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.
Highlights
Moving our limbs and interacting within the world involves the generation of a motor intention and motor commands, monitored by feedback arising from proprioceptive, tactile and visual information
Test in the we explored whether the percentage of inhibition of MEPtest in the PAIN condition intra-subject variability in Rather, the amount of inhibition for a given subject was very similar relative to the NEUTRAL condition was associated with pain intensity
(1) approximately that muscle responses consistent with several other studies showing that experimental cutaneous and muscle hand pain were inhibited in the presence of pain; (2) that significant inhibition was observed when the transcranial magnetic stimulation (TMS) pulse reduce the corticospinal excitability hand muscles test amplitudes occurred
Summary
Moving our limbs and interacting within the world involves the generation of a motor intention and motor commands, monitored by feedback arising from proprioceptive, tactile and visual information. This constant integration of sensorimotor information is essential to maintain a coherent representation of our body as well as to adapt to new conditions. Harris proposed that this type of discordance could result in the sensation of pain and might be related to some pathological pain states such as phantom limb pain [4]. While Harris’ hypothesis has raised a lot of interest from a clinical perspective, the neural mechanisms underlying discordance” or
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