Alhassani Ghufran, Clothier Peter J, Liston Matthew B, Schabrun Siobhan M
School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia.
Centre for Human and Applied Physiological Sciences, Kings College, Strand, London, UK.
J Pain. 2024 Jan;25(1):284-292. doi: 10.1016/j.jpain.2023.08.013. Epub 2023 Aug 28.
Lateral epicondylalgia (LE), commonly referred to as tennis elbow, is a musculoskeletal condition characterized by pain and sensorimotor dysfunction. In some individuals with chronic unilateral LE, sensorimotor symptoms develop on the unaffected side despite no evidence of tissue damage. Altered interhemispheric inhibition (IHI) is one mechanism that could underpin this phenomenon. The aim of this cross-sectional study was to examine IHI between the primary motor cortices (M1) in individuals with chronic LE and healthy controls. In 20 individuals with chronic LE and 20 healthy participants, transcranial magnetic stimulation was used to assess 1) short and long-latency IHI from the affected (corresponding to the injured side) to the unaffected M1 and 2) corticomotor excitability of the affected and unaffected M1. Sensorimotor function was evaluated bilaterally at the extensor carpi radialis brevis muscle using pressure pain threshold, grip strength, 2-point discrimination, and temporal summation tests. Short- and long-latency IHI from the affected to the unaffected M1 and corticomotor excitability of the affected and unaffected M1 were not altered in individuals with LE compared with healthy participants. No differences in sensorimotor function were observed for the affected or unaffected extensor carpi radialis brevis muscles when individuals with LE were compared with healthy participants. IHI is not altered in individuals with chronic LE. Further studies are required to determine the mechanisms that underpin the development of bilateral sensorimotor symptoms in unilateral LE. PERSPECTIVE: IHI is unaltered from the affected M1 (corresponding to the painful muscle) to unaffected M1 in individuals with LE compared to healthy controls. The absence of bilateral sensorimotor dysfunction and low pain severity in this cohort of individuals with LE may explain this finding.
外侧上髁炎(LE),通常称为网球肘,是一种以疼痛和感觉运动功能障碍为特征的肌肉骨骼疾病。在一些患有慢性单侧LE的个体中,尽管没有组织损伤的证据,但未受影响的一侧仍会出现感觉运动症状。半球间抑制(IHI)改变是这一现象的一种潜在机制。本横断面研究的目的是检查慢性LE患者和健康对照者初级运动皮层(M1)之间的IHI。对20名慢性LE患者和20名健康参与者,采用经颅磁刺激来评估:1)从受影响侧(对应于受伤侧)到未受影响的M1的短潜伏期和长潜伏期IHI;2)受影响和未受影响的M1的皮质运动兴奋性。使用压力痛阈、握力、两点辨别和时间总和测试,在双侧桡侧腕短伸肌处评估感觉运动功能。与健康参与者相比,LE患者从受影响侧到未受影响侧M1的短潜伏期和长潜伏期IHI以及受影响和未受影响M1的皮质运动兴奋性没有改变。当将LE患者与健康参与者进行比较时,未观察到受影响或未受影响的桡侧腕短伸肌在感觉运动功能上存在差异。慢性LE患者的IHI没有改变。需要进一步研究以确定单侧LE中双侧感觉运动症状发展的潜在机制。观点:与健康对照相比,LE患者从受影响的M1(对应于疼痛肌肉)到未受影响的M1的IHI没有改变。该LE患者队列中缺乏双侧感觉运动功能障碍和低疼痛严重程度可能解释了这一发现。