ISSLS Prize Winner: Smudging the Motor Brain in Young Adults With Recurrent Low Back Pain

Tsao, Henry, Danneels, Lieven A. and Hodges, Paul W. (2011) ISSLS Prize Winner: Smudging the Motor Brain in Young Adults With Recurrent Low Back Pain. Spine, 36 21: 1721-1727. doi:10.1097/BRS.0b013e31821c4267


Author Tsao, Henry
Danneels, Lieven A.
Hodges, Paul W.
Title ISSLS Prize Winner: Smudging the Motor Brain in Young Adults With Recurrent Low Back Pain
Journal name Spine   Check publisher's open access policy
ISSN 0362-2436
1528-1159
Publication date 2011-10-01
Year available 2011
Sub-type Article (original research)
DOI 10.1097/BRS.0b013e31821c4267
Open Access Status Not yet assessed
Volume 36
Issue 21
Start page 1721
End page 1727
Total pages 7
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams and Wilkins
Language eng
Abstract Study Design. Cross-sectional design.
Formatted abstract
Study Design.: Cross-sectional design. Objective.: To investigate whether recurrent low back pain (LBP) is associated with changes in motor cortical representation of different paraspinal muscle fascicles. Summary of Background Data.: Fascicles of the lumbar paraspinal muscles are differentially activated during function. Human studies indicate this may be associated with a spatially separate array of neuronal networks at the motor cortex. Loss of discrete control of paraspinal muscle fascicles in LBP may be because of changes in cortical organization. Methods.: Data were collected from 9 individuals with recurrent unilateral LBP and compared with 11 healthy participants from an earlier study. Fine-wire electrodes selectively recorded myoelectric activity from short/deep fascicles of deep multifidus (DM) and long/superficial fascicles of longissimus erector spinae (LES), bilaterally. Motor cortical organization was investigated using transcranial magnetic stimulation at different scalp sites to evoke responses in paraspinal muscles. Location of cortical representation (center of gravity; CoG) and motor excitability (map volume) were compared between healthy and LBP groups. Results.: Individuals with LBP had a more posterior location of LES center of gravity, which overlapped with that for DM on both hemispheres. In healthy individuals, LES center of gravity was located separately at a more anterior location to that for DM. Map volume was reduced in LBP compared to healthy individual across muscles. Conclusion.: The findings highlight that LBP is associated with a loss of discrete cortical organization of inputs to back muscles. Increased overlap in motor cortical representation of DM and LES may underpin loss of differential activation in this group. The results further unravel the neurophysiological mechanisms of motor changes in recurrent LBP and suggest motor rehabilitation that includes training of differential activation of the paraspinal muscles may be required to restore optimal control in LBP.
Keyword Low back pain
Motor Control
Motor cortex organization
Lumbar paraspinal muscles
Transcranial Magnetic Stimulation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2012 Collection
School of Health and Rehabilitation Sciences Publications
 
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