Moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients: A TMS study.

OBJECTIVE:Primary motor (M1) cortical excitability alterations are involved in the development and maintenance of chronic pain. Less is known about M1-cortical excitability implications in the acute phase of an orthopedic trauma. This study aims to assess acute M1-cortical excitability in patients w...

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Main Authors: Marianne Jodoin, Dominique M Rouleau, Audrey Bellemare, Catherine Provost, Camille Larson-Dupuis, Émilie Sandman, Georges-Yves Laflamme, Benoit Benoit, Stéphane Leduc, Martine Levesque, Nadia Gosselin, Louis De Beaumont
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0226452
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author Marianne Jodoin
Dominique M Rouleau
Audrey Bellemare
Catherine Provost
Camille Larson-Dupuis
Émilie Sandman
Georges-Yves Laflamme
Benoit Benoit
Stéphane Leduc
Martine Levesque
Nadia Gosselin
Louis De Beaumont
author_facet Marianne Jodoin
Dominique M Rouleau
Audrey Bellemare
Catherine Provost
Camille Larson-Dupuis
Émilie Sandman
Georges-Yves Laflamme
Benoit Benoit
Stéphane Leduc
Martine Levesque
Nadia Gosselin
Louis De Beaumont
author_sort Marianne Jodoin
collection DOAJ
description OBJECTIVE:Primary motor (M1) cortical excitability alterations are involved in the development and maintenance of chronic pain. Less is known about M1-cortical excitability implications in the acute phase of an orthopedic trauma. This study aims to assess acute M1-cortical excitability in patients with an isolated upper limb fracture (IULF) in relation to pain intensity. METHODS:Eighty-four (56 IULF patients <14 days post-trauma and 28 healthy controls). IULF patients were divided into two subgroups according to pain intensity (mild versus moderate to severe pain). A single transcranial magnetic stimulation (TMS) session was performed over M1 to compare groups on resting motor threshold (rMT), short-intracortical inhibition (SICI), intracortical facilitation (ICF), and long-interval cortical inhibition (LICI). RESULTS:Reduced SICI and ICF were found in IULF patients with moderate to severe pain, whereas mild pain was not associated with M1 alterations. Age, sex, and time since the accident had no influence on TMS measures. DISCUSSION:These findings show altered M1 in the context of acute moderate to severe pain, suggesting early signs of altered GABAergic inhibitory and glutamatergic facilitatory activities.
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spelling doaj.art-839d204d32534f579ab6543f608f87cc2022-12-21T22:40:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01153e022645210.1371/journal.pone.0226452Moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients: A TMS study.Marianne JodoinDominique M RouleauAudrey BellemareCatherine ProvostCamille Larson-DupuisÉmilie SandmanGeorges-Yves LaflammeBenoit BenoitStéphane LeducMartine LevesqueNadia GosselinLouis De BeaumontOBJECTIVE:Primary motor (M1) cortical excitability alterations are involved in the development and maintenance of chronic pain. Less is known about M1-cortical excitability implications in the acute phase of an orthopedic trauma. This study aims to assess acute M1-cortical excitability in patients with an isolated upper limb fracture (IULF) in relation to pain intensity. METHODS:Eighty-four (56 IULF patients <14 days post-trauma and 28 healthy controls). IULF patients were divided into two subgroups according to pain intensity (mild versus moderate to severe pain). A single transcranial magnetic stimulation (TMS) session was performed over M1 to compare groups on resting motor threshold (rMT), short-intracortical inhibition (SICI), intracortical facilitation (ICF), and long-interval cortical inhibition (LICI). RESULTS:Reduced SICI and ICF were found in IULF patients with moderate to severe pain, whereas mild pain was not associated with M1 alterations. Age, sex, and time since the accident had no influence on TMS measures. DISCUSSION:These findings show altered M1 in the context of acute moderate to severe pain, suggesting early signs of altered GABAergic inhibitory and glutamatergic facilitatory activities.https://doi.org/10.1371/journal.pone.0226452
spellingShingle Marianne Jodoin
Dominique M Rouleau
Audrey Bellemare
Catherine Provost
Camille Larson-Dupuis
Émilie Sandman
Georges-Yves Laflamme
Benoit Benoit
Stéphane Leduc
Martine Levesque
Nadia Gosselin
Louis De Beaumont
Moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients: A TMS study.
PLoS ONE
title Moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients: A TMS study.
title_full Moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients: A TMS study.
title_fullStr Moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients: A TMS study.
title_full_unstemmed Moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients: A TMS study.
title_short Moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients: A TMS study.
title_sort moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients a tms study
url https://doi.org/10.1371/journal.pone.0226452
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