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The relationship of corticospinal excitability with pain,motor performance and disability in subjects with chronic wrist/hand pain
Affiliation:1. Department of Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada;2. Department of Physical Therapy, University of Alberta, Alberta, BC, Canada;1. Professor, Chiropractic Medicine and Radiology Departments, Orthopaedic University Hospital Balgrist, University of Zürich, Zürich, Switzerland;2. Professor, Chiropractic Medicine Department, Orthopaedic University Hospital Balgrist, University of Zürich, Zürich, Switzerland;3. Chiropractic Intern and Masters Student, Chiropractic Medicine Department, Orthopaedic University Hospital Balgrist, University of Zürich, Zürich, Switzerland;4. Private Practice, Zürich, Switzerland
Abstract:There is a growing body of evidence of changes in corticospinal excitability associated with musculoskeletal disorders, however there is a lack of knowledge of how these changes relate to measures of pain, motor performance and disability. An exploratory study was performed utilizing Transcranial Magnetic Stimulation to investigate differences in corticospinal excitability in the Abductor Pollicis Brevis (APB) between 15 pain-free subjects and 15 subjects with chronic wrist/hand pain and to determine how corticospinal excitability was associated with measures of pain (visual analog scale, AUSCAN™), hand motor performance (isometric and key pinch strength, Purdue Pegboard Test), disability (AUSCAN™), and spinal motoneuronal excitability. Input–output curves demonstrated increased corticospinal excitability of the APB in the affected hand of subjects with chronic pain (p < 0.01). Changes in corticospinal excitability were significantly correlated with pain intensity (r = 0.77), disability (r = 0.58), and negatively correlated with motoneuronal excitability (r = −0.57). Corticospinal excitability in subjects with heterogeneous injuries of the wrist/hand was associated with disability and pain.
Keywords:Musculoskeletal  Input-output curve  Transcranial Magnetic Stimulation  Motor Evoked Potentials  Motor function  Disability  Strength  AH"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0045"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Affected Hand  APB"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0055"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Abductor Pollicis Brevis  AUSCAN™"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0065"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Australian Canadian Osteoarthritis Hand Index  CMSD"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0075"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Chronic Musculoskeletal Disorders  CNS"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0085"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Central Nervous System  EMG"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0095"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Electromyography  I-O"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0105"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Input-Output curve  M1"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0115"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Primary Motor Cortex  MEP"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0125"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Motor Evoked Potential  Mmax"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0135"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Maximum Compound Motor Action Potential  NAH"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0145"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Non-Affected Hand  PPG"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0155"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Purdue Pegboard Test  RH"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0165"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Right Hand  rMT"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0175"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Resting Motor Threshold  S1"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0185"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Primary Somatosensory Cortex  TMS"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0195"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Transcranial Magnetic Stimulation  VAS"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0205"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Visual Analog Scale
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