Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus, Aalborg, Denmark.
J Pain. 2023 Jun;24(6):1039-1055. doi: 10.1016/j.jpain.2023.01.017. Epub 2023 Jan 28.
Repetitive movements (RM) are a main risk factor for musculoskeletal pain, which is partly explained by the overloading of musculoskeletal structures. However, RM may also drive brain plasticity, leading to maladaptive changes in sensorimotor areas and altered pain processing. This study aimed to understand whether individuals performing extensive RM (musicians) exhibit altered brain processing to prolonged experimental muscle pain. Nineteen healthy musicians and 20 healthy nontrained controls attended 3 sessions (Day 1-Day 3-Day 8). In each session, event-related potentials (ERPs) to non-nociceptive superficial and nociceptive intraepidermal electrical stimulation, reaction times, electrical detection thresholds, and pressure pain thresholds (PPTs) were recorded. In all participants, prolonged muscle pain was induced by intramuscular injection of nerve growth factor (NGF) into the right first dorsal interosseous muscle at the end of Day1. Pain intensity was assessed on a numerical rating scale (NRS) and was lower in musicians compared to non-musicians (P < .007). Moreover, in musicians, the higher amount of weekly training was associated with lower NRS pain scores on Day 3 to Day 8 (P < .037). Compared with Day1, NGF reduced PPTs on Day 3 to Day 8 (P < .001) and non-nociceptive P200 and P300 ERP amplitudes on Day 8 (P < .044) in both groups. Musicians compared to controls showed secondary hyperalgesia to electrical stimulation on Day 3 to Day 8 (P < .004) and reduced nociceptive P200 ERP amplitudes on Day 8 (P < .005). Across participants, ERP components correlated with pain detection reaction times, sensitivity (PPTs and electrical detection thresholds), and severity (NRS), (all P < .043). These results show that repetitive sensorimotor training leads to brain changes in the processing of prolonged pain, biasing the cortical response to nociceptive inputs. PERSPECTIVE: Repetitive sensorimotor training may increase the responsiveness of nociceptive inputs during the development of prolonged muscle pain. These novel data highlight the role of repetitive sensorimotor practice as a source for interindividual variability in central pain processing.
重复运动（RM）是肌肉骨骼疼痛的主要危险因素，部分原因是肌肉骨骼结构的超负荷。然而，RM 也可能驱动大脑的可塑性，导致感觉运动区域的适应不良变化和疼痛处理的改变。本研究旨在了解进行大量 RM（音乐家）的个体是否表现出对长时间实验性肌肉疼痛的大脑处理改变。19 名健康音乐家和 20 名健康非训练对照者参加了 3 次会议（第 1 天-第 3 天-第 8 天）。在每次会议中，记录了非伤害性浅表和伤害性表皮内电刺激的事件相关电位（ERP）、反应时间、电检测阈值和压力疼痛阈值（PPT）。在所有参与者中，在第 1 天结束时通过向右侧第一背间骨间肌内注射神经生长因子（NGF）来诱导长时间肌肉疼痛。使用数字评分量表（NRS）评估疼痛强度，音乐家的疼痛强度低于非音乐家（P <.007）。此外，在音乐家中，每周训练量与第 3 天至第 8 天的 NRS 疼痛评分较低相关（P <.037）。与第 1 天相比，NGF 在第 3 天至第 8 天降低了 PPT（P <.001）和两组第 8 天的非伤害性 P200 和 P300 ERP 幅度（P <.044）。与对照组相比，音乐家在第 3 天至第 8 天对电刺激表现出二次痛觉过敏（P <.004），并且在第 8 天对伤害性 P200 ERP 幅度降低（P <.005）。在所有参与者中，ERP 成分与疼痛检测反应时间、敏感性（PPT 和电检测阈值）和严重程度（NRS）相关（所有 P <.043）。这些结果表明，重复的感觉运动训练会导致长时间疼痛处理中的大脑变化，从而影响皮质对伤害性输入的反应。观点：重复的感觉运动训练可能会增加长时间肌肉疼痛发展过程中伤害性输入的反应性。这些新数据强调了重复感觉运动练习作为个体间中央疼痛处理变异性来源的作用。
