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

Abstract

When a movement repeatedly generates pain, we anticipate movement-related pain and establish self-protective strategies during motor preparation, but the underlying mechanisms remains poorly understood. The current study investigated the effect of movement-related pain anticipation on the modulation of behaviour and corticospinal excitability during the preparation of arm movements. Participants completed an instructed-delay reaction-time (RT) task consisting of elbow flexions and extensions instructed by visual cues. Nociceptive laser stimulations (unconditioned stimuli) were applied to the lateral epicondyle during movement execution in a specific direction (CS+) but not in the other (CS-), depending on experimental group. During motor preparation, transcranial magnetic stimulation was used to measure corticospinal excitability in the biceps brachii (BB). RT and peak end-point velocity were also measured. Neurophysiological results revealed an opposite modulation of corticospinal excitability in BB depending on whether it plays an agonist (i.e. flexion) or antagonist (i.e. extension) role for the CS+ movements (P < 0.001). Moreover, behavioural results showed that for the CS+ movements RT did not change relative to baseline, whereas the CS- movements were initiated more quickly (P = 0.023) and the CS+ flexion movements were faster relative to the CS- flexion movements (P < 0.001). This is consistent with the pain adaptation theory which proposes that in order to protect the body from further pain, agonist muscle activity is reduced and antagonist muscle activity is increased. If these strategies are initially relevant and lead to short-term pain alleviation, they may potentially have detrimental long-term consequences and lead to the development of chronic pain.

Cortical dynamics of movement‐evoked pain in chronic low back pain

“…With regard to reaction time, studies investigating movement-related experimental pain in humans have shown both shorter and prolonged reaction times (Misra et al 2017a;Neige et al 2018). In the current study we found longer reaction times in the cLBP+ group, perhaps as a result of an increase in endogenous movement-evoked pain.…”

Neurophysiological evidence of the dynamic and adaptive pain‐motor interaction

“…Neige et al. provide new evidence of how the anticipation of movement‐related pain alters corticospinal tract excitability during motor preparation (Neige, Mavromatis, Gagné, Bouyer, & Mercier, ). They recorded motor evoked potentials from the biceps brachii immediately preceding the execution of elbow flexion and extension movements.…”

Kinematic changes in goal-directed movements in a fear-conditioning paradigm

“…In contrast, several previous studies reported that healthy participants performed movements quickly under the experimental condition of feeling fear 27,34 . We suspect that these differences in results between previous investigations and our present study are due to the timing of the delivery of the painful stimulation.…”