Sensorimotor Cortical Activity in Acute Low Back Pain: A Cross-Sectional Study

JOURNAL OF PAIN

卷:20

Article

Chang, Wei-Ju¹  Buscemi, Valentina¹  Liston, Matthew B.²  McAuley, James H.³  Hodges, Paul W.⁴  Schabrun, Siobhan M.³ 

[1] Western Sydney Univ, Sch Sci & Hlth, Sydney, NSW, Australia

[2] Kings Coll London, Fac Life Sci & Med, Ctr Human & Appl Physiol Sci, Shepherds House, London, England

[3] Neurosci Res Australia NeuRA, Sydney, NSW, Australia

[4] Univ Queensland, Sch Hlth & Rehabil Sci, St Lucia, Qld, Australia

关键词: Low back pain;    primary sensory cortex;    primary motor cortex;    sensory evoked potentials;    transcranial magnetic stimulation;   

DOI  :  10.1016/j.jpain.2019.01.006

来源: Elsevier

【 摘 要 】

Sensorimotor cortical activity is altered in both the immediate acute and chronic stages of musculoskeletal pain. However, these changes are opposite, with decreased cortical activity reported in experimentally induced acute pain (lasting minutes to hours), and increased cortical activity in chronic, clinical pain (lasting >6 months). It is unknown whether sensorimotor cortical activity is altered in acute, clinical musculoskeletal pain (lasting <4 weeks). In 36 individuals with acute, nonspecific, clinical low back pain (LBP) and 36 age- and sex-matched, pain-free controls, we investigated the processing of non-noxious afferent inputs using sensory evoked potentials (SEPs), as well as corticomotor excitability and organization of the primary motor cortex using transcranial magnetic stimulation. Processing of non-noxious sensory inputs was lower (smaller area of the N-80-N-150-P260 SEP complex) in acute LBP (F-1,F-70 = 45.28, P < .01). The examination of specific SEP components revealed a smaller area of the N-150 and P-260 SEP components in acute LBP, although interindividual variability was high. Motor cortical map volume was lower in acute LBP (F-1,F-70 = 5.61, P= .02). These findings demonstrate that acute LBP is characterized by lower sensorimotor cortical activity at the group level. However, individual variation was high, suggesting individual adaptation of cortical plasticity in acute pain. Perspective: This is the first study to examine sensorimotor cortical activity in the acute stage of clinical LBP. This information is critical for understanding the neurophysiology of acute LBP. (C) 2019 by the American Pain Society

【 授权许可】

Free