Structural and Functional Grey and White Matter Changes in Patients With Pain Disorders

Structural and Functional Grey and White Matter Changes in Patients With Pain Disorders

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.

Inclusion Criteria:

1. Patients with thalamic central post-stroke pain (CPSP) :

   Patients fulfilling all of the following inclusion criteria are eligible for the study:

   • Informed Consent as documented by signature (Appendix Informed Consent Form)
   • History of thalamic stroke (infarction or bleed)
   • Diagnosis of definite central-post stroke pain (according to the criteria proposed by Klit et al, 2009)
   • No other chronic pain condition
   • Age: ≥18 years old

2. Patients with thalamic stroke without CPSP:

   Patients fulfilling all of the following inclusion criteria are eligible for the study:

   • Informed Consent as documented by signature (Appendix Informed Consent Form)
   • History of thalamic stroke (infarction or bleed), at least 2 years ago
   • No chronic pain condition (neither CPSP or other pain condition)
   • Age ≥18 years old

3. Patients with migraine (other pain condition):

   Patients fulfilling all of the following inclusion criteria are eligible for the study:

   • Informed Consent as documented by signature (Appendix Informed Consent Form)
   • History of highly frequent (≥8 monthly migraine days) or chronic migraine (≥15 monthly migraine days).
   • No history of stroke
   • Age ≥18 years old

4. Healthy controls:

Participants fulfilling all of the following inclusion criteria are eligible for the study:

• Informed Consent as documented by signature (Appendix Informed Consent Form)
• No history of stroke
• No chronic pain condition
• Age: ≥18 years old

Exclusion Criteria:

• History of severe neurological, internistic or psychiatric disease

• MRI related exclusion criteria:

  • paramagnetic and/or superparamagnetic foreign objects in the body (especially when located close to the brain)
  • Pacemaker
  • Claustrophobia
  • Pregnancy