School of Health Sciences, Western Sydney University, Penrith, NSW, Australia.
Centre for Human and Applied Physiological Sciences, Kings College, London, UK.
J Pain. 2022 Jul;23(7):1177-1186. doi: 10.1016/j.jpain.2022.01.005. Epub 2022 Feb 4.
Bilateral deficits in sensorimotor function have been observed in unilateral musculoskeletal pain conditions. Altered interhemispheric inhibition (IHI) between primary sensory cortices (S1s) is one mechanism that could explain this phenomenon. However, IHI between S1s in response to acute muscle pain, and the relationship between IHI and pressure pain sensitivity in the unaffected limb have not been examined. In 21 healthy individuals, IHI was assessed using somatosensory evoked potentials in response to paired median nerve electrical stimulation at: 1) baseline; 2) immediately following pain resolution; and 3) at 30-minutes follow-up. Acute muscle pain was induced by injection of hypertonic saline into the right abductor pollicis brevis (APB) muscle. Pressure pain thresholds were assessed at the right and left APB muscles before and 30-minutes after pain resolution. Compared to baseline, IHI from the affected to unaffected S1 was unaltered in response to acute muscle pain immediately following pain resolution, or at 30-minutes follow-up. Pressure pain thresholds were reduced over the right (P = .001) and left (P = .001) APB muscles at 30-minutes follow-up. These findings suggest IHI between S1s is unaffected by acute, short-lasting muscle pain, despite the development of increased sensitivity to pressure in the unaffected APB muscle. PERSPECTIVE: IHI from the affected S1 (contralateral to the side of pain) to unaffected S1 is unaltered following the resolution of acute muscle pain. This finding suggests that IHI between S1s may not be relevant in the development of bilateral sensorimotor symptoms in unilateral pain conditions.
在单侧肌肉骨骼疼痛情况下,已经观察到感觉运动功能的双侧缺陷。初级感觉皮层(S1)之间的抑制(IHI)改变是一种可以解释这种现象的机制。然而,尚未研究急性肌肉疼痛时 S1 之间的 IHI 以及未受影响肢体的 IHI 与压痛敏感性之间的关系。在 21 名健康个体中,通过在以下情况下使用体感诱发电位评估 S1 之间的 IHI:1)基线;2)疼痛缓解后立即;3)在 30 分钟随访时。通过向右侧拇短展肌(APB)肌肉注射高渗盐水来诱导急性肌肉疼痛。在疼痛缓解前和缓解后 30 分钟评估右侧和左侧 APB 肌肉的压痛阈值。与基线相比,在疼痛缓解后立即或 30 分钟随访时,受影响的 S1 到未受影响的 S1 的 IHI 没有变化。在 30 分钟随访时,右侧(P=0.001)和左侧(P=0.001)APB 肌肉的压痛阈值降低。这些发现表明,尽管未受影响的 APB 肌肉对压力的敏感性增加,但急性,短暂的肌肉疼痛不会影响 S1 之间的 IHI。观点:急性肌肉疼痛缓解后,受影响的 S1(疼痛侧的对侧)到未受影响的 S1 的 IHI 不变。这一发现表明,在单侧疼痛情况下双侧感觉运动症状的发展中,S1 之间的 IHI 可能并不相关。