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Brain Stimulation
Article . 2017 . Peer-reviewed
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Brain Stimulation
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Pain-motor integration in the primary motor cortex in Parkinson's disease

Authors: SUPPA, ANTONIO; LEONE, CATERINA; DI STASIO, FLAVIO; MARSILI, LUCA; Di Santo, A; Biasiotta, A; LA CESA, SILVIA; +3 Authors

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

Abstract

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.We here examined the possible influence of chronic pain on motor responses to Laser-PAS in patients with PD, with and without chronic pain.We compared motor responses to Laser-PAS in healthy subjects and in patients with PD, with and without chronic pain.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.In PD, chronic pain degrades response to Laser-PAS through abnormal pain-motor integration.

Keywords

Adult, Male, Neuronal Plasticity, Long-Term Potentiation, Motor Cortex, Parkinson Disease, Laser-evoked potentials; Pain-motor integration; Paired associative stimulation; Parkinson's disease; Primary motor cortex, Middle Aged, Evoked Potentials, Motor, Transcranial Magnetic Stimulation, Random Allocation, Laser-Evoked Potentials, Humans, Female, Chronic Pain, laser-evoked potentials; pain-motor integration; paired associative stimulation; Parkinson's disease; primary motor cortex, Aged

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    15
    popularity
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    Top 10%
    influence
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    impulse
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
15
Top 10%
Average
Average
Green
gold