Pain tolerance after stroke: The Tromsø study.

Autor: Melum TA; Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway.; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.; Department of Pain, University Hospital of Northern Norway, Tromsø, Norway., Årnes AP; Department of Pain, University Hospital of Northern Norway, Tromsø, Norway., Stigum H; Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway., Stubhaug A; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Steingrímsdóttir ÓA; Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway., Mathiesen EB; Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway.; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway., Nielsen CS; Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway.
Jazyk: angličtina
Zdroj: European journal of pain (London, England) [Eur J Pain] 2023 Aug; Vol. 27 (7), pp. 912-921. Date of Electronic Publication: 2023 May 11.
DOI: 10.1002/ejp.2124
Abstrakt: Background: Stroke lesions might alter pain processing and modulation by affecting the widely distributed network of brain regions involved. We aimed to compare pain tolerance in stroke survivors and stroke-free persons in the general population, with and without chronic pain.
Methods: We included all participants of the sixth and seventh wave of the population-based Tromsø Study who had been tested with the cold pressor test (hand in cold water bath, 3°C, maximum time 106 s in the sixth wave and 120 s in the seventh) and who had information on previous stroke status and covariates. Data on stroke status were obtained from the Tromsø Study Cardiovascular Disease Register and the Norwegian Stroke Register. Cox regression models were fitted using stroke prior to study attendance as the independent variable, cold pressor endurance time as time variable and hand withdrawal from cold water as event. Statistical adjustments were made for age, sex, diabetes, hypertension, hyperlipidaemia, body mass index and smoking.
Results: In total 21,837 participants were included, 311 of them with previous stroke. Stroke was associated with decreased cold pain tolerance time, with 28% increased hazard of hand withdrawal (hazard ratio [HR] 1.28, 95% CI 1.10-1.50). The effect was similar in participants with (HR 1.28, 95% CI 0.99-1.66) and without chronic pain (HR 1.29, 95% CI 1.04-1.59).
Conclusions: Stroke survivors, with and without chronic pain, had lower cold pressor pain tolerance, with possible clinical implications for pain in this group.
Significance: We found lower pain tolerance in participants with previous stroke compared to stroke-free participants of a large, population-based study. The association was present both in those with and without chronic pain. The results may warrant increased awareness by health professionals towards pain experienced by stroke patients in response to injuries, diseases and procedures.
(© 2023 European Pain Federation - EFIC®.)
Databáze: MEDLINE
Externí odkaz: