ABSTRACT
Background and Objective
Pain influences motor control. Previous reviews observed that pain reduces the excitability of corticospinal projections to muscles tested with transcranial magnetic stimulation. However, the independent effect of the type of pain models (tonic, phasic), pain location and tissues targeted (e.g. muscle, skin) remains unexplored. The objective of this review was to determine the influence of experimental pain and of different methodological factors on the corticospinal excitability.
Databases and Data Treatment: Three electronic databases were searched: Embase, Pubmed and Web of Science. Meta‐analyses were conducted in three consecutive steps to reduce methodological variability: (1) all studies; (2) same pain location; (3) same tissues, pain location and muscle state. Strength of evidence was assessed for each analysis performed.
Results
Forty studies were included in the review and 26 in the meta‐analysis as it focused only on studies using tonic pain. Overall, there was conflicting/moderate evidence of a diminution of corticospinal excitability during and after tonic pain. When considering only pain location, tonic hand and face pain induced a reduction in corticospinal excitability (limited evidence). Both muscle and cutaneous hand pain reduced corticospinal excitability (limited/conflicting evidence). Similar results were observed for phasic pain (limited evidence).
Conclusions
Our results confirm the inhibitory effect of pain on corticospinal excitability for both tonic and phasic pain. This reduction was specific to hand and face pain. Also, both cutaneous and muscle hand pain reduced excitability. The strength of evidence remains limited/conflicting due to methodological/results heterogeneity, risk of bias and the small number of studies. More high‐quality studies are needed to confirm our conclusions.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/3rSJhAf
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