Prognosis of Pain after Stroke during Rehabilitation Depends on the Pain Quality.

OBJECTIVE: Pain after a stroke interferes with daily life and the rehabilitation process. This study aimed to clarify the prognosis of pain in subgroups of patients with pain after a stroke using pain quality data. METHODS: The study included 85 patients with pain after stroke undergoing exercise-based rehabilitation. Items of the Neuropathic Pain Symptom Inventory (NPSI) were used, and patients with pain after stroke were clustered according to their scores of NPSI. Other clinical assessments, such as physical and psychological conditions, were assessed by interviews and questionnaires, and then these were compared among subgroups in a cross-sectional analysis. Longitudinal pain intensity in each subgroup was recorded during 12 weeks after the stroke and the patients' pain prognoses were compared between subgroups. RESULTS: Four distinct subgroups were clustered: cluster 1 (cold-evoked pain and tingling), cluster 2 (tingling only), cluster 3 (pressure-evoked pain), and cluster 4 (deep muscle pain with a squeezing and pressure sensation). The cross-sectional analysis showed varying clinical symptoms among the subgroups, with differences in the prevalence of joint pain, limited range of motion, somatosensory dysfunction, and allodynia. There were no significant differences in pain intensity at baseline among the subgroups. A longitudinal analysis showed divergent prognoses of pain intensity among the subgroups. The pain intensity in cluster 4 was significantly alleviated, which suggested that musculoskeletal pain could be reduced with conventional exercise-based rehabilitation. However, the pain intensity of patients in clusters 1 and 2 remained over 12 weeks. CONCLUSION: The study classified patients into clinically meaningful subgroups using pain quality data and provided insight into their prognosis of pain. The findings could be useful for guiding personalized rehabilitation strategies for pain management. IMPACT: Assessment of pain quality in patients with pain after stroke leads to personalized rehabilitation for pain management.

Imaging features inferring symptom onset due to spinal metastasis progression: a preliminary study.

BACKGROUND: Spinal metastases can cause intractable pain and neurological deficits, which can markedly worsen both patients' activities of daily living (ADL) and their health-related quality of life (QOL). Early intervention is essential to prevent irreversible neurological deficits and pain associated with spinal metastases. We investigated the imaging features of spinal metastases that led to neurological deficits. METHODS: We analyzed axial cross-sectional computed tomography (CT) images of cervical and thoracic spinal metastases in patients with and without lower limb motor paralysis, neuropathic pain, and local nociceptive pain. We distinguished regions of the spine associated with these respective symptoms, and explored their inferable performance using images obtained before symptom onset. In addition, we analyzed the imaging features and type of bone metastasis (osteolytic and osteoblastic). RESULTS: Spinal lesions occupied the area in and around the spinal canal and around the pedicle in patients with motor paralysis. Lesions around the pedicle and in the most posterior vertebral body part before symptom onset were inferable. In patients with neuropathic pain, spinal metastases spread along the pedicle before symptom onset, and had surrounded the spinal canal circumferentially at symptom onset. Local nociceptive pain was more common near the center of the vertebral body either at or before symptom onset. There was no difference in the imaging features according to the type of bone metastasis. CONCLUSIONS: Lesions in certain regions in the asymptomatic metastatic spine can indicate the onset of spinal metastasis-related symptoms in the next few months. Early therapeutic intervention might be applied to prevent neurological disorder.

Fourier transform two-dimensional fluorescence excitation spectrometer by using tandem Fabry-Pérot interferometer.

A Fourier transform two-dimensional fluorescence excitation spectrometer (FT-2DFES) was developed based on the multiplex technique using a tandem Fabry-Pérot interferometer (tandem FPI). In addition to the advantage of the multiplex technique, the main advantage of the tandem FPI is applicable to the modulation of transition with a large absorption bandwidth (larger than 100 nm) and is thus applicable to the modulation of the excitation of molecules in the condensed phase. As a demonstration of the effectiveness of FT-2DFES, we succeeded in separately observing the fluorescence excitation peaks from a mixed methanol solution of laser dyes (coumarin 480, rhodamine 6G, DCM (4-dicyanomethylene-2-methyl-6-(p-(dimethylamino)styryl)-4H-pyran), and LDS750). Furthermore, the energy transfer from rhodamine 6G to LDS750 was observed.

Polarity controlled reaction path and kinetics of thermal cis-to-trans isomerization of 4-aminoazobenzene.

Spectral and kinetic behavior of thermal cis-to-trans isomerization of 4-aminoazobenzene (AAB) is examined in various solvents of different polarities. In contrast to azobenzene (AB), it is found the rate of thermal isomerization of AAB is highly dependent on solvent polarity. Accelerated rates are observed in polar solvents as compared to nonpolar solvents. Moreover, a decrease in the barrier height with an increase in medium polarity is observed. Our observations suggest that inversion is the preferred pathway in cis-to-trans thermal isomerization in a nonpolar medium; however, in a polar medium, the isomerization path deviates from the inversion route and rotational behavior is incorporated. Differences in the kinetics and in mechanisms of isomerization in different media are rationalized in terms of modulation in barrier height by polarity of the medium and solute-solvent interaction. It is found that kinetics as well as the mechanism of thermal isomerization in AAB is controlled by the polarity of the medium.

Cross-term selective, two-pulse correlation measurements by phase-shifted parallel modulation for analysis of a multi-photon process.

We propose a new modulation technique for phase-sensitive detection to extract a cross-term signal appearing in multi-pulse experiments and demonstrate the selective detection of cross-term signal on two-pulse correlation measurements. This modulation technique can be widely applied to the selective detection in multi-beam laser experiments such as two-pulse correlation, auto-correlation, and double-resonance experiments, because the selectivity can be realized by using a conventional single-frequency mechanical chopper and 2f phase-sensitive detection. The effectiveness of the proposed technique was confirmed by two-pulse correlation measurements of two-photon-excited fluorescence from rhodamine 6G. In addition to the selective observation of a correlation peak, the technique succeeded in observing a weak correlation background. By combining asymmetric, two-pulse correlation measurements with the proposed technique, it was clarified that the background was produced by a three-photon process and assigned to fluorescence depletion caused by an up-conversion process. The results indicate that the cross-term selective, two-pulse correlation method that is based on the phase-shifted parallel modulation technique is powerful tool to find and analyze a high-order optical event buried in a low-order optical event.