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Primary sensory and motor cortex function in response to acute muscle pain: A systematic review and meta‐analysis
Author(s) -
Burns E.,
Chipchase L.S.,
Schabrun S.M.
Publication year - 2016
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.859
Subject(s) - primary motor cortex , physical medicine and rehabilitation , meta analysis , neuroimaging , sensory system , neuroscience , psychology , critical appraisal , medicine , transcranial magnetic stimulation , pathology , alternative medicine , stimulation
Acute muscle pain has both motor and sensory consequences, yet the effect of muscle pain on the primary sensory ( S 1) and motor ( M 1) cortices has yet to be systematically evaluated. Here we aimed to determine the strength of the evidence for (1) altered activation of S 1/ M 1 during and after pain, (2) the temporal profile of any change in activation and (3) the relationship between S 1/ M 1 activity and the symptoms of pain. In S eptember 2015, five electronic databases were systematically searched for neuroimaging and electrophysiological studies investigating the effect of acute experimental muscle pain on S 1/ M 1 in healthy volunteers. Demographic data, methodological characteristics and primary outcomes for each study were extracted for critical appraisal. Meta‐analyses were performed where appropriate. Twenty‐five studies satisfied the inclusion criteria. There was consistent evidence from f MRI for increased S 1 activation in the contralateral hemisphere during pain, but insufficient evidence to determine the effect at M 1. Meta‐analyses of TMS and EEG data revealed moderate to strong evidence of reduced S 1 and corticomotor excitability during and following the resolution of muscle pain. A comprehensive understanding of the temporal profile of altered activity in S 1/ M 1, and the relationship to symptoms of pain, is hampered by differences in methodological design, pain modality and pain severity between studies. Overall, the findings of this review indicate reduced S 1 and corticomotor activity during and after resolution of acute muscle pain, mechanisms that could plausibly underpin altered sensorimotor function in pain. What does this review add? We provide the first systematic evaluation of the primary sensory ( S 1) and motor ( M 1) cortex response to acute experimental muscle pain in healthy volunteers. We present evidence from a range of methodologies to provide a comprehensive understanding of the effect of pain on S 1/ M 1. Through meta‐analyses we evaluate the strength of evidence concerning the direction and temporal profile of the S 1/ M 1 response to acute muscle pain.

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