Review Notes: 

Central Post-Stroke Pain (CPSP)

This page includes notes based on internet research with AI guidance. Information provided here should be confirmed and reviewed with one’s physician prior to engaging treatment of Central post-stroke pain.

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Definitions and Terms Related to Pain

 

Central Post-Stroke Pain (CPSP)

Central Post-Stroke Pain (CPSP) is a chronic neuropathiP pain syndrome following stroke, often presenting with persistent dysesthesia and pain in areas corresponding to the stroke lesion. CPSP is frequently resistant to pharmacological treatment, and monotherapy with antidepressants or anticonvulsants often provides incomplete relief or is limited by adverse effects.

The Most Effective Treatments for Unilateral Central Post-Stroke Pain

First-line pharmacological treatments

First-line pharmacological treatments for unilateral central post-stroke pain are antidepressants (such as duloxetine and amitriptyline) and anticonvulsants (including gabapentin, pregabalin, and lamotrigine), with duloxetine and amitriptyline supported by the most robust evidence for effectiveness.[1][2][3][4] Duloxetine has demonstrated significant pain reduction in randomized controlled trials, and amitriptyline is frequently recommended based on clinical experience and meta-analyses.

  • Pregabalin, gabapentin, lamotrigine, duloxetine, and amitriptyline have the strongest evidence for efficacy and safety in unilateral central post-stroke pain.
  • Pregabalin and gabapentin are most effective for pain reduction but have higher rates of adverse effects.
  • Amitriptyline is effective but less well tolerated.
  • Lamotrigine and duloxetine offer good efficacy with favorable safety profiles.
The approach to using lamotrigine involves starting with a low amount and gradually increasing it over time. This gradual increase is a critical step to help reduce the risk of serious side effects, particularly severe skin rashes, which can include Stevens-Johnson Syndrome. 

The schedule for increasing the amount of lamotrigine can vary depending on whether the patient is taking other medications that might interact with how the body processes lamotrigine. For example, certain medications like valproic acid can affect how the body handles lamotrigine, requiring adjustments in how it is administered. Conversely, other medications, such as carbamazepine or phenytoin, can speed up how the body processes lamotrigine, which also necessitates a modified approach to increasing the amount used. 

Clinical studies on lamotrigine for CPSPS have indicated that certain amounts may be associated with more significant effects compared to lower amounts. However, it is essential that the use of lamotrigine and any adjustments to the amount are managed by a healthcare professional who is knowledgeable about the medication and its potential interactions. They can determine the appropriate strategy based on the individual patient’s medical history and current medications. 
The gradual increase in the amount of lamotrigine is not optional; it is a mandatory safety measure. While studies suggest a potential benefit at certain levels, it’s important to note that lower amounts did not demonstrate a significant effect on pain reduction in clinical trials for CPSPS. 

 

Second-line pharmacological treatments

Recent network meta-analyses indicate that pamidronate, prednisone, and levetiracetam may be more effective than traditional agents, but these options are not yet guideline-recommended and require further investigation before routine use.[5][6] Guideline statements from the American Academy of Family Physicians note these agents as possible short- or medium-term options, but emphasize the need for more data.

 

Neuromodulation Therapy

For refractory cases, neuromodulation techniques such as repetitive transcranial magnetic stimulation and motor cortex stimulation may be considered, with moderate evidence for pain reduction but notable risks and procedural complexity.[2][7][8] These interventions are reserved for patients who do not respond to pharmacological therapy.

 

Multimodal Management

A multimodal management approach—including physical therapy and psychosocial support—is recommended for comprehensive care, although high-quality evidence for non-pharmacological interventions remains limited.[7][8][9][10] Most experts advocate for individualized treatment plans that address both pain and associated functional impairments.

There is a lack of large, multicenter, placebo-controlled trials directly comparing these treatments, and further research is needed to clarify optimal therapy and long-term outcomes.[1][2] In summary, duloxetine, amitriptyline, gabapentin, pregabalin, and lamotrigine are the most evidence-based first-line options, with other agents and neuromodulation reserved for refractory cases.

References

  1. Efficacy and Safety of Different Antidepressants and Anticonvulsants in Central Poststroke Pain: A Network Meta-Analysis and Systematic Review. Chen KY, Li RY. PloS One. 2022;17(10):e0276012. doi:10.1371/journal.pone.0276012.
  2. Management of Central Poststroke Pain: Systematic Review and Meta-Analysis. Tamasauskas A, Silva-Passadouro B, Fallon N, et al. The Journal of Pain. 2025;26:104666. doi:10.1016/j.jpain.2024.104666.
  3. Pharmacotherapy to Manage Central Post-Stroke Pain. Choi HR, Aktas A, Bottros MM. CNS Drugs. 2021;35(2):151-160. doi:10.1007/s40263-021-00791-3.
  4. Efficacy of Duloxetine in Patients With Central Post-Stroke Pain: A Randomized Double Blind Placebo Controlled Trial. Mahesh B, Singh VK, Pathak A, et al. Pain Medicine (Malden, Mass.). 2023;24(6):610-617. doi:10.1093/pm/pnac182.
  5. Pharmacotherapies for Central Post-Stroke Pain: A Systematic Review and Network Meta-Analysis. Bo Z, Jian Y, Yan L, et al. Oxidative Medicine and Cellular Longevity. 2022;2022:3511385. doi:10.1155/2022/3511385.
  6. Ischemic Stroke Management: Posthospitalization and Transition of Care. Scott T. Larson MD, Brigit E. Ray MD MME, Jason Wilbur MD. American Academy of Family Physicians (2023).
  7. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Winstein CJ, Stein J, Arena R, et al. Stroke. 2016;47(6):e98-e169. doi:10.1161/STR.0000000000000098.
  8. Advancements in Modern Treatment Approaches for Central Post-Stroke Pain: A Narrative Review. Asadauskas A, Stieger A, Luedi MM, Andereggen L. Journal of Clinical Medicine. 2024;13(18):5377. doi:10.3390/jcm13185377.
  9. Central Post-Stroke Pain: Clinical Characteristics, Pathophysiology, and Management. Klit H, Finnerup NB, Jensen TS. The Lancet. Neurology. 2009;8(9):857-68. doi:10.1016/S1474-4422(09)70176-0.
  10. Central Neuropathic Pain Syndromes: Current and Emerging Pharmacological Strategies. Gurba KN, Chaudhry R, Haroutounian S. CNS Drugs. 2022;36(5):483-516. doi:10.1007/s40263-022-00914-4.

 

Nutraceutical Supplements

There is currently no high-quality evidence supporting the use of nutraceutical supplements for the treatment of unilateral central post-stroke pain, and major guidelines do not recommend them for this indication.[1][2][3][4][5]

Systematic reviews of nutraceuticals and dietary supplements in neuropathic pain show promising results in animal models and for other neuropathic pain conditions, such as diabetic neuropathy (DPN) and chemotherapy-induced neuropathy, but no clinical trials have specifically evaluated their efficacy in central post-stroke pain.[6][7] The available human data are limited and do not address CPSP directly.

Vitamins (such as B1, B12, and coenzyme Q10 (CoQ10)) have been studied for post-stroke fatigue, but the available data are limited to small, non-randomized studies and do not address central post-stroke pain directly or provide evidence for pain relief in this population.[8]

Further research is needed to determine whether nutraceuticals have a role in the management of central post-stroke pain, as current evidence is insufficient and no supplement can be recommended at this time.[1][5][6] Pharmacological therapy with antidepressants and anticonvulsants remains the evidence-based approach.

References

  1. Management of Central Poststroke Pain: Systematic Review and Meta-Analysis. Tamasauskas A, Silva-Passadouro B, Fallon N, et al. The Journal of Pain. 2025;26:104666. doi:10.1016/j.jpain.2024.104666.
  2. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Winstein CJ, Stein J, Arena R, et al. Stroke. 2016;47(6):e98-e169. doi:10.1161/STR.0000000000000098.
  3. Advancements in Modern Treatment Approaches for Central Post-Stroke Pain: A Narrative Review. Asadauskas A, Stieger A, Luedi MM, Andereggen L. Journal of Clinical Medicine. 2024;13(18):5377. doi:10.3390/jcm13185377.
  4. Prevalence and Management Challenges in Central Post-Stroke Neuropathic Pain: A Systematic Review and Meta-Analysis. Liampas A, Velidakis N, Georgiou T, et al. Advances in Therapy. 2020;37(7):3278-3291. doi:10.1007/s12325-020-01388-w.
  5. Management of Central Poststroke Pain: Systematic Review of Randomized Controlled Trials. Mulla SM, Wang L, Khokhar R, et al. Stroke. 2015;46(10):2853-60. doi:10.1161/STROKEAHA.115.010259.
  6. The Role of Diet and Non-Pharmacologic Supplements in the Treatment of Chronic Neuropathic Pain: A Systematic Review. Frediani JK, Lal AA, Kim E, et al. Pain Practice : The Official Journal of World Institute of Pain. 2024;24(1):186-210. doi:10.1111/papr.13291.
  7. A Systematic Review and Meta-Analysis on the Role of Nutraceuticals in the Management of Neuropathic Pain in in Vivo Studies. Ilari S, Proietti S, Russo P, et al. Antioxidants (Basel, Switzerland). 2022;11(12):2361. doi:10.3390/antiox11122361.
  8. Poststroke Fatigue: Emerging Evidence and Approaches to Management: A Scientific Statement for Healthcare Professionals From the American Heart Association. Hinkle JL, Becker KJ, Kim JS, et al. Stroke. 2017;48(7):e159-e170. doi:10.1161/STR.0000000000000132.

Summary of the latest research on pharmacological treatments

Recent systematic reviews and network meta-analyses indicate that pregabalin, gabapentin, lamotrigine, duloxetine, and amitriptyline have the strongest evidence for efficacy among pharmacological treatments for unilateral central post-stroke pain, with pregabalin and gabapentin ranking highest for pain reduction but also associated with more adverse effects.[1][2][3]

Pregabalin and gabapentin consistently show significant pain reduction in both direct and indirect comparisons, though adverse reactions (e.g., dizziness, somnolence) are more frequent. Lamotrigine (Lamictal) is supported by multiple randomized controlled trials and meta-analyses as effective, with a favorable safety profile and is often cited as having the strongest evidence among anticonvulsants.[1][3][4] Duloxetine has demonstrated efficacy in a recent randomized controlled trial, showing significant improvement in pain scores and disability compared to placebo, with good tolerability at doses of 30–60 mg daily.[5] Amitriptyline remains a first-line agent per guidelines and meta-analyses, but its use is limited by anticholinergic side effects and tolerability, especially in older patients.[3][6][7][8]

Other agents such as carbamazepine, morphine, and ketamine have not shown consistent benefit over placebo and are not recommended as first-line treatments.[9][7] Recent network meta-analyses also suggest prednisone, and levetiracetam (Keppra) may be effective, but these are not yet guideline-recommended and require further study.[2][9]

A 2022 Systematic Review and Network Meta-Analysis (11)  concluded that Pamidronate (intravenous (IV) infusion), prednisone, and levetiracetam ranked as the first three most effective treatments. In subgroup analyses, prednisone, levetiracetam, lamotrigine, and pregabalin were more effective than placebo as oral pharmacotherapies, while etanercept was more effective than placebo as injectable pharmacotherapy. However, multiple other studies have concluded that levetiracetam is ineffective for CPSP. This study confirmed that pamidronate, prednisone, and guideline-recommended anticonvulsants were effective for reducing pain intensity for CPSP. Pamidronate and prednisone showed better effect than other pharmacotherapies, warranting further investigation.

In summary:

  • Pregabalin, gabapentin, lamotrigine, duloxetine, and amitriptyline have the strongest evidence for efficacy and safety in unilateral central post-stroke pain.
  • Pregabalin and gabapentin are most effective for pain reduction but have higher rates of adverse effects.
  • Lamotrigine and duloxetine offer good efficacy with favorable safety profiles.
  • Amitriptyline is effective but less well tolerated.

 

References

  1. Efficacy and Safety of Different Antidepressants and Anticonvulsants in Central Poststroke Pain: A Network Meta-Analysis and Systematic Review. Chen KY, Li RY. PloS One. 2022;17(10):e0276012. doi:10.1371/journal.pone.0276012.
  2. Pharmacotherapies for Central Post-Stroke Pain: A Systematic Review and Network Meta-Analysis. Bo Z, Jian Y, Yan L, et al. Oxidative Medicine and Cellular Longevity. 2022;2022:3511385. doi:10.1155/2022/3511385.
  3. Management of Central Poststroke Pain: Systematic Review and Meta-Analysis. Tamasauskas A, Silva-Passadouro B, Fallon N, et al. The Journal of Pain. 2025;26:104666. doi:10.1016/j.jpain.2024.104666.
  4. Prevalence and Management Challenges in Central Post-Stroke Neuropathic Pain: A Systematic Review and Meta-Analysis. Liampas A, Velidakis N, Georgiou T, et al. Advances in Therapy. 2020;37(7):3278-3291. doi:10.1007/s12325-020-01388-w.
  5. Efficacy of Duloxetine in Patients With Central Post-Stroke Pain: A Randomized Double Blind Placebo Controlled Trial. Mahesh B, Singh VK, Pathak A, et al. Pain Medicine (Malden, Mass.). 2023;24(6):610-617. doi:10.1093/pm/pnac182.
  6. Pharmacotherapy to Manage Central Post-Stroke Pain. Choi HR, Aktas A, Bottros MM. CNS Drugs. 2021;35(2):151-160. doi:10.1007/s40263-021-00791-3.
  7. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Winstein CJ, Stein J, Arena R, et al. Stroke. 2016;47(6):e98-e169. doi:10.1161/STR.0000000000000098.
  8. Pharmacological Management of Central Post-Stroke Pain: A Practical Guide. Kim JS. CNS Drugs. 2014;28(9):787-97. doi:10.1007/s40263-014-0194-y.
  9. Ischemic Stroke Management: Posthospitalization and Transition of Care. Scott T. Larson MD, Brigit E. Ray MD MME, Jason Wilbur MD. American Academy of Family Physicians (2023).
  10. Advancements in Modern Treatment Approaches for Central Post-Stroke Pain: A Narrative Review. Asadauskas A, Stieger A, Luedi MM, Andereggen L. Journal of Clinical Medicine. 2024;13(18):5377. doi:10.3390/jcm13185377.
  11. Pharmacotherapies for Central Post-Stroke Pain- A Systematic Review and Network Meta-Analysis – 2022

 

Summary of the comparative long-term outcomes and discontinuation rates

Long-term outcomes and discontinuation rates for antidepressants and anticonvulsants in unilateral central post-stroke pain are highly variable, with efficacy often limited by tolerability and adverse effects, leading to moderate discontinuation rates in real-world practice. Lamotrigine and duloxetine show the most favorable balance of effectiveness and tolerability, while gabapentin and pregabalin are effective but associated with higher rates of adverse effects and discontinuation.

Recent systematic reviews and network meta-analyses indicate that pregabalin and gabapentin provide significant pain reduction but are associated with the highest rates of adverse reactions (e.g., dizziness, somnolence), which frequently lead to discontinuation.[1][2][3] Amitriptyline, while effective, is often poorly tolerated in stroke populations due to anticholinergic side effects, resulting in high discontinuation rates, especially in older adults.[1][3][4]  Lamotrigine (Lamictal) demonstrates strong evidence for sustained pain relief and is better tolerated than tricyclic antidepressants, with lower discontinuation rates.[3][5] Duloxetine has shown significant pain reduction and improvement in disability, with good tolerability and lower discontinuation rates compared to tricyclics and gabapentinoids.[3][6]

Real-world effectiveness is often lower than in clinical trials due to side effect burden and comorbidities in post-stroke populations. Many patients require dose adjustments or switch agents due to adverse effects, and combination therapy is sometimes used to balance efficacy and tolerability.[3][7] Long-term data are limited, but available evidence suggests that lamotrigine and duloxetine are most likely to be continued over time, while gabapentin, pregabalin, and amitriptyline are more frequently discontinued due to side effects.[1][3][5]

In summary

Lamotrigine and duloxetine offer the best long-term balance of efficacy and tolerability, with lower discontinuation rates, while gabapentin, pregabalin, and amitriptyline are effective but less well tolerated in real-world post-stroke populations.[1][3][5][6]

References

  1. Efficacy and Safety of Different Antidepressants and Anticonvulsants in Central Poststroke Pain: A Network Meta-Analysis and Systematic Review. Chen KY, Li RY. PloS One. 2022;17(10):e0276012. doi:10.1371/journal.pone.0276012.
  2. Pharmacotherapies for Central Post-Stroke Pain: A Systematic Review and Network Meta-Analysis. Bo Z, Jian Y, Yan L, et al. Oxidative Medicine and Cellular Longevity. 2022;2022:3511385. doi:10.1155/2022/3511385.
  3. Management of Central Poststroke Pain: Systematic Review and Meta-Analysis. Tamasauskas A, Silva-Passadouro B, Fallon N, et al. The Journal of Pain. 2025;26:104666. doi:10.1016/j.jpain.2024.104666.
  4. Pharmacological Management of Central Post-Stroke Pain: A Practical Guide. Kim JS. CNS Drugs. 2014;28(9):787-97. doi:10.1007/s40263-014-0194-y.
  5. Prevalence and Management Challenges in Central Post-Stroke Neuropathic Pain: A Systematic Review and Meta-Analysis. Liampas A, Velidakis N, Georgiou T, et al. Advances in Therapy. 2020;37(7):3278-3291. doi:10.1007/s12325-020-01388-w.
  6. Efficacy of Duloxetine in Patients With Central Post-Stroke Pain: A Randomized Double Blind Placebo Controlled Trial. Mahesh B, Singh VK, Pathak A, et al. Pain Medicine (Malden, Mass.). 2023;24(6):610-617. doi:10.1093/pm/pnac182.
  7. Advancements in Modern Treatment Approaches for Central Post-Stroke Pain: A Narrative Review. Asadauskas A, Stieger A, Luedi MM, Andereggen L. Journal of Clinical Medicine. 2024;13(18):5377. doi:10.3390/jcm13185377.

Combination therapy strategies with antidepressants and anticonvulsants 

Comparative data from systematic reviews and meta-analyses show that combination therapy (e.g., antidepressant plus anticonvulsant) is widely used in neuropathic pain, but does not consistently outperform monotherapy for either pain relief or tolerability. For example, meta-analyses of gabapentinoid-antidepressant combinations found no clear superiority over monotherapy, and adverse event profiles were similar.[3][9] Specific combinations, such as duloxetine plus pregabalin or nortriptyline plus gabapentin, may offer benefit in select patients—particularly those with refractory symptoms or dose-limiting side effects from monotherapy.[4][10] In these cases, combination therapy can allow lower doses of each drug, potentially reducing side effects while maintaining efficacy.

Safety data indicate that combination therapy does not substantially increase adverse events compared to monotherapy, though some combinations (e.g., nortriptyline plus gabapentin) may increase specific side effects like dry mouth. Long-term outcomes and discontinuation rates are similar, but careful monitoring is recommended when using combination regimens.[3][4][10]

There is a lack of high-quality, CPSP-specific randomized controlled trials evaluating combination therapy, and current evidence is extrapolated from broader neuropathic pain populations. Further research is needed to clarify optimal combinations and long-term safety in CPSP.[3][9]

In summary, combination therapy with antidepressants and anticonvulsants is not generally superior to monotherapy for CPSP, but may be considered in select, refractory cases with careful monitoring for safety and tolerability.[3][4][9][10]

References

  1. Pharmacotherapy to Manage Central Post-Stroke Pain. Choi HR, Aktas A, Bottros MM. CNS Drugs. 2021;35(2):151-160. doi:10.1007/s40263-021-00791-3.
  2. Central Post-Stroke Pain: Clinical Characteristics, Pathophysiology, and Management. Klit H, Finnerup NB, Jensen TS. The Lancet. Neurology. 2009;8(9):857-68. doi:10.1016/S1474-4422(09)70176-0.
  3. Combination Pharmacotherapy for the Treatment of Neuropathic Pain in Adults: Systematic Review and Meta-Analysis. Balanaser M, Carley M, Baron R, et al. Pain. 2023;164(2):230-251. doi:10.1097/j.pain.0000000000002688.
  4. Pregabalin and Duloxetine in Patients With Non-Nociceptive Pain: A Narrative Review Exploring the Pharmacological Effects of This Combination. Marcianò G, Evangelista M, Vocca C, et al. Pharmaceuticals (Basel, Switzerland). 2025;18(10):1434. doi:10.3390/ph18101434.
  5. Efficacy and Safety of Different Antidepressants and Anticonvulsants in Central Poststroke Pain: A Network Meta-Analysis and Systematic Review. Chen KY, Li RY. PloS One. 2022;17(10):e0276012. doi:10.1371/journal.pone.0276012.
  6. Pharmacotherapies for Central Post-Stroke Pain: A Systematic Review and Network Meta-Analysis. Bo Z, Jian Y, Yan L, et al. Oxidative Medicine and Cellular Longevity. 2022;2022:3511385. doi:10.1155/2022/3511385.
  7. Antidepressants for Pain Management in Adults With Chronic Pain: A Network Meta-Analysis. Birkinshaw H, Friedrich CM, Cole P, et al. The Cochrane Database of Systematic Reviews. 2023;5:CD014682. doi:10.1002/14651858.CD014682.pub2.
  8. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Winstein CJ, Stein J, Arena R, et al. Stroke. 2016;47(6):e98-e169. doi:10.1161/STR.0000000000000098.
  9. Combination Pharmacotherapy for Management of Chronic Pain: From Bench to Bedside. Gilron I, Jensen TS, Dickenson AH. The Lancet. Neurology. 2013;12(11):1084-95. doi:10.1016/S1474-4422(13)70193-5.
  10. Nortriptyline and Gabapentin, Alone and in Combination for Neuropathic Pain: A Double-Blind, Randomised Controlled Crossover Trial. Gilron I, Bailey JM, Tu D, et al. Lancet (London, England). 2009;374(9697):1252-61. doi:10.1016/S0140-6736(09)61081-3.

Acupuncture

Acupuncture may provide modest pain relief and improved functional outcomes in unilateral central post-stroke pain, with several recent systematic reviews and meta-analyses showing superiority over conventional medical therapy, but the overall quality of evidence is low to moderate and further high-quality trials are needed.[1][2][3][4]

Meta-analyses report significant reductions in pain scores (VAS, PPI, PRI) and higher total efficacy rates for acupuncture compared to standard pharmacological treatments, with some studies also noting increased β-endorphin levels and reduced substance P, suggesting a biological basis for pain relief.[1][2][3] Sham-controlled trials confirm greater pain reduction with acupuncture, though effects on neurological or functional recovery are less clear.[4]

Safety
Acupuncture-related therapies are generally safe, with a lower incidence of adverse events compared to conventional treatments, but most studies are small and at risk of bias.[1][3][4] Adverse event rates are consistently lower or similar to drug therapy, and serious complications are rare.

Traditional Chinese Herbal Medicine

Evidence for traditional Chinese herbal medicine in post-stroke pain is limited; while some meta-analyses show benefit for stroke recovery and neurological function, there is insufficient direct evidence for pain relief in unilateral central post-stroke pain specifically.[5][6] Chinese herbal patent medicines (e.g., MLC601, Shuxuetong, BuchangNaoxintong) may improve neurological recovery and functional scores after stroke, but studies do not directly address pain outcomes in CPSP populations.

Major systematic reviews highlight significant gaps in research quality and standardization for both acupuncture and herbal medicine, and current guidelines do not recommend these therapies as first-line treatments for central post-stroke pain.[7][8][9][10] Most studies are small, single-center, and at risk of bias, and there is a lack of standardized protocols and outcome measures.

There is a lack of large, multicenter, placebo-controlled trials evaluating traditional Chinese herbal medicine specifically for unilateral central post-stroke pain. Current evidence supports acupuncture as a potentially safe adjunct for pain relief, but neither acupuncture nor herbal medicine is recommended as first-line therapy for CPSP until more rigorous data are available.

References

  1. Acupuncture Effects of Post-Stroke Thalamic Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Zhang T, Zhai J, Cheng L, et al. Frontiers in Neurology. 2025;16:1528956. doi:10.3389/fneur.2025.1528956.
  2. Acupuncture for Thalamic Pain After Stroke: A Systematic Review and Meta-Analysis. Li W, Chen S. Medicine. 2023;102(9):e33006. doi:10.1097/MD.0000000000033006.
  3. Comparative Efficacy and Safety of Acupuncture and Western Medicine for Poststroke Thalamic Pain. Yang J, Li X, Li C, et al. Anatomical Record (Hoboken, N.J. : 2007). 2023;306(12):3050-3059. doi:10.1002/ar.24902.
  4. Clinical Evaluation of Acupuncture as Treatment for Complications of Cerebrovascular Accidents: A Randomized, Sham-Controlled, Subject- And Assessor-Blind Trial. Liao HY, Ho WC, Chen CC, et al. Evidence-Based Complementary and Alternative Medicine : eCAM. 2017;2017:7498763. doi:10.1155/2017/7498763.
  5. Management of Central Poststroke Pain: Systematic Review and Meta-Analysis. Tamasauskas A, Silva-Passadouro B, Fallon N, et al. The Journal of Pain. 2025;26:104666. doi:10.1016/j.jpain.2024.104666.
  6. Acupuncture for Stroke Rehabilitation. Yang A, Wu HM, Tang JL, et al. The Cochrane Database of Systematic Reviews. 2016;(8):CD004131. doi:10.1002/14651858.CD004131.pub3.
  7. Therapeutic Effect of Chinese Herbal Medicines for Post Stroke Recovery: A Traditional and Network Meta-Analysis. Han SY, Hong ZY, Xie YH, Zhao Y, Xu X. Medicine. 2017;96(49):e8830. doi:10.1097/MD.0000000000008830.
  8. Characteristics of Traditional Chinese Medicine Usage in Patients With Stroke in Taiwan: A Nationwide Population-Based Study. Chang CC, Lee YC, Lin CC, et al. Journal of Ethnopharmacology. 2016;186:311-321. doi:10.1016/j.jep.2016.04.018.
  9. Acupuncture-Related Therapies for Post-Stroke Pain Management: A Scoping Review and Evidence Map. Zhou Z, Ke C, Shi W, et al. Frontiers in Neurology. 2025;16:1604655. doi:10.3389/fneur.2025.1604655.
  10. Management of Central Poststroke Pain: Systematic Review of Randomized Controlled Trials. Mulla SM, Wang L, Khokhar R, et al. Stroke. 2015;46(10):2853-60. doi:10.1161/STROKEAHA.115.010259.

 

 

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