Effect of Experimental Cutaneous Hand Pain on Corticospinal Excitability and Short Afferent Inhibition

Abstract

Sensorimotor integration is altered in people with chronic pain. While there is substantial evidence that pain interferes with neural activity in primary sensory and motor cortices, much less is known about its impact on integrative sensorimotor processes. Here, the short latency afferent inhibition (SAI) paradigm was used to assess sensorimotor integration in the presence and absence of experimental cutaneous heat pain applied to the hand. Ulnar nerve stimulation was combined with transcranial magnetic stimulation to condition motor evoked potentials (MEPs) in the first dorsal interosseous muscle. Four interstimulus intervals (ISI) were tested, based on the latency of the N20 component of the afferent sensory volley (N20−5 ms, N20+2 ms, N20+4 ms, N20+10 ms). In the PAIN condition, MEPs were smaller compared to the NEUTRAL condition (p = 0.005), and were modulated as a function of the ISI (p = 0.012). Post-hoc planned comparisons revealed that MEPs at N20+2 and N20+4 were inhibited compared to unconditioned MEPs. However, the level of inhibition (SAI) was similar in the PAIN and NEUTRAL conditions. This suggests that the interplay between pain and sensorimotor integration is not mediated through direct and rapid pathways as assessed by SAI, but rather might involve higher-order integrative areas.

Effect of movement‐related pain on behaviour and corticospinal excitability changes associated with arm movement preparation

“…, ; Dubé & Mercier, ; Mercier et al . ). As pointed out by recent reviews (Hodges & Tucker, ; Bank et al .…”

“…There is growing evidence that the nociceptive and motor systems are extensively connected. Neuroimaging studies report activation of movement-related brain areas in response to nociceptive stimuli (Peyron et al 2000;Koyama et al 2005;Perini & Bergstrand, 2013; and transcranial magnetic stimulation (TMS) studies reveal that phasic experimental pain induces an inhibition of the corticospinal excitability measured at rest (Valeriani et al 1999(Valeriani et al , 2001Dubé & Mercier, 2011;Mercier et al 2016). As pointed out by recent reviews (Hodges & Tucker, 2011;Bank et al 2013), a large number of studies report an impact of experimental pain on motor execution during various motor tasks, but less is known about the effect of pain on motor preparation.…”

Intracortical motor networks are affected in both the contralateral and ipsilateral hemisphere during single limb cold water immersion

“…Studies that assess the effects of acute pain on corticomotor excitability have consistently observed MEP suppression for the contralateral hemisphere (Burns et al, 2016;Fierro et al, 2010;Le Pera et al, 2001;Martin et al, 2008;Mercier et al, 2016;Schabrun & Hodges, 2012;Schabrun et al, 2013;Svensson et al, 2003;Valeriani et al, 2001). Our opposing results may be due to our intervention, which elicited nociception using a different modality.…”

“…Our opposing results may be due to our intervention, which elicited nociception using a different modality. The majority of acute interventions elicit pain via injection to localised areas such as small hand (Burns et al, 2016;Le Pera et al, 2001;Schabrun & Hodges, 2012;Schabrun et al, 2013;Svensson et al, 2003), forearm and upper arm muscles (Martin et al, 2008), via laser stimulation to the dorsal hand , or via transient thermal heat stimulation (at 50 • C) to the side of the hand (Mercier et al, 2016). However, participants in the current study had a comparatively larger surface area exposed to the stimuli, with several participants reporting high levels of pain and cold temperature perception on the NRS scale.…”

The Influence of Experimental Pain on Primary Motor Cortex Function: Protocol for a Systematic Review and Meta-analysis

“…This can in part, be attributed to a limited understanding of the neurophysiological mechanisms that mediate pain. To understand these mechanisms, studies have used experimental models to induce transient pain (momentary pain which resolves within seconds) [2],tonic pain (pain that is sustained over several minutes) [3]or transitional pain (i.e. delayed onset pain sustained over several days or weeks) [4]in healthy individuals while concurrently investigating the effects of pain on brain activity.…”