Pain-motor integration in the primary motor cortex in Parkinson's disease

Autor: Caterina Leone, A. Di Santo, Alfredo Berardelli, S. La Cesa, Andrea Truini, Luca Marsili, Giorgio Cruccu, F. Di Stasio, Antonio Suppa, Antonella Biasiotta
Rok vydání: 2016
Předmět:
0301 basic medicine
Adult
Male
Parkinson's disease
Laser-Evoked Potentials
medicine.medical_treatment
Primary motor cortex
Long-Term Potentiation
Biophysics
lcsh:RC321-571
03 medical and health sciences
Random Allocation
0302 clinical medicine
medicine
Humans
Paired associative stimulation
laser-evoked potentials
pain-motor integration
paired associative stimulation
primary motor cortex
lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry
Anterior cingulate cortex
Aged
Neuronal Plasticity
General Neuroscience
Chronic pain
Motor Cortex
Parkinson Disease
Middle Aged
medicine.disease
Evoked Potentials
Motor

Transcranial Magnetic Stimulation
Pain-motor integration
Transcranial magnetic stimulation
030104 developmental biology
Nociception
medicine.anatomical_structure
Anesthesia
Body region
Female
Neurology (clinical)
Chronic Pain
Psychology
Neuroscience
030217 neurology & neurosurgery
Zdroj: Brain Stimulation, Vol 10, Iss 4, Pp 806-816 (2017)
ISSN: 1876-4754
Popis: Background In Parkinson's disease (PD), the influence of chronic pain on motor features has never been investigated. We have recently designed a technique that combines nociceptive system activation by laser stimuli and primary motor cortex (M1) activation through transcranial magnetic stimulation (TMS), in a laser-paired associative stimulation design (Laser-PAS). In controls, Laser-PAS induces long-term changes in motor evoked potentials reflecting M1 long-term potentiation-like plasticity, arising from pain-motor integration. Objective We here examined the possible influence of chronic pain on motor responses to Laser-PAS in patients with PD, with and without chronic pain. Methods We compared motor responses to Laser-PAS in healthy subjects and in patients with PD, with and without chronic pain. Results Unlike controls, we found reduced responses to Laser-PAS in patients with PD, with and without pain. Patients off and on dopaminergic therapy had similar responses to Laser-PAS. When comparing responses to Laser-PAS in patients with and without pain, the two patients' subgroups had similar abnormalities. When we compared patients with pain in the body region investigated with Laser-PAS, with those with pain in other body regions, we found prominent changes in patients with homotopic pain. Finally, when comparing Laser-PAS with the original PAS protocol, which combines electric peripheral nerve stimuli and TMS, in patients without pain and those with homotopic pain, we found similar responses to both techniques in patients without pain, whereas Laser-PAS induced greater abnormalities than PAS in patients with pain. Conclusions In PD, chronic pain degrades response to Laser-PAS through abnormal pain-motor integration.
Databáze: OpenAIRE