Department of Physical Medicine and Rehabilitation, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Brain Convergence Research Center, Korea University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2021 Jun 22;11(1):13093. doi: 10.1038/s41598-021-92564-7.
Complex regional pain syndrome (CRPS) is a common poststroke complication. However, the neural substrates associated with CRPS remain unclear. We investigated the neural correlates associated with poststroke CRPS using voxel-based lesion‒symptom mapping (VLSM) analysis. Among 145 patients with ischemic stroke, 35 were diagnosed with CRPS and categorized into the poststroke CRPS group, and the remaining 110 into the control group. We compared the clinical characteristics between the groups. VLSM analysis was performed to identify the brain region associated with the development of poststroke CRPS. The clinical findings suggested that the poststroke CRPS group had lower muscle strength; lower scores on Fugl‒Meyer assessment, Manual Function Test, Mini-Mental Status Examination; and higher incidence of absent somatosensory evoked potentials in the median nerve than the control group. The head of the caudate nucleus, putamen, and white matter complexes in the corona radiata were significantly associated with poststroke CRPS development in ischemic stroke patients. These results facilitate an understanding of poststroke CRPS pathophysiology. Monitoring patients with lesions in these structures may aid the prevention and early treatment of poststroke CRPS.
复杂性区域疼痛综合征（CRPS）是一种常见的中风后并发症。然而，与 CRPS 相关的神经机制仍不清楚。我们使用基于体素的病变-症状映射（VLSM）分析来研究与中风后 CRPS 相关的神经相关性。在 145 名缺血性中风患者中，35 名被诊断为 CRPS，并分为中风后 CRPS 组，其余 110 名分为对照组。我们比较了两组的临床特征。进行 VLSM 分析以确定与中风后 CRPS 发展相关的脑区。临床发现表明，中风后 CRPS 组的肌肉力量较低；Fugl-Meyer 评估、手动功能测试、简易精神状态检查的评分较低；正中神经体感诱发电位缺失的发生率高于对照组。尾状核头部、壳核和放射冠的白质复合体与缺血性中风患者中风后 CRPS 的发展显著相关。这些结果有助于了解中风后 CRPS 的病理生理学。监测这些结构存在病变的患者可能有助于预防和早期治疗中风后 CRPS。
