). However, there were no differences between the CPSP group and non-CPSP group for the LIs of FA or MD of the STP or for the LIs of FA, MD, or tract volume of the MLP (p > 0.05).


CONCLUSIONS
Decrease of tract volume without changes in the STP FA or MD values in the CPSP group indicates partial injury of STP. Therefore, injury of the STP seems to be a requirement for the development of CPSP in patients with intracerebral hemorrhage.
Hong
Ji Heon
JH
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
Bai
Dai Seg
DS
Jeong
Jin Young
JY
Choi
Byung Yun
BY
Chang
Chul Hoon
CH
Kim
Seong Ho
SH
Ahn
Sang Ho
SH
Jang
Sung Ho
SH
D000328:Adult; D000368:Aged; D016880:Anisotropy; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000293:injuries / Q000503:physiopathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000293:injuries / Q000503:physiopathology; D010146:Pain / Q000209:etiology / Q000473:pathology*; D010147:Pain Measurement; D013116:Spinal Cord / Q000503:physiopathology*; D020521:Stroke / Q000150:complications; D013788:Thalamus / Q000293:injuries / Q000503:physiopathology*