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Chronic pain syndromes after ischemic stroke: PRoFESS trial
Martin J O'Donnell1, Hans-Christoph Diener, Ralph L Sacco
1Population Health Research Institute, DBCVS Research Institute, McMaster University, 3rd Floor, 237 Barton St E, Hamilton, Ontario, L8L 2X2, Canada. odonnm@mcmaster.ca
Stroke
|April 6, 2013
Summary
Chronic pain is common after ischemic stroke, affecting 10.6% of patients. This post-stroke pain is linked to worse functional dependence and cognitive decline, highlighting the need for better management strategies.
Area of Science:
- Neurology
- Epidemiology
- Pain Medicine
Background:
- Chronic pain is a frequent complication following stroke.
- Previous studies often involved small patient groups with limited follow-up duration.
Purpose of the Study:
- To determine the prevalence, risk factors, and clinical consequences of new chronic pain syndromes after ischemic stroke.
- Utilized data from the large Prevention Regimen for Effectively avoiding Second Stroke (PRoFESS) trial.
Main Methods:
- Administered a standardized chronic pain questionnaire to participants reporting new pain post-stroke.
- Employed multivariable logistic regression to identify risk factors and associations with cognitive and functional decline.
- Analyzed data from 15,754 participants with a mean follow-up of 2.5 years.
Main Results:
- 10.6% of participants developed new chronic post-stroke pain syndromes.
- Identified predictors including stroke severity, female sex, alcohol intake, statin use, depressive symptoms, diabetes, antithrombotic use, and peripheral vascular disease.
- Post-stroke pain correlated with increased functional dependence (OR 2.16) and cognitive decline, particularly with peripheral neuropathy and pain from spasticity/shoulder subluxation.
Conclusions:
- Chronic pain syndromes are prevalent after ischemic stroke.
- These pain syndromes are significantly associated with greater functional dependence.
- Post-stroke pain also contributes to cognitive decline, emphasizing the importance of addressing pain in stroke recovery.
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