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| Name | Class |
|---|---|
| European Pain Federation | UNKNOWN |
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The goal of this observational study is to examine the association between exact lesion location and presence of thalamic CPSP (Central post-stroke pain) in a larger number of patients after thalamic stroke.
The researchers will explore how the brain areas and mechanisms of brain plasticity are involved in the generation of thalamic CPSP, compared to other pain disorders, using structural and functional magnetic resonance imaging (MRI) at 3 Tesla. The functional magnetic resonance imaging (fMRI) will be also used to assess the cerebral processing of heat/cold stimuli in patients with thalamic pain compared to thalamic stroke patients without pain, to patients with migraine (other central pain disorder) and to normal controls. In addition the researchers want to assess the somatosensory profile of thalamic pain patients and compare it with thalamic stroke patients without pain, patients with migraine (pain control) and normal controls.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with thalamic CPSP (central post-stroke pain) | Patients with CPSP of thalamic origin due to stroke. |
| |
| Patients with thalamic stroke without CPSP | Patients with thalamic stroke at least 2 years ago, but without CPSP or other chronic pain disorders |
| |
| Patients with migraine | Patients with migraine (other central pain disorder) |
| |
| Healthy controls | Age- and gender-matched healthy control subjects |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quantitative sensory testing (QST) | Diagnostic Test | The QST is a standardized, internationally accepted test battery consisting of several well-established, non-invasive tests, measuring parameters, which reflect nearly all aspects of somatosensation.
|
| Measure | Description | Time Frame |
|---|---|---|
| The exact lesion location in the thalamus in patients with thalamic pain compared to patients with thalamic stroke without pain | To determine the mutual lesion location in patients with CPSP of thalamic origin in standard stereotactic space using high-resolution 3 T MRI data and to calculate odds ratio maps for the risk of developing CPSP of thalamic origin with lesion of specific areas of the thalamus. | One time assessment with a duration of max. 90 minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| Structural gray matter changes in patients with thalamic pain compared to the other patient groups and the healthy controls | The 3 dimensional MPRAGE images will be used to assess cortical thickness and subcortical morphometry | One time assessment with a duration of max. 90 minutes. |
| Structural white matter changes in patients with thalamic pain compared to the other patient groups and the healthy controls |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of severity and characteristics of pain. | Pain characteristics will be assessed by the German pain questionnaire ("Deutscher Schmerzfragebogen"). It is a detailed questionnaire for the standardized collection of relevant pain characteristics, which is commonly used in the German language area. The first 8 items (sensory adjectives) represent a qualitative sensory description of pain that can provide information for the differential diagnosis of individual pain syndromes (e.g. headache, neuropathic pain). A summary evaluation is carried out for the affective scale. For this purpose, the total value (0-12) is formed from the individual ratings (each from 0 to 3) of the last four items (affective adjectives: miserable, horrid, horrible, terrible). A total value of 8 (corresponds to a percentage of 75%) can be set as the limit value for an increased affective experience of pain; values above this are to be assessed as conspicuous. |
Inclusion Criteria:
Patients with thalamic central post-stroke pain (CPSP) :
Patients fulfilling all of the following inclusion criteria are eligible for the study:
Patients with thalamic stroke without CPSP:
Patients fulfilling all of the following inclusion criteria are eligible for the study:
Patients with migraine (other pain condition):
Patients fulfilling all of the following inclusion criteria are eligible for the study:
Healthy controls:
Participants fulfilling all of the following inclusion criteria are eligible for the study:
Exclusion Criteria:
History of severe neurological, internistic or psychiatric disease
MRI related exclusion criteria:
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The recruitment of patients with thalamic pain will take place at the Department of Neurology, University Hospital Basel in collaboration with the chronic pain service of the Department of Anesthesiology, University Hospital Basel and the "Schmerzklinik Kirschgarten" in Basel. The recruitment of patients with thalamic stroke without pain as well as of patients with migraine (other pain disorder) will take place at the Department of Neurology, University Hospital Basel, the latter especially from the "Kopfsprechstunde". Healthy subjects will be recruited by public announcements on the University Hospital's and the University's notice board and website.
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| Name | Affiliation | Role |
|---|---|---|
| Athina Papadopoulou, PD Dr. med. | University Hospital Basel, Department of Neurology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Basel, Department of Neurology | Basel | 4031 | Switzerland |
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| ID | Term |
|---|---|
| D059350 | Chronic Pain |
| D013001 | Somatoform Disorders |
| D008881 | Migraine Disorders |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D008279 | Magnetic Resonance Imaging |
| ID | Term |
|---|---|
| D014054 | Tomography |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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|
| Magnetic resonance imaging (MRI) | Diagnostic Test | Functional and structural MRI data will be collected using a 3 Tesla Siemens Scanner with a multi-channel head coil. For the resting state functional MRI the subjects will merely lie in the scanner for about 10 minutes. A "painful heat/cold stimulation" will be performed to study the differences in pain processing between the three groups |
|
| Clinical interview/exam | Other | The pain characteristics will be assessed through a standardized questionnaire. The german pain questionnaire is a validated questionnaire that assesses various dimensions of pain. Patients will also get a complete neurological examination by an experienced clinician. |
|
| Follow-up interview | Other | Structured telephone interview with 3 Questionnaires
|
|
Diffusion Tensor Imaging (DTI) will be used to asess the integrity of the white matter |
| One time assessment with a duration of max. 90 minutes. |
| Functional brain changes regarding the connectivity of pain networks in patients with thalamic pain compared to the other patient groups and the healthy controls | Resting state fMRI (functional MRI) will be used to assess the functional connectivity between the thalamus and cortical areas next to the default-mode network and the sensory-motor network. | One time assessment with a duration of max. 90 minutes. |
| Functional brain changes regarding the central processing of heat/cold stimulation in patients with thalamic pain compared to the other patient groups and the healthy controls | Painful heat- and cold stimulation will be performed during the fMRI session at one time-point to assess the central processing of pain in all participants | One time assessment with a duration of max. 90 minutes. |
| Somatosensory profile of patients with thalamic pain vs. migraine (pain-control-group) | Somatosensory profile will be assessed by quantitative sensory testing (QST). This standardized, internationally accepted test battery consists of well-established, non-invasive tests, which are performed on the face, hand or foot of the participants. The tests measure parameters which reflect nearly all aspects of somatosensation (thermal detection thresholds, thermal pain thresholds, mechanical detection thresholds for touch, mechanical pain threshold, mechanical allodynia, vibration detection threshold and pressure pain threshold). | One time assessment with a duration of max. 60 minutes. |
| Two time assessment at baseline and 8-year-follow-up with a duration of max. 60 minutes. |
| Longitudinal evaluation of clinical development in CPSP | The clinical development of CPSP will be assessed by an 8-year follow-up interview via phone call. The interview/questionnaire consists of 6 questions. | One time assessment with a duration of max. 10 minutes. |
| D001523 | Mental Disorders |
| D051270 | Headache Disorders, Primary |
| D020773 | Headache Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |