Abstract
ObjectivesIt has been proposed that in the same way that conflict between vestibular and visual inputs leads to motion sickness, conflict between motor commands and sensory information associated with these commands may contribute to some chronic pain states. Attempts to test this hypothesis by artificially inducing a state of sensorimotor incongruence and assessing self-reported pain have yielded equivocal results. To help clarify the effect sensorimotor incongruence has on pain we investigated the effect of moving in an environment of induced incongruence on pressure pain thresholds (PPT) and the pain experienced immediately on completion of PPT testing.MethodsThirty-five healthy subjects performed synchronous and asynchronous upper-limb movements with and without mirror visual feedback in random order. We measured PPT over the elbow and the pain evoked by testing. Generalised linear mixed-models were performed for each outcome. Condition (four levels) and baseline values for each outcome were within-subject factors.ResultsThere was no effect of condition on PPT (p = 0.887) or pressure-evoked pain (p = 0.771). A sensitivity analysis using only the first PPT measure after each condition confirmed the result (p = 0.867).DiscussionInducing a state of movement related sensorimotor incongruence in the upper-limb of healthy volunteers does not influence PPT, nor the pain evoked by testing. We found no evidence that sensorimotor incongruence upregulates the nociceptive system in healthy volunteers.
Highlights
There is increasing evidence that a number of chronic pain conditions are characterised by functional and structural changes within the brain [1,2,3,4]
The repeatability (ICC) of pressure pain thresholds (PPT) readings for the elbow determined for the three repeated measures collected at baseline was 0.95
The aim of this study was to investigate whether moving in an environment of induced sensorimotor incongruence leads to upregulation of the nociceptive system
Summary
There is increasing evidence that a number of chronic pain conditions are characterised by functional and structural changes within the brain [1,2,3,4]. Some authors have suggested that these changes may be maladaptive and contribute, at least in part, to the maintenance of the chronic pain state [5,6,7]. A mismatch between the brain’s motor control and sensory systems has been suggested as one mechanism whereby maladaptive neuroplastic changes might contribute to the experience of chronic pain [8,9]. It is hypothesised that pain may arise to warn of an error in information processing [8]. Pain induced disruption of cortical somatosensory representation and subsequent distortion of body perception are considered possible mechanisms underpinning the production of sensorimotor incongruence in clinical populations [8,12]
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