Prevalence and Impact of Central Post-Stroke Pain on Quality of Life Among Stroke Survivors: A Cross-Sectional Study
Keywords:
Central post-stroke pain, Quality of life, Depression, Stroke severity, Cross-sectional studyAbstract
Background: Stroke continues to be a significant public health challenge. Central post-stroke pain (CPSP) is a notable aspect of post-stroke pain that not only causes physical discomfort but also affects psychological well-being, leading to a reduced quality of life. The objective of this was to assess the prevalence of CPSP and its relationship with quality of life. Methods: This hospital-based cross-sectional study was conducted between August and December 2023 in Manado, Indonesia, the study involved the consecutive recruitment of stroke patients. CPSP diagnosis adhered to the 2017 criteria set forth by the American Pain Society, while quality of life was evaluated using the Indonesian version of the Stroke Specific Quality of Life (SS-QoL) scale. Results: The study comprised 166 stroke patients, revealing that 30.1% experienced CPSP. Notably, there was a significant difference in mean SS-QoL scores based on both the severity of the stroke and the presence of depression. Within the CPSP group, a significant variation in SS-QoL summary scores was observed between male and female patients. Those with CPSP reported significantly lower mean scores in the Thinking and Energy categories. However, there was no significant difference in the overall SS-QoL scores between CPSP and non-CPSP patients. Conclusion: In summary, stroke patients suffering from depression, greater severity of stroke, and those experiencing burning or pressure-like sensations are at an increased risk of having a lower quality of life.References
Feigin VL, Brainin M, Norrving B, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. International Journal of Stroke. 2022;17(1):18–29; doi: 10.1177/17474930211065917.
Aunthakot K, Loahasiriwong W, Tiamkao S. Recurrence stroke of ischemic stroke patients in Thailand: a nationwide study. Int J Publ Health Sci. 2023;12(2):614–20; doi: 10.11591/ijphs.v12i2.22504.
Balitbangkes. Hasil Riskesdas 2018. Badan Penelitian dan Pengembangan Kesehatan 2019.
Pandian JD, Srivastava MVP, Aaron Sanjith, et al. The burden, risk factors and unique etiologies of stroke in South-East Asia Region (SEAR). The Lancet Regional Health - Southeast Asia. 2023;17; doi: 10.1016/j.lansea.2023.100289.
Boehme C, Toell T, Lang W, et al. Longer term patient management following stroke: A systematic review. International Journal of Stroke. 2021;16(8):917–26; doi: 10.1177/17474930211016963.
Westerlind E, Singh R, Persson HC, et al. Experienced pain after stroke: A cross-sectional 5-year follow-up study. BMC Neurol. 2020;20(1):1–8; doi: 10.1186/s12883-019-1584-z.
Olawale OA, Ajepe TO, Oke KI, et al. Chronic pain after stroke: a hospital-based study of its profile and correlation with health-related quality of life. Middle East Journal of Rehabilitation and Health. 2016;4(1):1–6; doi: 10.17795/mejrh-41874.
Paolucci S, Iosa M, Toni D, et al. Prevalence and time course of post-stroke pain: A multicenter prospective hospital-based study. Pain Medicine (United States). 2016;17(5):924–30; doi: 10.1093/pm/pnv019.
Finnerup NB, Kuner R, Jensen TS. Neuropathic pain: From mechanisms to treatment. Physiol Rev. 2021;101(1):259–301; doi: 10.1152/PHYSREV.00045.2019.
Choi HR, Aktas A, Bottros MM. Pharmacotherapy to manage central post-stroke pain. CNS Drugs. 2021;35(2):151–160; doi: 10.1007/s40263-021-00791-3.
Singer J, Conigliaro A, Spina E, et al. Central poststroke pain: A systematic review. International Journal of Stroke. 2017;12(4):343–55; doi: 10.1177/1747493017701149.
Gonzales GR. Central pain: Diagnosis and treatment strategies. 1995.
Harrison RA, Field TS. Post stroke pain: Identification, assessment, and therapy. Cerebrovasc Dis. 2015;39:190–201; doi: 10.1159/000375397.
Tang WK, Liang H, Mok V, et al. Is pain associated with suicidality in stroke? Arch Phys Med Rehabil. 2013;94(5):863–866; doi: 10.1016/j.apmr.2012.11.044.
Kemenkes RI. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Nyeri. 2019.
Hadiati D. Uji validitas dan reliabilitas stroke specific quality of life (Ss-Qol) berbahasa Indonesia pada pasien stroke. Fakultas Kedokteran Universitas Indonesia: Jakarta; 2014.
Tiksnadi BB, Triani N, Fihaya FY, et al. Validation of hospital anxiety and depression scale in an Indonesian population: A scale adaptation study. Fam Med Community Health. 2023;11(2); doi: 10.1136/fmch-2022-001775.
Widyadharma E, Adnyana O. Reliability Indonesian version of the hospital anxiety and depression scale (HADS) of stroke patients in Sanglah General Hospital Denpasar. 2013.
Widerstrom-Noga E. AAPT diagnostic criteria for central neuropathic pain. J Pain. 2017;18(12); doi: 10.1016/j.jpain.2017.06.003.
Kumar M, Kumar A, Saroj U, et al. A Study on the clinical profiles of patients with cerebrovascular accident (stroke) in a tertiary care hospital in Jharkhand. Cureus. 2023; doi: 10.7759/cureus.35919.
Bashir AH, Abdullahi A, Abba MA, et al. Central poststroke pain: Its profile among stroke survivors in Kano, Nigeria. Behavioural Neurology. 2017;2017; doi: 10.1155/2017/9318597.
Bhattacharyya R, Goswami S, Ghosh KC, et al. Clinical features and imaging of central poststroke pain. 2016. Available from: https://www.indianjpain.org/article.asp?issn=0970-5333;year=2016;volume=30;issue=1;spage=34;epage=37;aulast=Bhattacharyya [Last accessed: 3/5/2022].
Kumar A, Bhoi SK, Kalita J, et al. Central poststroke pain can occur with normal sensation. Clinical Journal of Pain 2016;32(11):955–60; doi: 10.1097/AJP.0000000000000344.
Mhangara CT, Naidoo V, Ntsiea MV. The prevalence and management of central post-stroke pain at a hospital in Zimbabwe. Malawi Med J. 2020;32(3):132-8; doi: 10.4314/MMJ.V32I3.5.
Ahangar AA, Saadat P, Heidari B, et al. Sex difference in types and distribution of risk factors in ischemic and hemorrhagic stroke. International Journal of Stroke. 2018;13(1):83–6; doi: 10.1177/1747493017724626.
Dotson AL, Offner H. Sex differences in the immune response to experimental stroke: Implications for translational research. J Neurosci Res. 2017;95(1–2):437–46; doi: 10.1002/jnr.23784.
Ru X, Wang W, Sun H, et al. Geographical difference, rural-urban transition and trend in stroke prevalence in China: Findings from a National Epidemiological Survey of Stroke in China. Sci Rep. 2019;9(1); doi: 10.1038/s41598-019-53848-1.
Farooq A, Tariq M, Sultan S, et al. Frequency of undiagnosed diabetes mellitus in patients presenting with acute stroke in a medical emergency. Pakistan Journal of Medical and Health Sciences. 2022;16(6):707–8; doi: 10.53350/pjmhs22166707.
Turana Y, Tengkawan J, Chia YC, et al. Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. J Clin Hypertens (Greenwich). 2021;23(3):513–21; doi: 10.1111/JCH.14099.
Bang OY. Considerations when subtyping ischemic stroke in Asian patients. Journal of Clinical Neurology (Korea). 2016;12(2):129–36; doi: 10.3988/jcn.2016.12.2.129.
Bhattacharyya R, Goswami S, Ghosh KC, et al. Clinical features and imaging of central poststroke pain. Indian Journal of Pain. 2016;30(1):34; doi: 10.4103/0970-5333.173462.
Murphy SJ, Werring DJ. Stroke: causes and clinical features. Medicine (United Kingdom). 2020;48(9):561–6; doi: 10.1016/J.MPMED.2020.06.002.
Venketasubramanian N, Yoon BW, Pandian J, et al. Stroke epidemiology in South, east, and south-east Asia: A review. J Stroke. 2017;19(3):286–94; doi: 10.5853/jos.2017.00234.
Barbosa LM, da Silva VA, de Lima Rodrigues AL, et al. Dissecting central post-stroke pain: a controlled symptom-psychophysical characterization. Brain Commun. 2022;4(3); doi: 10.1093/braincomms/fcac090.
Jing L, Tian Y, Ren G, et al. Epidemiological features of hypertension among ischemic survivors in Northeast China: insights from a population-based study, 2017–2019. BMC Public Health. 2021;21(1); doi: 10.1186/s12889-021-11692-x.
Sadekur M, Sarkar R, Hasan M, et al. Relationship of central post-stroke pain with location and type of lesions in the brain among thalamic stroke patients. Journal of National Institute of Neurosciences Bangladesh. 2022;8(1):9–13; doi: 10.3329/jninb.v8i1.59925.
Olamoyegun MA, Akinlade AT, Fawale MB, et al. Dyslipidaemia as a risk factor in the occurrence of stroke in Nigeria: prevalence and patterns. Pan African Medical Journal. 2016;25; doi: 10.11604/PAMJ.2016.25.72.6496.
Rammal SA, Almekhlafi MA. Diabetes mellitus and stroke in the Arab world. J Taibah Univ Med Sci. 2016;11(4):295–300; doi: 10.1016/j.jtumed.2016.05.001.
Massi DG, Doumbe J, Patouokoumche RN, et al. Outcome between diabetic versus non-diabetic acute stroke in a black African population: A cohort study. World J Neurosci. 2021;11(03):231–45; doi: 10.4236/wjns.2021.113017.
Tang XN, Liebeskind DS, Towfighi A. The role of diabetes, obesity, and metabolic syndrome in stroke. Semin Neurol. 2017;37(3):267–73; doi: 10.1055/s-0037-1603753.
Wang Z, Shi Y, Liu F, et al. Diversiform etiologies for poststroke depression. Front Psychiatry. 2019;10; doi: 10.3389/fpsyt.2018.00761.
Robinson RG, Jorge RE. Post-stroke depression: A review. American Journal of Psychiatry 2016;173(3):221–31; doi: 10.1176/appi.ajp.2015.15030363.
Pan B, Jin X, Jun L, et al. The relationship between smoking and stroke: A meta-analysis. Medicine (United States). 2019;98(12); doi: 10.1097/MD.0000000000014872.
Feigin VL, Roth GA, Naghavi M, et al. Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol. 2016;15(9):913–24; doi: 10.1016/S1474-4422(16)30073-4.
Benowitz NL, Burbank AD. Cardiovascular toxicity of nicotine: implications for electronic cigarette use. Trends Cardiovasc Med. 2016;26(6):515–23; doi: 10.1016/j.tcm.2016.03.001.
Shi Y, Yang D, Zeng Y, et al. Risk factors for post-stroke depression: A meta-analysis. Front Aging Neurosci. 2017;9(Jul); doi: 10.3389/fnagi.2017.00218.
Stein LA, Goldmann E, Zamzam A, et al. Association between anxiety, depression, and post-traumatic stress disorder and outcomes after ischemic stroke. Front Neurol. 2018;9(Nov); doi: 10.3389/fneur.2018.00890.
Mulla SM, Wang L, Khokhar R, et al. Management of central poststroke pain: Systematic review of randomized controlled trials. Stroke. 2015;46(10):2853–60; doi: 10.1161/STROKEAHA.115.010259/FORMAT/EPUB.
Harno H, Haapaniemi E, Putaala J, et al. Central poststroke pain in young ischemic stroke survivors in the Helsinki young stroke registry. 2014.
Munsch F, Sagnier S, Asselineau J, et al. Stroke location is an independent predictor of cognitive outcome. Stroke. 2016;47(1):66–73; doi: 10.1161/STROKEAHA.115.011242.
Pinzon RT, Sanyasi RDL, Totting S. The prevalence and determinant factors of post-stroke cognitive impairment. Asian Pacific Journal of Health Sciences. 2018;5(1):78–83; doi: 10.21276/apjhs.2018.5.1.17.
Turk DC, Fillingim RB, Ohrbach R, et al. Assessment of psychosocial and functional impact of chronic pain. Journal of Pain. 2016;17(9):T21–T49; doi: 10.1016/j.jpain.2016.02.006.
Lee J, Green BM, Palmarella G, et al. Negative impact of chronic pain: The role of locus of control and perceived family validation of chronic pain. Health Psychol Open. 2022;9(2); doi: 10.1177/20551029221125170.
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