Driving plasticity in the motor cortex in recurrent low back pain

Tsao, Henry, Galea, Mary P. and Hodges, Paul W. (2010) Driving plasticity in the motor cortex in recurrent low back pain. European Journal of Pain, 14 8: 832-839. doi:10.1016/j.ejpain.2010.01.001


Author Tsao, Henry
Galea, Mary P.
Hodges, Paul W.
Title Driving plasticity in the motor cortex in recurrent low back pain
Journal name European Journal of Pain   Check publisher's open access policy
ISSN 1090-3801
1532-2149
Publication date 2010-09
Sub-type Article (original research)
DOI 10.1016/j.ejpain.2010.01.001
Volume 14
Issue 8
Start page 832
End page 839
Total pages 8
Place of publication Kidlington, Oxford., United Kingdom
Publisher Elsevier
Collection year 2011
Language eng
Abstract The sensory and motor systems can reorganise following injury and learning of new motor skills. Recently we observed adaptive changes in motor cortical organisation in patients with recurrent low back pain (LBP), which are linked to altered motor coordination. Although changes in motor coordination can be trained and are associated with improved symptoms and function, it remains unclear whether these training-induced changes are related to reorganisation of the motor cortex. This was investigated using the model of a delay in postural activation of the deep abdominal muscle, transversus abdominis (TrA) in 20 individuals with recurrent LBP. Subjects were allocated to either motor skill training that involved isolated voluntary contractions of TrA, or a control intervention of self-paced walking exercise for 2 weeks. Electromyographic (EMG) activity was recorded from TrA bilaterally using intramuscular fine-wire electrodes. Motor cortical organisation using transcranial magnetic stimulation (TMS) and postural activation associated with single rapid arm movements were investigated before and after training. Motor skill training induced an anterior and medial shift in motor cortical representation of TrA, towards that observed in healthy individuals from our previous study. This shift was associated with earlier postural activation of TrA. Changes were not observed following unskilled walking exercise. This is the first observation that motor training can reverse reorganisation of neuronal networks of the motor cortex in people with recurrent pain. The observed relationship between cortical reorganisation and changes in motor coordination following motor training provides unique insight into potential mechanisms that underlie recovery. © 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.
Keyword Motor cortex
Skilled motor training
Recurrent low back pain
Transcranial magnetic stimulation
Motor control
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Sun, 12 Sep 2010, 00:04:53 EST