Association of anxiety with intracortical inhibition and descending pain modulation in chronic myofascial pain syndrome

BMC Neuroscience

Wolnei Caumo³  Felipe Fregni¹  Joanna R Rozisky²  Gabriela Laste²  Aline Brietzke²  Alicia Deitos²  Letizzia Dall’Agnol²  Jairo Alberto Dussán-Sarria²  Liciane Fernandes Medeiros²  Iraci LS Torres²  Liliane Pinto Vidor² 

[1] Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States of America;Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil;Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, Bairro Santa Cecilia, Porto Alegre, Rio Grande do Sul CEP 90035-903, Brazil

关键词: Myofascial pain syndrome;    Anxiety;    Neuromodulation;    Noninvasive brain stimulation;    Chronic pain;    Transcranial magnetic stimulation;   

Others  :  799431
DOI  :  10.1186/1471-2202-15-42

 received in 2013-10-01, accepted in 2014-03-12,  发布年份 2014

【 摘 要 】

Background

This study aimed to answer three questions related to chronic myofascial pain syndrome (MPS): 1) Is the motor cortex excitability, as assessed by transcranial magnetic stimulation parameters (TMS), related to state-trait anxiety? 2) Does anxiety modulate corticospinal excitability changes after evoked pain by Quantitative Sensory Testing (QST)? 3) Does the state-trait anxiety predict the response to pain evoked by QST if simultaneously receiving a heterotopic stimulus [Conditional Pain Modulation (CPM)]? We included females with chronic MPS (n = 47) and healthy controls (n = 11), aged 19 to 65 years. Motor cortex excitability was assessed by TMS, and anxiety was assessed based on the State-Trait Anxiety Inventory. The disability related to pain (DRP) was assessed by the Profile of Chronic Pain scale for the Brazilian population (B:PCP:S), and the psychophysical pain measurements were measured by the QST and CPM.

Results

In patients, trait-anxiety was positively correlated to intracortical facilitation (ICF) at baseline and after QST evoked pain (β = 0.05 and β = 0.04, respectively) and negatively correlated to the cortical silent period (CSP) (β = -1.17 and β = -1.23, respectively) (P <0.05 for all comparisons). After QST evoked pain, the DRP was positively correlated to ICF (β = 0.02) (P < 0.05). Pain scores during CPM were positively correlated with trait-anxiety when it was concurrently with high DRP (β = 0.39; P = 0.02). Controls’ cortical excitability remained unchanged after QST.

Conclusions

These findings suggest that, in chronic MPS, the imbalance between excitatory and inhibitory descending systems of the corticospinal tract is associated with higher trait-anxiety concurrent with higher DRP.

【 授权许可】

   
2014 Vidor et al.; licensee BioMed Central Ltd.

【 图 表 】

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