Intracortical Inhibition in the Affected Hemisphere in Limb Amputation

Santos, Ludmilla Candido; Gushken, Fernanda; Gadotti, Gabriela Morelli; Dias, Bruna de Freitas; Pedrini, Stella Marinelli; Barreto, Maria Eduarda Slhessarenko Fraife; Zippo, Emanuela; Pinto, Camila Bonin; Piza, Polyana Vulcano de Toledo; Fregni, Felipe

doi:10.3389/fneur.2020.00720

Cited by 13 publications

(6 citation statements)

References 50 publications

(128 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is an interesting finding, besides expected. We have shown in several studies that pain intensity does not correlate with ICI 6 , 9 . In a review, Santos et al analyzed ICI and CSP in studies targeting individuals with limb amputation and most of these showed no relationship between cortical excitability and pain intensity 9 .…”

Section: Discussionmentioning

confidence: 82%

“…We have shown in several studies that pain intensity does not correlate with ICI 6 , 9 . In a review, Santos et al analyzed ICI and CSP in studies targeting individuals with limb amputation and most of these showed no relationship between cortical excitability and pain intensity 9 . Additionally, Teixeira et al were not able to find any association between changing in cortical excitability and pain intensity, analyzing longitudinal data from a clinical trial targeting subjects with phantom limb pain 6 .…”

Section: Discussionmentioning

confidence: 82%

“…These modifications on the central nervous system imply an imbalance of the neural stability between excitability and inhibition 8 . Current evidence has shown that a deficit in neuronal inhibition occurs in patients with motor disability and pain conditions 9 – 11 and this lack of cortex inhibition is associated with more disability 12 . In fact, one of the contributors of pain in these patients may be an impaired cortical inhibitory system that cannot compensate for excessive peripheral increased nociception.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Increased motor cortex inhibition as a marker of compensation to chronic pain in knee osteoarthritis

Simis

Imamura

Melo

et al. 2021

Sci Rep

Self Cite

View full text Add to dashboard Cite

This study aims to investigate the associative and multivariate relationship between different sociodemographic and clinical variables with cortical excitability as indexed by transcranial magnetic stimulation (TMS) markers in subjects with chronic pain caused by knee osteoarthritis (OA). This was a cross-sectional study. Sociodemographic and clinical data were extracted from 107 knee OA subjects. To identify associated factors, we performed independent univariate and multivariate regression models per TMS markers: motor threshold (MT), motor evoked potential (MEP), short intracortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). In our multivariate models, the two markers of intracortical inhibition, SICI and CSP, had a similar signature. SICI was associated with age (β: 0.01), WOMAC pain (β: 0.023), OA severity (as indexed by Kellgren–Lawrence Classification) (β: − 0.07), and anxiety (β: − 0.015). Similarly, CSP was associated with age (β: − 0.929), OA severity (β: 6.755), and cognition (as indexed by the Montreal Cognitive Assessment) (β: − 2.106). ICF and MT showed distinct signatures from SICI and CSP. ICF was associated with pain measured through the Visual Analogue Scale (β: − 0.094) and WOMAC (β: 0.062), and anxiety (β: − 0.039). Likewise, MT was associated with WOMAC (β: 1.029) and VAS (β: − 2.003) pain scales, anxiety (β: − 0.813), and age (β: − 0.306). These associations showed the fundamental role of intracortical inhibition as a marker of adaptation to chronic pain. Subjects with higher intracortical inhibition (likely subjects with more compensation) are younger, have greater cartilage degeneration (as seen by radiographic severity), and have less pain in WOMAC scale. While it does seem that ICF and MT may indicate a more acute marker of adaptation, such as that higher ICF and MT in the motor cortex is associated with lesser pain and anxiety.

show abstract

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Increased motor cortex inhibition as a marker of compensation to chronic pain in knee osteoarthritis

Simis

Imamura

Melo

et al. 2021

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…Following SCI, extensive functional plasticity and the reorganization of neuronal circuits often involve altered inhibitory neurotransmission [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Although brain disinhibition has been explored extensively for pathologies such as peripheral deafferentation and stroke [ 38 , 39 , 40 , 41 , 42 , 43 ], it remains resolved to a lesser extent in the context of SCI [ 44 ]. The establishment of direct comparisons between cortical output and motor performance after SCI and after other pathologies, such as peripheral deafferentation or stroke, is hindered by discrepancies intrinsic to various conditions.…”

Section: Tms As a Methods To Analyze The Loss Of Inhibition After Scimentioning

confidence: 99%

Spinal Cord Injury and Loss of Cortical Inhibition

Benedetti

Weidenhammer

Reisinger

et al. 2022

IJMS

View full text Add to dashboard Cite

After spinal cord injury (SCI), the destruction of spinal parenchyma causes permanent deficits in motor functions, which correlates with the severity and location of the lesion. Despite being disconnected from their targets, most cortical motor neurons survive the acute phase of SCI, and these neurons can therefore be a resource for functional recovery, provided that they are properly reconnected and retuned to a physiological state. However, inappropriate re-integration of cortical neurons or aberrant activity of corticospinal networks may worsen the long-term outcomes of SCI. In this review, we revisit recent studies addressing the relation between cortical disinhibition and functional recovery after SCI. Evidence suggests that cortical disinhibition can be either beneficial or detrimental in a context-dependent manner. A careful examination of clinical data helps to resolve apparent paradoxes and explain the heterogeneity of treatment outcomes. Additionally, evidence gained from SCI animal models indicates probable mechanisms mediating cortical disinhibition. Understanding the mechanisms and dynamics of cortical disinhibition is a prerequisite to improve current interventions through targeted pharmacological and/or rehabilitative interventions following SCI.

show abstract

“…However, evidence suggests that injuries in the nervous system unbalance neural stability (6). For example, recently, evidence has shown that a deficit in neuronal inhibition is detected in patients with a disability regardless of etiology (7)(8)(9), and this lack of inhibition is associated with more disability (10). The understanding of brain plasticity has advanced; however, this knowledge has had a low impact on the rehabilitation practice (1).…”

Section: Introductionmentioning

confidence: 99%

Deficit of Inhibition as a Marker of Neuroplasticity (DEFINE Study) in Rehabilitation: A Longitudinal Cohort Study Protocol

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: Brain plasticity is an intrinsic property of the nervous system, which is modified during its lifetime. This is one mechanism of recuperation after injuries with an important role in rehabilitation. Evidence suggests that injuries in the nervous system disturb the stability between inhibition and excitability essential for the recuperation process of neuroplasticity. However, the mechanisms involved in this balance are not completely understood and, besides the advancement in the field, the knowledge has had a low impact on the rehabilitation practice. Therefore, the understanding of the relationship between biomarkers and functional disability may help to optimize and individualize treatments and build consistent studies in the future.Methods: This cohort study, the deficit of inhibition as a marker of neuroplasticity study, will follow four groups (stroke, spinal cord injury, limb amputation, and osteoarthritis) to understand the neuroplasticity mechanisms involved in motor rehabilitation. We will recruit 500 subjects (including 100 age- and sex-matched controls). A battery of neurophysiological assessments, transcranial magnetic stimulation, electroencephalography, functional near-infrared spectroscopy, and magnetic resonance imaging, is going to be used to assess plasticity on the motor cortex before and after rehabilitation. One of the main hypotheses in this cohort is that the level of intracortical inhibition is related to functional deficits. We expect to develop a better understanding of the neuroplasticity mechanisms involved in the rehabilitation, and we expect to build neurophysiological “transdiagnostic” biomarkers, especially the markers of inhibition, which will have great relevance in the scientific and therapeutic improvement in rehabilitation. The relationship between neurophysiological and clinical outcomes will be analyzed using linear and logistic regression models.Discussion: By evaluating the reliability of electroencephalography, functional near-infrared spectroscopy, transcranial magnetic stimulation, and magnetic resonance imaging measures as possible biomarkers for neurologic rehabilitation in different neurologic disorders, this study will aid in the understanding of brain plasticity mechanisms in rehabilitation, allowing more effective approaches and screening methods to take place.

show abstract

Intracortical Inhibition in the Affected Hemisphere in Limb Amputation

Cited by 13 publications

References 50 publications

Increased motor cortex inhibition as a marker of compensation to chronic pain in knee osteoarthritis

Increased motor cortex inhibition as a marker of compensation to chronic pain in knee osteoarthritis

Spinal Cord Injury and Loss of Cortical Inhibition

Deficit of Inhibition as a Marker of Neuroplasticity (DEFINE Study) in Rehabilitation: A Longitudinal Cohort Study Protocol

Contact Info

Product

Resources

About