Biomedical Signals and Systems, MIRA institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
NeuroRehabilitation. 2011;28(4):331-44. doi: 10.3233/NRE-2011-0661.
Post-stroke shoulder pain (PSSP), traditionally regarded as purely nociceptive pain, is often persistent and the mechanisms underlying the pain complaints are not well understood. This explorative study is the first to address the possible changes in cortical somatosensory processing in patients with PSSP. Cortical potentials were recorded following intracutaneous electrostimulaton in stroke patients with chronic PSSP (n= 6), pain-free stroke patients (PF, n=14) and healthy controls (HC, n=20) using EEG. Amplitudes and latencies of both sensory discriminative (N90) as well as cognitive evaluative (N150, P200, the N150-P200 peak-to-peak difference and P300) evoked potential components were evaluated. Stroke was associated with reduced N150 and P300 amplitudes and increased N90, N150 and P300 latencies at both sides. Compared to PF and HC, the P200 and N150-P200 latencies were increased in PSSP patients after stimulation at both sides, even when comparing subgroups with similar lesion size and location. Stroke was associated with reduced sensory-discriminative as well as with reduced cognitive-evaluative cortical somatosensory processing. This reduction was more pronounced in patients with PSSP and may be related to the central effects of persistent nociceptive pain.
卒中后肩痛（PSSP），传统上被认为是纯粹的伤害感受性疼痛，往往是持续存在的，疼痛的潜在机制尚不清楚。本探索性研究首次针对 PSSP 患者皮质体感处理可能发生的变化进行研究。使用 EEG 记录了慢性 PSSP（n=6）、无痛卒中（PF，n=14）和健康对照（HC，n=20）卒中患者经皮电刺激后的皮质电位。评估了感觉辨别（N90）和认知评估（N150、P200、N150-P200 峰峰值差异和 P300）诱发电位成分的振幅和潜伏期。与 PF 和 HC 相比，双侧刺激时 PSSP 患者的 N150 和 P300 振幅降低，N90、N150 和 P300 潜伏期延长。即使比较相似的病变大小和位置亚组，PSSP 患者的 P200 和 N150-P200 潜伏期在双侧刺激时也增加。卒中与感觉辨别能力降低以及认知评估能力降低有关皮质体感处理。这种减少在 PSSP 患者中更为明显，可能与持续的伤害感受性疼痛的中枢效应有关。
