Cutaneous temperature sensitivity alteration in subjects with chronic stroke sequelae – pharmacological perspectives

Artur Cesar Aquino Santos; Fábio Marcon Alfieri; Linamara Rizzo Battistella

doi:10.1515/jbcpp-2016-0179

Article

Cutaneous temperature sensitivity alteration in subjects with chronic stroke sequelae – pharmacological perspectives

Artur Cesar Aquino Santos , Fábio Marcon Alfieri and Linamara Rizzo Battistella

Published/Copyright: August 3, 2017

Published by

Become an author with De Gruyter Brill

Submit Manuscript Author Information Explore this Subject

From the journal Journal of Basic and Clinical Physiology and Pharmacology Volume 28 Issue 5

Abstract

Background:

Stroke can result in body temperature sensitivity changes. This study analyzed abnormal temperature perception of patients with stroke and the use of vasoactive drugs.

Methods:

A cross-sectional retrospective study was carried out consisting of 100 patients (55.6±12.9 years old), from both genres, with either hemorrhagic or ischemic stroke, with unilateral hemiplegia or hemiparesis. Subjects had axillary temperature and different temperature sensitivities of the limbs measured using a visual analog scale (VAS). Information on the use of medical drugs was collected in clinical records.

Results:

In total, 64 patients reported body temperature alterations, and 62 patients stated they feel cold in the affected side. They reported 6.12±2.44 cm alteration for the upper limb and 6.72±2.44 cm for the lower limb in the VAS. Some 86 different drugs were identified in the 85 medical records available. There was a prevalence of a group of drugs formed by the β-blockers, dopamine agonists, dopamine reuptake Inhibitors, tricyclic antidepressants (TCAs) and another group formed by the selective serotonin reuptake inhibitors.

Conclusions:

Most of the subjects reported a sensation of cold in the affected limbs. The β-blockers, dopamine agonists, dopamine reuptake inhibitors, and TCAs seem to be related to this sensation, however, due to the number of uncontrolled variables that may be related to these drugs and the possible role of nitric oxide, it was not possible to establish precise relations regarding the use of a specific group of drugs and the cold sensation in the affected limbs, as reported by the patients.

Keywords: medical drugs; stroke; temperature sensitivity

Corresponding author: Fábio Marcon Alfieri, PhD, Researcher, Faculdade de Medicina, Clinical Research Center, Instituto de Medicina Física e de Reabilitação do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil, Phone/Fax: +55 (11) 3905-8616

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Fujita K, Yamamoto T, Kamezaki T, Matsumura A. Efficacy of Keishibukuryogan, a traditional Japanese herbal medicine, in treating cold sensation and numbness after stroke: clinical improvement and skin temperature normalization in 22 stroke patients. Neurol Med Chir 2010;50:1–6.10.2176/nmc.50.1Search in Google Scholar PubMed

2. Wanklyn P, Ilsley DW, Greennstein D, Hampton IF, Roper TA, Kester RC, et al. The cold hemipleg arm. Stroke 1994;25: 1765–70.10.1161/01.STR.25.9.1765Search in Google Scholar PubMed

3. Wanklyn P, Forster A, Young J, Mulley G. Prevalence and associated features of the cold hemiplegic arm. Stroke 1995;26:1867–70.10.1161/01.STR.26.10.1867Search in Google Scholar PubMed

4. Naver H, Blomstrand C, Ekholm S, Jensen C, Karlsson T, Wallin G. Autonomic and thermal sensory symptoms and dysfunction after stroke. Stroke 1995;26:1379–85.10.1161/01.STR.26.8.1379Search in Google Scholar

5. Bucy P. Vasomotor changes associated with paralysis of cerebral origin. Arch Neurol Psychiatry 1935;33:30–52.10.1001/archneurpsyc.1935.02250130036003Search in Google Scholar

6. Thurston N, Kent B, Jewell M, Blood H. Thermographic evaluation of the painful shoulder in the hemiplegic patient. Phys Ther 1988; 66:1376–81.10.1093/ptj/66.9.1376Search in Google Scholar PubMed

7. Korpelainen JT, Sotaniemi KA, Myllylä VV. A symmetrical skin temperature in ischemic stroke. Stroke 1995;26:1543–47.10.1161/01.STR.26.9.1543Search in Google Scholar

8. Mulley G. Axillary temperature differences in hemiplegia. Postgrad Med J 1980;46:248–9.10.1136/pgmj.56.654.248Search in Google Scholar PubMed PubMed Central

9. Toki K, Yamai T, Fukai K. Skin temperature changes during a footbath in patients who had had a stroke with consequent sensory impairment. Jpn J Nurs Sci 2015;12:276–86.10.1111/jjns.12066Search in Google Scholar PubMed

10. Chapman RS, Syrjala KL. Measurement of pain. In: Bonica JJ, editor. The management of pain. London: Lea and Febiger, 1990:580–94.Search in Google Scholar

11. Rang HP, Dale MM, Ritter JM, Moore PK. Pharmacology, 5th ed. New York: Churchill Livingstone, 2003.Search in Google Scholar

12. Tagawa T, Imaizumi T, Endo T, Shiramoto M, Harasawa Y, Takeshita A. Role of nitric oxide in reactive hyperemia in human forearm vessels. Circulation 1994;90:2285–90.10.1161/01.CIR.90.5.2285Search in Google Scholar PubMed

13. Förstermann U, Closs EI, Pollock JS, Nakane M, Schwarz P, Gath I, et al. Nitric oxide synthase isozymes: characterization, purification, molecular cloning, and functions. Hypertension 1994;23:1121–31.10.1161/01.HYP.23.6.1121Search in Google Scholar

Received: 2016-11-25

Accepted: 2017-5-29

Published Online: 2017-8-3

Published in Print: 2017-9-26

You are currently not able to access this content.

Articles in the same Issue

https://doi.org/10.1515/jbcpp-2016-0179

Keywords for this article

medical drugs; stroke; temperature sensitivity