Abstract
Chronic low back pain (CLBP) was shown to be associated with longer reflex response latencies of trunk muscles during external upper limb perturbations. One theoretical, but rarely investigated possibility for longer reflex latencies might be related to modulated somatosensory information processing. Therefore, the present study investigated somatosensory evoked potentials (SEPs) to median nerve stimulation in CLBP patients and healthy controls (HC). Latencies of the peripheral N9 SEP component were used as the primary outcome. In addition, latencies and amplitudes of the central N20 SEP component, sensory thresholds, motor thresholds and nerve conduction velocity were also analyzed in CLBP patients and HC. There is a trend for the CLBP patients to exhibit longer N9 latencies at the ipsilateral Erb’s point compared to HC. This trend is substantiated by significantly longer N9 latencies in CLBP patients compared to normative data. None of the other parameters showed any significant difference between CLBP patients and HC. Overall, our data indicate small differences of the peripheral N9 SEP component; however, these differences cannot explain the reflex delay observed in CLBP patients. While it was important to rule out the contribution of early somatosensory processing and to elucidate its contribution to the delayed reflex responses in CLBP patients, further research is needed to find the primary source(s) of time-delayed reflexes in CLBP.
Highlights
Back pain has become one of the biggest problems of public health in the Western countries
chronic low back pain (CLBP) patients show impairments of muscle relaxation (Paquet et al, 1994), postural control (Radebold et al, 2000), proprioception (Brumagne et al, 2004), respond with pain to nociceptive stimuli of low intensity (Puta et al, 2012, 2013), and show cortical reorganization of representation areas of the back compared to healthy controls (HC; Flor et al, 1997)
Our results demonstrate for the first time that there is only a small temporal difference of 0.4 ms in latency of the N9 component measured at Erb’s point between CLBP patients and HC
Summary
Back pain has become one of the biggest problems of public health in the Western countries. The prevalence of chronic low back pain (CLBP) is 23%, and 12% of the population in the Western countries is disabled by low back pain (Airaksinen et al, 2006). CLBP patients show impairments of muscle relaxation (Paquet et al, 1994), postural control (Radebold et al, 2000), proprioception (Brumagne et al, 2004), respond with pain to nociceptive stimuli of low intensity (Puta et al, 2012, 2013), and show cortical reorganization of representation areas of the back compared to healthy controls (HC; Flor et al, 1997). Data indicate that CLBP subjects show significant changes of body image and a decrease of tactile acuity in the body area affected by pain (Moseley, 2008)
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