Predicting chronic post-stroke pain using advanced neuroimaging

• Research type

  Research Study

• Full title

  Mechanism-based prediction of chronic post-stroke pain using advanced neuroimaging techniques

• IRAS ID

  320112

• Contact name

  Andrew Marshall

• Contact email

  andrew.marshall@liverpool.ac.uk

• Sponsor organisation

  University of Liverpool

• Duration of Study in the UK

  2 years, 11 months, 30 days

• Research summary

  Central post-stroke pain (CPSP) is a chronic condition which develops in 8% to 18% of stroke patients. Why some patients develop CPSP after a stroke and others do not is poorly understood. CPSP contributes to reduced quality of life and functioning in stroke patients (SPa) and unfortunately is difficult to treat. Transcranial Magnetic Stimulation (rTMS) has been trialled as a treatment. rTMS utilises non-invasive magnetic pulses to selectively inhibit specific brain areas. Some studies have shown CPSP alleviation when targeting the motor movement area of the brain, but there is variability in effectiveness between subjects.
  The aim of this study is to use advanced brain imaging methods and analysis combined with careful clinical assessment and sensory testing to determine why patients develop CPSP. We will focus on a newly identified area of the brain, called BA3a, that we believe plays an important role in generating the symptoms of pain. We will also determine whether inadvertent targeting of BA3a is the reason why rTMS is beneficial in treating CPSP.
  Four groups of participants will be recruited through local NHS Trusts: SPa with CPSP, SPa with non-neuropathic pain, SPa without pain and healthy controls. In the first part of the study, all groups will be invited to Aintree University Hospital for initial questionnaires and detailed Sensory Testing to establish their sensitivity to touch, pinprick and temperature stimulation. Participants will then be invited to Liverpool Magnetic Resonance Imaging Centre to take part in Magnetic Resonance Imaging (MRI) and functional MRI (fMRI). CPSP patient MRI images will be compared with imaging scans from their patient records. The MRI scan findings are expected to contribute to the identification of biomarkers for prediction of CPSP development and treatment response.

• REC name

  North West - Preston Research Ethics Committee

• REC reference

  23/NW/0123

• Date of REC Opinion

  30 May 2023

• REC opinion

  Further Information Favourable Opinion