Djojoseputro Robert E, Ciaves Angela F, Widyadharma I Putu E
Department of Neurology, Faculty of Medicine, Universitas Udayana, Bali-Indonesia.
Postep Psychiatr Neurol. 2025 Mar;34(1):44-53. doi: 10.5114/ppn.2025.149952. Epub 2025 Apr 30.
This review aims to emphasize the diagnostic value of functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) tractography in detecting and diagnosing central post-stroke pain (CPSP).
CPSP is a debilitating form of chronic neuropathic pain that develops in patients with a history of stroke. CPSP has a wide range of onset and non-specific clinical presentations, making it difficult to detect. Until now, CPSP has been considered a diagnosis of exclusion, often leading to delays in the initiation of the appropriate treatment plan. fMRI and DTI tractography are valuable tools for assessing cerebral metabolic activity and the structural characteristics of the spinothalamic tracts, respectively. By combining these sets of information, physicians can detect CPSP early and implement more effective treatment strategies.
Diagnosing CPSP has been challenging for physicians due to its complex nature. However, fMRI and DTI have the potential in enabling earlier detection of CPSP, giving physicians more time to initiate treatment. This review highlights the capacities of fMRI and DTI in identifying alterations in the spinothalamic pathways associated with CPSP.
本综述旨在强调功能磁共振成像(fMRI)和弥散张量成像(DTI)纤维束成像在检测和诊断中风后中枢性疼痛(CPSP)方面的诊断价值。
CPSP是一种使人衰弱的慢性神经性疼痛形式,发生于有中风病史的患者。CPSP的发病时间范围广且临床表现不具特异性,难以检测。到目前为止,CPSP一直被视为一种排除性诊断,常常导致适当治疗方案的启动延迟。fMRI和DTI纤维束成像分别是评估脑代谢活动和脊髓丘脑束结构特征的宝贵工具。通过整合这些信息,医生能够早期检测出CPSP并实施更有效的治疗策略。
由于其性质复杂,CPSP的诊断对医生来说一直具有挑战性。然而,fMRI和DTI有潜力实现对CPSP的早期检测,使医生有更多时间开始治疗。本综述突出了fMRI和DTI在识别与CPSP相关的脊髓丘脑通路改变方面的能力。