Characterisation of motor cortex organisation in patients with different presentations of persistent low back pain

Elgueta‐Cancino, Edith, Sheeran, Liba, Salomoni, Sauro, Hall, Leanne, and Hodges, Paul W. (2021) Characterisation of motor cortex organisation in patients with different presentations of persistent low back pain. European Journal of Neuroscience, 54 (11). pp. 7989-8005.

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Persistence of low back pain is thought to be associated with different underlying pain mechanisms, including ongoing nociceptive input and central sensitisation. We hypothesised that primary motor cortex (M1) representations of back muscles (a measure of motor system adaptation) would differ between pain mechanisms, with more consistent observations in individuals presumed to have an ongoing contribution of nociceptive input consistently related to movement/posture. We tested 28 participants with low back pain sub-grouped by the presumed underlying pain mechanisms: nociceptive pain, nociplastic pain and a mixed group with features consistent with both. Transcranial magnetic stimulation was used to study M1 organisation of back muscles. M1 maps of multifidus (deep and superficial) and longissimus erector spinae were recorded with fine-wire electromyography and thoracic erector spinae with surface electromyography. The nociplastic pain group had greater variability in M1 map location (centre of gravity) than other groups (p < .01), which may suggest less consistency, and perhaps relevance, of motor cortex adaptation for that group. The mixed group had greater overlap of M1 representations between deep/superficial muscles than nociceptive pain (deep multifidus/longissimus: p = .001, deep multifidus/thoracic erector spinae: p = .008) and nociplastic pain (deep multifidus/longissimus: p = .02, deep multifidus/thoracic erector spinae: p = .02) groups. This study provides preliminary evidence of differences in M1 organisation in subgroups of low back pain classified by likely underlying pain mechanisms. Despite the sample size, differences in cortical re-organisation between subgroups were detected. Differences in M1 organisation in subgroups of low back pain supports tailoring of treatment based on pain mechanism and motor adaptation.

Item ID: 72420
Item Type: Article (Research - C1)
ISSN: 1460-9568
Copyright Information: © 2021 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Funders: National Health and Medical Research Council of Australia (NHMRC)
Projects and Grants: NHMRC Grant/Award Number: APP1091302, NHMRC Grant/Award Number: APP1102905
Date Deposited: 15 Feb 2022 22:28
FoR Codes: 42 HEALTH SCIENCES > 4201 Allied health and rehabilitation science > 420106 Physiotherapy @ 100%
SEO Codes: 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280112 Expanding knowledge in the health sciences @ 100%
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