Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
Department of Statistics, Umeå University, Umeå, Sweden.
Exp Brain Res. 2024 Aug;242(8):1903-1915. doi: 10.1007/s00221-024-06873-0. Epub 2024 Jun 19.
Musculoskeletal trauma often leads to lasting psychological impacts stemming from concerns of future injuries. Often referred to as kinesiophobia or re-injury anxiety, such concerns have been shown to hinder return to physical activity and are believed to increase the risk for secondary injuries. Screening for re-injury anxiety is currently restricted to subjective questionnaires, which are prone to self-report bias. We introduce a novel approach to objectively identify electrocortical activity associated with the threat of destabilising perturbations. We aimed to explore its feasibility among non-injured persons, with potential future implementation for screening of re-injury anxiety. Twenty-three participants stood blindfolded on a translational balance perturbation platform. Consecutive auditory stimuli were provided as low (neutral stimulus [CS]) or high (conditioned stimulus [CS]) tones. For the main experimental protocol (Protocol I), half of the high tones were followed by a perturbation in one of eight unpredictable directions. A separate validation protocol (Protocol II) requiring voluntary squatting without perturbations was performed with 12 participants. Event-related potentials (ERP) were computed from electroencephalography recordings and significant time-domain components were detected using an interval-wise testing procedure. High-amplitude early contingent negative variation (CNV) waves were significantly greater for CS compared with CS trials in all channels for Protocol I (> 521-800ms), most prominently over frontal and central midline locations (P ≤ 0.001). For Protocol II, shorter frontal ERP components were observed (541-609ms). Our test paradigm revealed electrocortical activation possibly associated with movement-related fear. Exploring the discriminative validity of the paradigm among individuals with and without self-reported re-injury anxiety is warranted.
肌肉骨骼创伤常导致持久的心理影响，源于对未来受伤的担忧。这种担忧通常被称为运动恐惧症或再损伤焦虑，已被证明会阻碍身体活动的恢复，并被认为会增加二次损伤的风险。再损伤焦虑的筛查目前仅限于主观问卷，这些问卷容易受到自我报告偏差的影响。我们介绍了一种客观识别与不稳定扰动威胁相关的皮层电活动的新方法。我们旨在探索其在未受伤人群中的可行性，以便将来用于再损伤焦虑的筛查。23 名参与者蒙上眼罩站在平移平衡扰动平台上。连续提供低频（中性刺激[CS]）或高频（条件刺激[CS]）声音。对于主要的实验方案（方案 I），一半的高音后面跟着 8 个不可预测方向中的一个扰动。与 12 名参与者一起进行了单独的验证方案（方案 II），要求在没有扰动的情况下自愿蹲下。使用事件相关电位（ERP）从脑电图记录中计算，并使用间隔测试程序检测显著的时域分量。与 CS 相比，在方案 I 中的所有通道中，CS 试验的早期高振幅条件性负变（CNV）波显著更大（>521-800ms），最突出的是在前额和中央中线位置（P≤0.001）。对于方案 II，观察到较短的额部 ERP 成分（541-609ms）。我们的测试范式揭示了可能与运动相关的恐惧相关的皮层电激活。在有和没有自我报告的再损伤焦虑的个体中探索该范式的鉴别有效性是合理的。
