Is there a relationship between somatosensory impairment and the perception of pain in stroke survivors? An exploratory study

Fatima-Tul Zahra; Leeanne M Carey; Brendon Haslam; Maryam Zoghi

doi:10.1097/MRR.0000000000000629

Is there a relationship between somatosensory impairment and the perception of pain in stroke survivors? An exploratory study

Int J Rehabil Res. 2024 Apr 29. doi: 10.1097/MRR.0000000000000629. Online ahead of print.

Authors

Fatima-Tul Zahra¹, Leeanne M Carey^{1

2}, Brendon Haslam^{1

2}, Maryam Zoghi^{3

4}

Affiliations

¹ Discipline of Occupational therapy, School of Allied Health, Human Services and Sport, La Trobe University.
² Neurorehabilitation and Recovery, Florey Institute , The University of Melbourne, Melbourne.
³ Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University, Victoria.
⁴ Department of Physiotherapy, Podiatry, and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.

PMID: 38682376
DOI: 10.1097/MRR.0000000000000629

Abstract

Pain and somatosensory impairments are commonly reported following stroke. This study investigated the relationship between somatosensory impairments (touch detection, touch discrimination and proprioceptive discrimination) and the reported presence and perception of any bodily pain in stroke survivors. Stroke survivors with somatosensory impairment (N = 45) completed the Weinstein Enhanced Sensory Test (WEST), Tactile Discrimination Test, and Wrist Position Sense Test for quantification of somatosensation in both hands and the McGill Pain Questionnaire, visual analog scale and the Neuropathic Pain Symptom Inventory (NPSI) for reporting presence and perception of pain. No relationship was observed between somatosensory impairment (affected contralesional hand) of touch detection, discriminative touch or proprioceptive discrimination with the presence or perception of pain. However, a weak to moderate negative relationship between touch detection in the affected hand (WEST) and perception of pain intensity (NPSI) was found, suggesting that stroke survivors with milder somatosensory impairment of touch detection, rather than severe loss, are likely to experience higher pain intensity [rho = -0.35; 95% confidence interval (CI), -0.60 to -0.03; P = 0.03]. Further, a moderate, negative relationship was found specifically with evoked pain (NPSI) and touch detection in the affected hand (rho = -0.43; 95% CI, -0.72 to -0.02; P = 0.03). In summary, our findings indicate a weak to moderate, albeit still uncertain, association, which prevents making a definitive conclusion. Nevertheless, our findings contribute to our understanding of the complexities surrounding the experience of pain in survivors of stroke and provide direction for future studies.