{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T15:02:09Z","timestamp":1782226929295,"version":"3.54.5"},"reference-count":42,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To provide a new insight into the diagnosis and treatment of hemiplegic shoulder pain (HSP) by investigating changes in serum pain mediators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects\/patients<\/jats:title>\n                    <jats:p>\n                      Shoulder pain group (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a034) and control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a021).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pain\u2010free shoulder mobility, anxiety status, depression status, and shoulder pain were measured by passive range of motion (PROM), self\u2010rating anxiety scale, self\u2010rating depression scale (SDS), and visual analog scale, respectively. The enzyme\u2010linked immunosorbent assay was used to test the serum pain mediators, including interleukin (IL)\u20101\u03b2, IL\u20102, IL\u20106, IL\u201010, nerve growth factor (NGF), tumor necrosis factor\u2010\u03b1 (TNF\u2010\u03b1), substance P (SP), calcitonin gene\u2010related peptide (CGRP), bradykinin (BK), 5\u2010hydroxytryptamine (5\u2010HT), prostaglandin E2 (PGE2), and lysophosphatidic acid (LPA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Shoulder pain group pain\u2010free PROM significantly lower than control (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01), and SDS index score of shoulder pain group was significantly higher than control (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.05). The rate of spasticity in the flexor elbow muscles is higher in shoulder pain group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01). CGRP, IL\u201010, and IL\u20102 were significantly upregulated in shoulder pain group compared with control (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01), whereas NGF, TNF\u2010\u03b1, IL\u20106, 5\u2010HT, PGE2, SP, LPA, BK, and IL\u20101\u03b2 were significantly decreased (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with HSP have a higher risk of joint mobility disorders and depression; spasticity may be an important factor in the development of shoulder pain; CGRP is thought to be the major pain mediator in HSP, and HSP may not be inflammatory.<\/jats:p>\n                  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