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The causes of PSP remain underexplored, although there is likely a complex interplay of lesion effects, psychological factors, and mobility that play a role in its development. The aim of the study was to investigate clinical characteristics associated with PSP, as well as structural and functional correlates of PSP using lesion symptom (LSM) and network mapping (LNM). We analyzed data from the INSPiRE\u2010TMS cohort, encompassing 1022 minor ischemic stroke patients. Pain severity and psychological factors (EQUATION 5D\u20103L questionnaire) were assessed annually for up to 3\u2009years. In a sub\u2010group of 391 patients with available imaging data, LSM and LNM analyses were conducted to identify neural correlates of PSP. Overall, 47% of patients reported pain 1\u2010year post\u2010stroke. Multivariable regression analyses identified baseline anxiety as associated with PSP assessed at 1\u2010year post\u2010stroke (OR 2.90, 95% CI 1.17\u20137.17,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.021). LSM did not identify any voxels associated with new severe pain. LNM identified a network involving the anterior cingulate cortex, thalamus, and insular cortex. Adjusting for anxiety highlighted distinct network contributions, suggesting interactive effects of psychological states on pain perception. Automated comparison to large metanalytical findings using Neurosynth associated the terms \u2018pain\u2019 and \u2018nociception\u2019 most strongly to the identified network. PSP is closely associated with psychological factors such as anxiety. LNM of PSP revealed disruptions in a pain\u2010related neural network consistent with prior pain research. These results warrant external validation and could guide future network\u2010targeted neuromodulation therapies.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    identifier: NCT01586702\n                  <\/jats:p>","DOI":"10.1002\/hbm.70602","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:54:18Z","timestamp":1783569258000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroimaging Correlates of Post\u2010Stroke Pain After Ischemic Stroke: Secondary Analysis of the\n                    <scp>INSPiRE<\/scp>\n                    \u2010\n                    <scp>TMS<\/scp>\n                    Trial"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0401-0698","authenticated-orcid":false,"given":"Alina","family":"Stegemann","sequence":"first","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin, Klinik f\u00fcr Neurologie Mit Experimenteller Neurologie  Berlin Germany"},{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin Center for Stroke Research Berlin (CSB)  Berlin Germany"},{"name":"Berlin Institute of Health (BIH) at Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Sofia","family":"Rios","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin, Klinik f\u00fcr Neurologie Mit Experimenteller Neurologie  Berlin Germany"},{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin Center for Stroke Research Berlin (CSB)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Khalil","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin, Klinik f\u00fcr Neurologie Mit Experimenteller Neurologie  Berlin Germany"},{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin Center for Stroke Research Berlin (CSB)  Berlin 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