疼痛威胁下的局部选择性运动抑制

IF 5.9 1区 医学 Q1 ANESTHESIOLOGY
PAIN® Pub Date : 2024-12-01 Epub Date: 2024-06-25 DOI:10.1097/j.pain.0000000000003301
Sonia Betti, Marco Badioli, Daniela Dalbagno, Sara Garofalo, Giuseppe di Pellegrino, Francesca Starita
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引用次数: 0

摘要

摘要:在疼痛发生之前,只要受到疼痛的威胁,就可能会产生与疼痛相关的运动适应。然而,对于人类来说,预测疼痛时运动适应的神经生理机制仍然知之甚少。我们追踪了当健康成年人学会预测上肢肌肉特异性侧痛发生时皮质脊髓兴奋性(CSE)的变化。通过巴甫洛夫威胁条件反射任务,不同的视觉刺激预示着左右前臂(实验 1)或手部(实验 2)的疼痛。在疼痛发生前的刺激呈现过程中,对左侧初级运动皮层进行单脉冲经颅磁刺激,以探测 CSE 并诱发目标右前臂和手部肌肉的运动诱发电位。此外,还评估了参与者的特质焦虑与 CSE 之间的相关性。结果显示,疼痛威胁会触发皮质脊髓抑制,特别是在预期疼痛的肢体上。此外,皮质脊髓的抑制作用是相对于受威胁的肌肉而调节的,前臂受到疼痛的威胁会抑制前臂和手部肌肉,而手部受到疼痛的威胁只会抑制手部肌肉。最后,较强的皮质脊髓抑制与较强的特质焦虑相关。这些结果推进了对疼痛过程的机理认识,表明与疼痛相关的运动适应仅仅是在疼痛威胁下发生的,是一组与预期疼痛相关并受个体焦虑水平影响的预期性、地形上有组织的运动变化。将这种预期运动变化纳入疼痛模型可能会带来治疗疼痛相关疾病的新方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Topographically selective motor inhibition under threat of pain.

Abstract: Pain-related motor adaptations may be enacted predictively at the mere threat of pain, before pain occurrence. Yet, in humans, the neurophysiological mechanisms underlying motor adaptations in anticipation of pain remain poorly understood. We tracked the evolution of changes in corticospinal excitability (CSE) as healthy adults learned to anticipate the occurrence of lateralized, muscle-specific pain to the upper limb. Using a Pavlovian threat conditioning task, different visual stimuli predicted pain to the right or left forearm (experiment 1) or hand (experiment 2). During stimuli presentation before pain occurrence, single-pulse transcranial magnetic stimulation was applied over the left primary motor cortex to probe CSE and elicit motor evoked potentials from target right forearm and hand muscles. The correlation between participants' trait anxiety and CSE was also assessed. Results showed that threat of pain triggered corticospinal inhibition specifically in the limb where pain was expected. In addition, corticospinal inhibition was modulated relative to the threatened muscle, with threat of pain to the forearm inhibiting the forearm and hand muscles, whereas threat of pain to the hand inhibited the hand muscle only. Finally, stronger corticospinal inhibition correlated with greater trait anxiety. These results advance the mechanistic understanding of pain processes showing that pain-related motor adaptations are enacted at the mere threat of pain, as sets of anticipatory, topographically organized motor changes that are associated with the expected pain and are shaped by individual anxiety levels. Including such anticipatory motor changes into models of pain may lead to new treatments for pain-related disorders.

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来源期刊
PAIN®
PAIN® 医学-临床神经学
CiteScore
12.50
自引率
8.10%
发文量
242
审稿时长
9 months
期刊介绍: PAIN® is the official publication of the International Association for the Study of Pain and publishes original research on the nature,mechanisms and treatment of pain.PAIN® provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest.
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