Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, U.S.A.
J Clin Neurophysiol. 2014 Feb;31(1):94-8. doi: 10.1097/WNP.0000000000000025.
The purposes of this study were to assess corticomotor excitability in people with fibromyalgia during a noxious stimulus before and after fatiguing exercise and examine associations with pain perception. Fifteen women with fibromyalgia completed three sessions: one familiarization and two experimental. The experimental sessions were randomized and involved measurement of pain perception and motor evoked potentials before and after (1) quiet rest and (2) isometric contraction of the elbow flexor muscles. Motor evoked potential amplitude of brachioradialis muscle was measured following transcranial magnetic stimulation delivered before, during, and after a noxious mechanical stimulus. After quiet rest, there was no change in pain perception. After the submaximal contraction, there was considerable variability in the pain response. Based on the changes in the experimental pain, subjects were divided into three groups (increase, decrease, and no change in pain). There was an interaction between pain response and the pain-induced change in motor evoked potentials. Those individuals who had an increase in motor evoked potentials during the pain test had an increase in pain after exercise. Thus, women with fibromyalgia were classified based on their pain response to exercise, and this response was associated with the change in corticomotor excitability during the application of a noxious stimulus.
本研究旨在评估纤维肌痛患者在疲劳运动前后接受有害刺激时的皮质运动兴奋性，并探讨其与疼痛感知的相关性。15 名女性纤维肌痛患者完成了三个阶段：一个熟悉阶段和两个实验阶段。实验阶段是随机的，包括在（1）安静休息和（2）肘部屈肌等长收缩前后测量疼痛感知和运动诱发电位。在给予有害机械刺激之前、期间和之后，通过经颅磁刺激测量肱桡肌的运动诱发电位幅度。安静休息后，疼痛感知没有变化。在亚最大收缩后，疼痛反应有很大的可变性。基于实验疼痛的变化，将受试者分为三组（疼痛增加、疼痛减少和疼痛无变化）。疼痛反应和运动诱发电位引起的疼痛变化之间存在交互作用。在疼痛测试期间运动诱发电位增加的人在运动后疼痛增加。因此，根据对运动的疼痛反应对纤维肌痛患者进行分类，并且这种反应与有害刺激应用期间皮质运动兴奋性的变化相关。
