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Association of anxiety with intracortical inhibition and descending pain modulation in chronic myofascial pain syndrome

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Association of anxiety with intracortical inhibition and descending pain modulation in chronic myofascial pain syndrome

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Título Association of anxiety with intracortical inhibition and descending pain modulation in chronic myofascial pain syndrome
Autor Vidor, Liliane Pinto
Torres, Iraci Lucena da Silva
Medeiros, Liciane Fernandes
Sarria, Jairo Alberto Dussán
Dall'Agnol, Letizzia
Deitos, Alícia
Brietzke, Aline Patrícia
Laste, Gabriela
Rozisky, Joanna Ripoll
Fregni, Felipe
Caumo, Wolnei
Abstract Background: This study aimed to answer three questions related to chronic myofascial pain syndrome (MPS): 1) Is the motor cortex excitability, as assessed by transcranial magnetic stimulation parameters (TMS), related to state-trait anxiety? 2) Does anxiety modulate corticospinal excitability changes after evoked pain by Quantitative Sensory Testing (QST)? 3) Does the state-trait anxiety predict the response to pain evoked by QST if simultaneously receiving a heterotopic stimulus [Conditional Pain Modulation (CPM)]? We included females with chronic MPS (n = 47) and healthy controls (n = 11), aged 19 to 65 years. Motor cortex excitability was assessed by TMS, and anxiety was assessed based on the State-Trait Anxiety Inventory. The disability related to pain (DRP) was assessed by the Profile of Chronic Pain scale for the Brazilian population (B:PCP:S), and the psychophysical pain measurements were measured by the QST and CPM. Results: In patients, trait-anxiety was positively correlated to intracortical facilitation (ICF) at baseline and after QST evoked pain (β = 0.05 and β = 0.04, respectively) and negatively correlated to the cortical silent period (CSP) (β = -1.17 and β = -1.23, respectively) (P <0.05 for all comparisons). After QST evoked pain, the DRP was positively correlated to ICF (β= 0.02) (P < 0.05). Pain scores during CPM were positively correlated with trait-anxiety when it was concurrently with high DRP (β = 0.39; P = 0.02). Controls’ cortical excitability remained unchanged after QST. Conclusions: These findings suggest that, in chronic MPS, the imbalance between excitatory and inhibitory descending systems of the corticospinal tract is associated with higher trait-anxiety concurrent with higher DRP.
Contido em BMC neuroscience. London. Vol. 15 (19 mar. 2014), 42 [13] p.
Assunto Ansiedade
Dor crônica
Estimulação magnética transcraniana
Síndromes da dor miofascial
[en] Anxiety
[en] Chronic pain
[en] Myofascial pain syndrome
[en] Neuromodulation
[en] Noninvasive brain stimulation
[en] Transcranial magnetic stimulation
Origem Estrangeiro
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/110151
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