Chronic pain syndromes after ischemic stroke: PRoFESS trial

Martin J. O'Donnell, Hans Christoph Diener, Ralph L Sacco, Akbar A. Panju, Richard Vinisko, Salim Yusuf

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE-: Chronic pain syndromes are reported to be common after stroke, but most previous epidemiological studies have generally included small cohorts of patients with relatively short-term follow-up. In a large cohort with ischemic stroke (Prevention Regimen for Effectively avoiding Second Stroke [PRoFESS] trial), we determined the prevalence, risk factors, and clinical consequence of new poststroke pain syndromes. METHODS-: Within the PRoFESS trial (mean follow-up 2.5 years), a standardized chronic pain questionnaire was administered (at the penultimate follow-up visit) to all participants who reported chronic pain since their stroke and did not have a history of chronic pain before their index stroke. Multivariable logistic regression analyses were used to determine risk factors for poststroke pain (and pain subtypes), and the association between poststroke pain and cognitive (≥3 reduction in Mini-Mental State Examination score) and functional decline (≥1 increase in m-Rankin). RESULTS-: In total, 15 754 participants were included; of which 1665 participants (10.6%) reported new chronic poststroke pain, and included 431 participants (2.7%) with central poststroke pain, 238 (1.5%) with peripheral neuropathic pain, 208 (1.3%) with pain from spasticity, and 136 participants (0.9%) with pain from shoulder subluxation. More than 1 pain subtype was reported in 86 participants (0.6%). Predictors of poststroke pain included increased stroke severity, female sex, alcohol intake, statin use, depressive symptoms, diabetes mellitus, antithrombotic regimen, and peripheral vascular disease. A new chronic pain syndrome was associated with greater dependence (odds ratio, 2.16; 95% confidence interval, 1.82-2.56). Peripheral neuropathy and pain from spasticity/shoulder subluxation were associated with cognitive decline. CONCLUSIONS-: Chronic pain syndromes are common after ischemic stroke and are associated with increased functional dependence and cognitive decline.

Original languageEnglish
Pages (from-to)1238-1243
Number of pages6
JournalStroke
Volume44
Issue number5
DOIs
StatePublished - May 1 2013

Fingerprint

Chronic Pain
Stroke
Pain
Shoulder Pain
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Peripheral Vascular Diseases
Neuralgia
Peripheral Nervous System Diseases
Epidemiologic Studies
Diabetes Mellitus
Logistic Models
Odds Ratio
Regression Analysis
Alcohols
Confidence Intervals
Depression

Keywords

  • epidemiology
  • ischemic stroke
  • pain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

O'Donnell, M. J., Diener, H. C., Sacco, R. L., Panju, A. A., Vinisko, R., & Yusuf, S. (2013). Chronic pain syndromes after ischemic stroke: PRoFESS trial. Stroke, 44(5), 1238-1243. https://doi.org/10.1161/STROKEAHA.111.671008

Chronic pain syndromes after ischemic stroke : PRoFESS trial. / O'Donnell, Martin J.; Diener, Hans Christoph; Sacco, Ralph L; Panju, Akbar A.; Vinisko, Richard; Yusuf, Salim.

In: Stroke, Vol. 44, No. 5, 01.05.2013, p. 1238-1243.

Research output: Contribution to journalArticle

O'Donnell, MJ, Diener, HC, Sacco, RL, Panju, AA, Vinisko, R & Yusuf, S 2013, 'Chronic pain syndromes after ischemic stroke: PRoFESS trial', Stroke, vol. 44, no. 5, pp. 1238-1243. https://doi.org/10.1161/STROKEAHA.111.671008
O'Donnell MJ, Diener HC, Sacco RL, Panju AA, Vinisko R, Yusuf S. Chronic pain syndromes after ischemic stroke: PRoFESS trial. Stroke. 2013 May 1;44(5):1238-1243. https://doi.org/10.1161/STROKEAHA.111.671008
O'Donnell, Martin J. ; Diener, Hans Christoph ; Sacco, Ralph L ; Panju, Akbar A. ; Vinisko, Richard ; Yusuf, Salim. / Chronic pain syndromes after ischemic stroke : PRoFESS trial. In: Stroke. 2013 ; Vol. 44, No. 5. pp. 1238-1243.
@article{3bd4d83e441a4360b706da7926cc558c,
title = "Chronic pain syndromes after ischemic stroke: PRoFESS trial",
abstract = "BACKGROUND AND PURPOSE-: Chronic pain syndromes are reported to be common after stroke, but most previous epidemiological studies have generally included small cohorts of patients with relatively short-term follow-up. In a large cohort with ischemic stroke (Prevention Regimen for Effectively avoiding Second Stroke [PRoFESS] trial), we determined the prevalence, risk factors, and clinical consequence of new poststroke pain syndromes. METHODS-: Within the PRoFESS trial (mean follow-up 2.5 years), a standardized chronic pain questionnaire was administered (at the penultimate follow-up visit) to all participants who reported chronic pain since their stroke and did not have a history of chronic pain before their index stroke. Multivariable logistic regression analyses were used to determine risk factors for poststroke pain (and pain subtypes), and the association between poststroke pain and cognitive (≥3 reduction in Mini-Mental State Examination score) and functional decline (≥1 increase in m-Rankin). RESULTS-: In total, 15 754 participants were included; of which 1665 participants (10.6{\%}) reported new chronic poststroke pain, and included 431 participants (2.7{\%}) with central poststroke pain, 238 (1.5{\%}) with peripheral neuropathic pain, 208 (1.3{\%}) with pain from spasticity, and 136 participants (0.9{\%}) with pain from shoulder subluxation. More than 1 pain subtype was reported in 86 participants (0.6{\%}). Predictors of poststroke pain included increased stroke severity, female sex, alcohol intake, statin use, depressive symptoms, diabetes mellitus, antithrombotic regimen, and peripheral vascular disease. A new chronic pain syndrome was associated with greater dependence (odds ratio, 2.16; 95{\%} confidence interval, 1.82-2.56). Peripheral neuropathy and pain from spasticity/shoulder subluxation were associated with cognitive decline. CONCLUSIONS-: Chronic pain syndromes are common after ischemic stroke and are associated with increased functional dependence and cognitive decline.",
keywords = "epidemiology, ischemic stroke, pain",
author = "O'Donnell, {Martin J.} and Diener, {Hans Christoph} and Sacco, {Ralph L} and Panju, {Akbar A.} and Richard Vinisko and Salim Yusuf",
year = "2013",
month = "5",
day = "1",
doi = "10.1161/STROKEAHA.111.671008",
language = "English",
volume = "44",
pages = "1238--1243",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Chronic pain syndromes after ischemic stroke

T2 - PRoFESS trial

AU - O'Donnell, Martin J.

AU - Diener, Hans Christoph

AU - Sacco, Ralph L

AU - Panju, Akbar A.

AU - Vinisko, Richard

AU - Yusuf, Salim

PY - 2013/5/1

Y1 - 2013/5/1

N2 - BACKGROUND AND PURPOSE-: Chronic pain syndromes are reported to be common after stroke, but most previous epidemiological studies have generally included small cohorts of patients with relatively short-term follow-up. In a large cohort with ischemic stroke (Prevention Regimen for Effectively avoiding Second Stroke [PRoFESS] trial), we determined the prevalence, risk factors, and clinical consequence of new poststroke pain syndromes. METHODS-: Within the PRoFESS trial (mean follow-up 2.5 years), a standardized chronic pain questionnaire was administered (at the penultimate follow-up visit) to all participants who reported chronic pain since their stroke and did not have a history of chronic pain before their index stroke. Multivariable logistic regression analyses were used to determine risk factors for poststroke pain (and pain subtypes), and the association between poststroke pain and cognitive (≥3 reduction in Mini-Mental State Examination score) and functional decline (≥1 increase in m-Rankin). RESULTS-: In total, 15 754 participants were included; of which 1665 participants (10.6%) reported new chronic poststroke pain, and included 431 participants (2.7%) with central poststroke pain, 238 (1.5%) with peripheral neuropathic pain, 208 (1.3%) with pain from spasticity, and 136 participants (0.9%) with pain from shoulder subluxation. More than 1 pain subtype was reported in 86 participants (0.6%). Predictors of poststroke pain included increased stroke severity, female sex, alcohol intake, statin use, depressive symptoms, diabetes mellitus, antithrombotic regimen, and peripheral vascular disease. A new chronic pain syndrome was associated with greater dependence (odds ratio, 2.16; 95% confidence interval, 1.82-2.56). Peripheral neuropathy and pain from spasticity/shoulder subluxation were associated with cognitive decline. CONCLUSIONS-: Chronic pain syndromes are common after ischemic stroke and are associated with increased functional dependence and cognitive decline.

AB - BACKGROUND AND PURPOSE-: Chronic pain syndromes are reported to be common after stroke, but most previous epidemiological studies have generally included small cohorts of patients with relatively short-term follow-up. In a large cohort with ischemic stroke (Prevention Regimen for Effectively avoiding Second Stroke [PRoFESS] trial), we determined the prevalence, risk factors, and clinical consequence of new poststroke pain syndromes. METHODS-: Within the PRoFESS trial (mean follow-up 2.5 years), a standardized chronic pain questionnaire was administered (at the penultimate follow-up visit) to all participants who reported chronic pain since their stroke and did not have a history of chronic pain before their index stroke. Multivariable logistic regression analyses were used to determine risk factors for poststroke pain (and pain subtypes), and the association between poststroke pain and cognitive (≥3 reduction in Mini-Mental State Examination score) and functional decline (≥1 increase in m-Rankin). RESULTS-: In total, 15 754 participants were included; of which 1665 participants (10.6%) reported new chronic poststroke pain, and included 431 participants (2.7%) with central poststroke pain, 238 (1.5%) with peripheral neuropathic pain, 208 (1.3%) with pain from spasticity, and 136 participants (0.9%) with pain from shoulder subluxation. More than 1 pain subtype was reported in 86 participants (0.6%). Predictors of poststroke pain included increased stroke severity, female sex, alcohol intake, statin use, depressive symptoms, diabetes mellitus, antithrombotic regimen, and peripheral vascular disease. A new chronic pain syndrome was associated with greater dependence (odds ratio, 2.16; 95% confidence interval, 1.82-2.56). Peripheral neuropathy and pain from spasticity/shoulder subluxation were associated with cognitive decline. CONCLUSIONS-: Chronic pain syndromes are common after ischemic stroke and are associated with increased functional dependence and cognitive decline.

KW - epidemiology

KW - ischemic stroke

KW - pain

UR - http://www.scopus.com/inward/record.url?scp=84876877615&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876877615&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.111.671008

DO - 10.1161/STROKEAHA.111.671008

M3 - Article

C2 - 23559265

AN - SCOPUS:84876877615

VL - 44

SP - 1238

EP - 1243

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 5

ER -