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İnme Hastalarında Nöropatik Ağrı ile Serum Magnezyum Düzeyleri Arasındaki İlişkinin Değerlendirilmesi

Yıl 2026, Cilt: 16 Sayı: 1, 78 - 86, 15.03.2026
https://doi.org/10.16919/bozoktip.1817687
https://izlik.org/JA25KA67UZ

Öz

Amaç: Bu çalışma, inme sonrası hastalarda nöropatik ağrı ile serum magnezyum düzeyleri arasındaki ilişkiyi araştırmıştır.
Gereç ve Yöntemler: Akut dönemi tamamlamış ve rehabilitasyon için uygun hastalar çalışmaya dâhil edilmiştir. Katılımcıların sosyodemografik ve klinik özellikleri, eşlik eden hastalıkları ve ilaç kullanımları kaydedilmiştir. Nöropatik ağrı Douleur Neuropathique 4 (DN4) anketiyle; motor ve yürüme fonksiyonları ise sırasıyla Brunnstrom Evreleri ve Fonksiyonel Ambulasyon Sınıflaması (FAS) ile değerlendirilmiştir. Değerlendirmeler, başlangıçta ve dört haftalık rehabilitasyon programı sonrasında tekrarlanmıştır.
Bulgular: Analize alınan 110 hastanın %74,5’i iskemik inme geçirmiş olup, inme başlangıcından itibaren medyan süre 6 aydı (IQR: 4–12,8). Tedavi sonrası Brunnstrom evreleri ve FAS skorlarında anlamlı artış (tümü p<0,001), DN4 skorlarında ise azalma saptandı (ortanca (3 (1-5)’den 2 (0-3)’ye, p<0.001). Serum magnezyum düzeyi, tedavi sonrası DN4 skorlarıyla negatif (ρ = –0,219, p=0,022) ve motor ile fonksiyonel göstergelerle pozitif korelasyon gösterdi (sırasıyla ρ = 0,274, 0,271 ve 0,210, p<0,05).
Sonuç: Bulgular, düşük serum magnezyum düzeylerinin artmış nöropatik ağrı ve daha zayıf fonksiyonel iyileşmeyle ilişkili olabileceğini göstermektedir. Magnezyumun inme sonrası ağrı ve iyileşme üzerindeki rolünü aydınlatmak için ileriye dönük çalışmalar gereklidir.

Kaynakça

  • 1. Charlier F, Morgan P. The effect of mobilization on blood pressure for stroke survivors with moderate or severe injury: a rapid review. Top Stroke Rehabil. 2025.
  • 2. Zakel J, Chae J, Wilson RD. Innovations in Stroke Recovery and Rehabilitation: Poststroke Pain. Phys Med Rehabil Clin N Am. 2024;35(2):445-62.
  • 3. Doshi TL, Dworkin RH, Polomano RC, Carr DB, Edwards RR, Finnerup NB, et al. AAAPT Diagnostic Criteria for Acute Neuropathic Pain. Pain Med. 2021;22(3):616-36.
  • 4. Finnerup NB, Kuner R, Jensen TS. Neuropathic Pain: From Mechanisms to Treatment. Physiol Rev. 2021;101(1):259-301.
  • 5. Costigan M, Woolf CJ. Pain: molecular mechanisms. J Pain. 2000;1(3 Suppl):35-44.
  • 6. Liampas A, Velidakis N, Georgiou T, Vadalouca A, Varrassi G, Hadjigeorgiou GM, et al. Prevalence and Management Challenges in Central Post-Stroke Neuropathic Pain: A Systematic Review and Meta-analysis. Adv Ther. 2020;37(7):3278-91.
  • 7. Tamasauskas A, Silva-Passadouro B, Fallon N, Frank B, Laurinaviciute S, Keller S, et al. Management of Central Poststroke Pain: Systematic Review and Meta-analysis. J Pain. 2025;26:104666.
  • 8. Kirkland AE, Sarlo GL, Holton KF. The Role of Magnesium in Neurological Disorders. Nutrients. 2018;10(6):730.
  • 9. Shin H-J, Na H-S, Do S-H. Magnesium and pain. Nutrients. 2020;12(8):2184.
  • 10. Romani AM. Cellular magnesium homeostasis. Arch Biochem Biophys. 2011;512(1):1-23.
  • 11. Konrad M, Schlingmann KP, Gudermann T. Insights into the molecular nature of magnesium homeostasis. Am J Physiol Renal Physiol. 2004;286(4):F599-605.
  • 12. Schuchardt JP, Hahn A. Intestinal Absorption and Factors Influencing Bioavailability of Magnesium-An Update. Curr Nutr Food Sci. 2017;13(4):260-78.
  • 13. Nielsen FH. Guidance for the determination of status indicators and dietary requirements for magnesium. Magnes Res. 2016;29(4):154-60.
  • 14. Fiorentini D, Cappadone C, Farruggia G, Prata C. Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency. Nutrients. 2021;13(4):1136.
  • 15. Brill S, Sedgwick PM, Hamann W, Di Vadi PP. Efficacy of intravenous magnesium in neuropathic pain. Br J Anaesth. 2002;89(5):711-4.
  • 16. Kulik K, Zyzynska-Granica B, Kowalczyk A, Kurowski P, Gajewska M, Bujalska-Zadrozny M. Magnesium and Morphine in the Treatment of Chronic Neuropathic Pain-A Biomedical Mechanism of Action. Int J Mol Sci. 2021;22(24):13599.
  • 17. Unal-Cevik I, Sarioglu-Ay S, Evcik D. A comparison of the DN4 and LANSS questionnaires in the assessment of neuropathic pain: validity and reliability of the Turkish version of DN4. J Pain. 2010;11(11):1129-35.
  • 18. Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114(1-2):29-36.
  • 19. Brunnstrom S. Motor testing procedures in hemiplegia: based on sequential recovery stages. Phys Ther. 1966;46(4):357-75.
  • 20. Holden MK, Gill KM, Magliozzi MR, Nathan J, Piehl-Baker L. Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness. Phys Ther. 1984;64(1):35-40.
  • 21. Patel V, Akimbekov NS, Grant WB, Dean C, Fang X, Razzaque MS. Neuroprotective effects of magnesium: implications for neuroinflammation and cognitive decline. Front Endocrinol (Lausanne). 2024;15:1406455.
  • 22. Fatima G, Dzupina A, H BA, Magomedova A, Siddiqui Z, Mehdi A, et al. Magnesium Matters: A Comprehensive Review of Its Vital Role in Health and Diseases. Cureus. 2024;16(10):e71392.
  • 23. Avci Y, Rajarathinam M, Kalsekar N, Tawfic Q, Krause S, Nguyen D, et al. Unravelling the analgesic effects of perioperative magnesium in general abdominal surgery: a systematic review and meta-analysis of randomized controlled trials. Braz J Anesthesiol. 2024;74(4):844524.
  • 24. Wu EB, Wu KL, Hsu WT, Yuan WC, Chen KB. Pharmacological Efficacy of Intravenous Magnesium in Attenuating Remifentanil-Induced Postoperative Hyperalgesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pharmaceuticals (Basel). 2025;18(4):518.
  • 25. Xu Q, Hu L, Chen L, Li H, Tian X, Zuo Y, et al. Low serum magnesium is associated with poor functional outcome in acute ischemic stroke or transient ischemic attack patients. CNS Neurosci Ther. 2023;29(3):842-54.
  • 26. Yu Q, Liu Y, Chang X, Mao X, Wu X, Chu M, et al. High-Normal Serum Potassium, Calcium, and Magnesium Levels Are Associated With Decreased Risks of Adverse Outcomes After Ischemic Stroke. J Am Heart Assoc. 2025;14(10):e037601.
  • 27. Madani SP, Cham MB, Sajadi S, Mansouri K, Samadaeian N, Zare N. Assessing the Validity and Reliability of the DN4 Neuropathic Pain Questionnaire: A Systematic Review. Ann Mil Health Sci Res. 2025;23(1):1-10.
  • 28. Yousef AA, Al-deeb AE. A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Anaesthesia. 2013;68(3):260-6.
  • 29. Pickering G, Morel V, Simen E, Cardot JM, Moustafa F, Delage N, et al. Oral magnesium treatment in patients with neuropathic pain: a randomized clinical trial. Magnes Res. 2011;24(2):28-35.
  • 30. Sakarya ST, Akyol Y, Bedir A, Canturk F. The relationship between serum antioxidant vitamins, magnesium levels, and clinical parameters in patients with primary fibromyalgia syndrome. Clin Rheumatol. 2011;30(8):1039-43.
  • 31. Alisik T, Reis Altan YC, Olkay SG, Sahingoz Bakirci E. Serum magnesium levels and their association with sleep quality and disease severity in fibromyalgia syndrome: An observational cross-sectional study. Medicine (Baltimore). 2025;104(29):e43446.

The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients

Yıl 2026, Cilt: 16 Sayı: 1, 78 - 86, 15.03.2026
https://doi.org/10.16919/bozoktip.1817687
https://izlik.org/JA25KA67UZ

Öz

Objective: This study aimed to investigate the relationship between neuropathic pain and serum magnesium levels in post-stroke patients.
Material and Methods: Consecutive patients who had completed the acute phase and were eligible for rehabilitation were included. Sociodemographic and clinical data, comorbidities, and medications were recorded at baseline. Neuropathic pain was assessed using the Douleur Neuropathique 4 (DN4) questionnaire, and motor and gait functions were evaluated using the Brunnstrom Recovery Stages and Functional Ambulation Classification (FAC). Assessments were repeated after a four-week rehabilitation program.
Results: A total of 110 patients (74.5% ischemic stroke) were analyzed, with a median time since onset of 6 months (IQR: 4–12.8). Brunnstrom stages and FAC scores significantly improved post-treatment (all p<0.001), while DN4 scores decreased (median (3 (1-5) vs. 2 (0-3), p<0.001). Baseline serum magnesium was negatively correlated with post-treatment DN4 scores (ρ = –0.219, p=0.022) and positively correlated with baseline and post-treatment FAC and upper-limb Brunnstrom stages (ρ = 0.274, 0.271 and 0.210, respectively, p<0.05 for all). Conclusion: These findings suggest that lower serum magnesium concentrations are associated with greater neuropathic pain and poorer functional recovery after stroke rehabilitation. Further prospective studies are needed to elucidate the role of magnesium in post-stroke pain modulation and motor recovery.

Etik Beyan

The study protocol was approved by the Non-Interventional Clinical Research Ethics Committee of Bolu Abant İzzet Baysal University (Date: 06.05.2025 Approval No: 2025/205).

Destekleyen Kurum

none.

Teşekkür

None.

Kaynakça

  • 1. Charlier F, Morgan P. The effect of mobilization on blood pressure for stroke survivors with moderate or severe injury: a rapid review. Top Stroke Rehabil. 2025.
  • 2. Zakel J, Chae J, Wilson RD. Innovations in Stroke Recovery and Rehabilitation: Poststroke Pain. Phys Med Rehabil Clin N Am. 2024;35(2):445-62.
  • 3. Doshi TL, Dworkin RH, Polomano RC, Carr DB, Edwards RR, Finnerup NB, et al. AAAPT Diagnostic Criteria for Acute Neuropathic Pain. Pain Med. 2021;22(3):616-36.
  • 4. Finnerup NB, Kuner R, Jensen TS. Neuropathic Pain: From Mechanisms to Treatment. Physiol Rev. 2021;101(1):259-301.
  • 5. Costigan M, Woolf CJ. Pain: molecular mechanisms. J Pain. 2000;1(3 Suppl):35-44.
  • 6. Liampas A, Velidakis N, Georgiou T, Vadalouca A, Varrassi G, Hadjigeorgiou GM, et al. Prevalence and Management Challenges in Central Post-Stroke Neuropathic Pain: A Systematic Review and Meta-analysis. Adv Ther. 2020;37(7):3278-91.
  • 7. Tamasauskas A, Silva-Passadouro B, Fallon N, Frank B, Laurinaviciute S, Keller S, et al. Management of Central Poststroke Pain: Systematic Review and Meta-analysis. J Pain. 2025;26:104666.
  • 8. Kirkland AE, Sarlo GL, Holton KF. The Role of Magnesium in Neurological Disorders. Nutrients. 2018;10(6):730.
  • 9. Shin H-J, Na H-S, Do S-H. Magnesium and pain. Nutrients. 2020;12(8):2184.
  • 10. Romani AM. Cellular magnesium homeostasis. Arch Biochem Biophys. 2011;512(1):1-23.
  • 11. Konrad M, Schlingmann KP, Gudermann T. Insights into the molecular nature of magnesium homeostasis. Am J Physiol Renal Physiol. 2004;286(4):F599-605.
  • 12. Schuchardt JP, Hahn A. Intestinal Absorption and Factors Influencing Bioavailability of Magnesium-An Update. Curr Nutr Food Sci. 2017;13(4):260-78.
  • 13. Nielsen FH. Guidance for the determination of status indicators and dietary requirements for magnesium. Magnes Res. 2016;29(4):154-60.
  • 14. Fiorentini D, Cappadone C, Farruggia G, Prata C. Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency. Nutrients. 2021;13(4):1136.
  • 15. Brill S, Sedgwick PM, Hamann W, Di Vadi PP. Efficacy of intravenous magnesium in neuropathic pain. Br J Anaesth. 2002;89(5):711-4.
  • 16. Kulik K, Zyzynska-Granica B, Kowalczyk A, Kurowski P, Gajewska M, Bujalska-Zadrozny M. Magnesium and Morphine in the Treatment of Chronic Neuropathic Pain-A Biomedical Mechanism of Action. Int J Mol Sci. 2021;22(24):13599.
  • 17. Unal-Cevik I, Sarioglu-Ay S, Evcik D. A comparison of the DN4 and LANSS questionnaires in the assessment of neuropathic pain: validity and reliability of the Turkish version of DN4. J Pain. 2010;11(11):1129-35.
  • 18. Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114(1-2):29-36.
  • 19. Brunnstrom S. Motor testing procedures in hemiplegia: based on sequential recovery stages. Phys Ther. 1966;46(4):357-75.
  • 20. Holden MK, Gill KM, Magliozzi MR, Nathan J, Piehl-Baker L. Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness. Phys Ther. 1984;64(1):35-40.
  • 21. Patel V, Akimbekov NS, Grant WB, Dean C, Fang X, Razzaque MS. Neuroprotective effects of magnesium: implications for neuroinflammation and cognitive decline. Front Endocrinol (Lausanne). 2024;15:1406455.
  • 22. Fatima G, Dzupina A, H BA, Magomedova A, Siddiqui Z, Mehdi A, et al. Magnesium Matters: A Comprehensive Review of Its Vital Role in Health and Diseases. Cureus. 2024;16(10):e71392.
  • 23. Avci Y, Rajarathinam M, Kalsekar N, Tawfic Q, Krause S, Nguyen D, et al. Unravelling the analgesic effects of perioperative magnesium in general abdominal surgery: a systematic review and meta-analysis of randomized controlled trials. Braz J Anesthesiol. 2024;74(4):844524.
  • 24. Wu EB, Wu KL, Hsu WT, Yuan WC, Chen KB. Pharmacological Efficacy of Intravenous Magnesium in Attenuating Remifentanil-Induced Postoperative Hyperalgesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pharmaceuticals (Basel). 2025;18(4):518.
  • 25. Xu Q, Hu L, Chen L, Li H, Tian X, Zuo Y, et al. Low serum magnesium is associated with poor functional outcome in acute ischemic stroke or transient ischemic attack patients. CNS Neurosci Ther. 2023;29(3):842-54.
  • 26. Yu Q, Liu Y, Chang X, Mao X, Wu X, Chu M, et al. High-Normal Serum Potassium, Calcium, and Magnesium Levels Are Associated With Decreased Risks of Adverse Outcomes After Ischemic Stroke. J Am Heart Assoc. 2025;14(10):e037601.
  • 27. Madani SP, Cham MB, Sajadi S, Mansouri K, Samadaeian N, Zare N. Assessing the Validity and Reliability of the DN4 Neuropathic Pain Questionnaire: A Systematic Review. Ann Mil Health Sci Res. 2025;23(1):1-10.
  • 28. Yousef AA, Al-deeb AE. A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Anaesthesia. 2013;68(3):260-6.
  • 29. Pickering G, Morel V, Simen E, Cardot JM, Moustafa F, Delage N, et al. Oral magnesium treatment in patients with neuropathic pain: a randomized clinical trial. Magnes Res. 2011;24(2):28-35.
  • 30. Sakarya ST, Akyol Y, Bedir A, Canturk F. The relationship between serum antioxidant vitamins, magnesium levels, and clinical parameters in patients with primary fibromyalgia syndrome. Clin Rheumatol. 2011;30(8):1039-43.
  • 31. Alisik T, Reis Altan YC, Olkay SG, Sahingoz Bakirci E. Serum magnesium levels and their association with sleep quality and disease severity in fibromyalgia syndrome: An observational cross-sectional study. Medicine (Baltimore). 2025;104(29):e43446.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Tuğba Alışık 0000-0003-1856-9513

Ayşe Esma Yıldız 0009-0003-4508-5749

Gönderilme Tarihi 4 Kasım 2025
Kabul Tarihi 22 Ocak 2026
Yayımlanma Tarihi 15 Mart 2026
DOI https://doi.org/10.16919/bozoktip.1817687
IZ https://izlik.org/JA25KA67UZ
Yayımlandığı Sayı Yıl 2026 Cilt: 16 Sayı: 1

Kaynak Göster

APA Alışık, T., & Yıldız, A. E. (2026). The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients. Bozok Tıp Dergisi, 16(1), 78-86. https://doi.org/10.16919/bozoktip.1817687
AMA 1.Alışık T, Yıldız AE. The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients. Bozok Tıp Dergisi. 2026;16(1):78-86. doi:10.16919/bozoktip.1817687
Chicago Alışık, Tuğba, ve Ayşe Esma Yıldız. 2026. “The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients”. Bozok Tıp Dergisi 16 (1): 78-86. https://doi.org/10.16919/bozoktip.1817687.
EndNote Alışık T, Yıldız AE (01 Mart 2026) The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients. Bozok Tıp Dergisi 16 1 78–86.
IEEE [1]T. Alışık ve A. E. Yıldız, “The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients”, Bozok Tıp Dergisi, c. 16, sy 1, ss. 78–86, Mar. 2026, doi: 10.16919/bozoktip.1817687.
ISNAD Alışık, Tuğba - Yıldız, Ayşe Esma. “The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients”. Bozok Tıp Dergisi 16/1 (01 Mart 2026): 78-86. https://doi.org/10.16919/bozoktip.1817687.
JAMA 1.Alışık T, Yıldız AE. The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients. Bozok Tıp Dergisi. 2026;16:78–86.
MLA Alışık, Tuğba, ve Ayşe Esma Yıldız. “The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients”. Bozok Tıp Dergisi, c. 16, sy 1, Mart 2026, ss. 78-86, doi:10.16919/bozoktip.1817687.
Vancouver 1.Tuğba Alışık, Ayşe Esma Yıldız. The Relationship Between Neuropathic Pain and Serum Magnesium Levels in Stroke Patients. Bozok Tıp Dergisi. 01 Mart 2026;16(1):78-86. doi:10.16919/bozoktip.1817687
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