Post-stroke sensory hypersensitivity: insights from lesion-symptom and disconnection mapping

A post-injury increase in sensory sensitivity is frequently reported by acquired brain injury patients, including stroke patients. These symptoms are related to poor functional outcomes, but their underlying neural mechanisms remain unclear. Since stroke results in focal lesions that can easily be visualized on imaging, the lesions of stroke survivors can be used to study the neuroanatomy of post-injury sensory hypersensitivity. We used multivariate support vector regression lesion-symptom mapping and indirect structural disconnection mapping to uncover the lesion location and white matter tracts related to post-stroke sensory hypersensitivity. A total of 103 patients were included in the study, of which 47% reported post-stroke sensory hypersensitivity across different sensory modalities. The lesion-symptom and structural connectivity mapping identified the putamen, thalamus, amygdala and insula in the grey matter as well as fronto-insular tracts, and the fronto-striatal tract in the white matter as neural structures potentially involved in post-stroke sensory hypersensitivity. By examining the neuroanatomy of post-stroke sensory hypersensitivity in a large stroke sample, this study offers a significant advancement in our understanding of the neural basis of post-stroke sensory hypersensitivity.