Sensory changes, C-and A-fiber function, and shoulder-hand syndrome in hemiplegic patients after stroke

作     者：Yi Yuan Xiaohong Zi Xian Huang 

作者机构：Department of Neurology the Third Xiangya Hospital Central South University Changsha 410013 Hunan Province China 

出 版 物：《Neural Regeneration Research》 (中国神经再生研究（英文版）)

年 卷 期：2008年第3卷第7期

页      面：760-763页

核心收录：

学科分类：0710[理学-生物学] 07[理学] 071006[理学-神经生物学] 

基　　金：This study belongs under the sub-topic of"Treatment and assessment of stroke under biol-ogy-psychology-society pattern" that has received the Third-class Award of Medical Science and Technology of Hu’nan Province  No. 200203-U-08 

主　　题：shoulder-hand syndrome stroke quantitative sensory testing 

摘      要：BACKGROUND： Clinical diagnosis of various neurological disorders involving the sensory nerves depends primarily on subjective description, which cannot be quantitatively evaluated, and is also less reproducible and specific. Quantitative sensory testing methods can overcome these shortcomings and is currently used to identify the function of the C- and A-fibers. OBJECTIVE： To apply the quantitative sensory testing method for analyzing changes in temperature sensation, cryalgesia, thermalgesia, and vibration sense on the skin surface of hemiplegic patients with post-stroke shoulder-hand syndrome, and to analyze the relationship between these changes and shoulder-hand syndrome. DESIGN, TIME AND SETTING： A non-randomized, concurrent, control study was performed at the Clinic and Inpatient Department of the Third Xiangya Hospital, Central South University, between June 2000 and April 2001. PARTICIPANTS： Thirty post-stroke, hemiplegic patients were divided into shoulder-hand syndrome and control groups, according to whether patients exhibited shoulder-hand syndrome, with 15 patients in each group. METHODS： A TSA2001 quantitative sensory testing device （Medoc, Israel） was used for quantitative sensory testing. All sensory testing employed limits, testing temperature sense on the palm thenar eminence and vibration sense on the thumb metacarpal. Cold threshold was ≤ 28 ℃, warmth threshold was ≥ 36 ℃, cold-evoked pain threshold was ≤ 5 ℃, heat-evoked pain threshold was ≥ 51 ℃, vibration threshold was ≥ 5 μm/s; if a patient met one of these items, he/she was considered to be hypoanesthesia. MAIN OUTCOME MEASURES： Cold, warm, cold-evoked pain, heat-evoked pain and vibration threshold changes on skin from the paralyzed upper extremity was measured in the shoulder-hand syndrome and control groups. RESULTS： Incidence of sensory disability in the shoulder-hand syndrome group increased more significantly than in the control group （P 〈 0.05）, with the primary manifestati