Corticospinal excitability as a biomarker of myofascial pain syndrome

[en] Introduction: Myofascial pain syndrome (MPS) is a common chronic pain disorder that lacks effective diagnostic criteria. To better understand neurophysiological changes in chronic pain, several trials exploring corticospinal excitability in different populations of patients with chronic pain have been performed. Objectives: In this systematic review, we aimed to investigate the current literature on MPS and intracortical disinhibition, by means of increased intracortical facilitation and decreased intracortical inhibition (ICI). Methods: We performed a search on PubMed to identify clinical trials on MPS and transcranial magnetic stimulation measurements. We then applied the Harford Hill criteria to the identified studies to assess the possible causal relationship between intracortical disinhibition measurements and MPS. Finally, we compared our findings on MPS with other chronic pain conditions. Results: Four studies assessing corticospinal excitability in patients with MPS were found. Although the amount of trials available is limited, all the reported studies indicated an increased intracortical disinhibition in patients with MPS. Importantly, these measurements were also correlated with psychological factors, such as pain catastrophism, or anxiety. However, based on the Harford Hill criteria, we could not assert a strong causal relationship between these markers and MPS. Although intracortical disinhibition has been consistently found in patients having MPS, this lack of cortical inhibition was not only observed in this specific chronic pain syndrome but also in fibromyalgia and neuropathic pain conditions. Conclusion: Intracortical disinhibition seems to be a marker that has been consistently observed in MPS. Future prospective cohort studies could provide new insights in the development of neoplastic and maladaptive changes occurring in chronic pain syndromes and help the development of new therapeutic options. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

Disciplines :

Neurology

Author, co-author :

Thibaut, Aurore ; Université de Liège - ULiège > Consciousness-Coma Science Group

Zeng, D.; Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, 79/96, 13th St, Charlestown, MA 02129, United States, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China

Caumo, W.; Laboratory of Pain and Neuromodulation, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil

Liu, J.

Fregni, F.; Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, 79/96, 13th St, Charlestown, MA 02129, United States

Language :

English

Title :

Corticospinal excitability as a biomarker of myofascial pain syndrome

Publication date :

2017

Journal title :

PAIN Reports

eISSN :

2471-2531

Publisher :

Lippincott Williams and Wilkins

Volume :

Issue :

Peer reviewed :

Peer Reviewed verified by ORBi

Funders :

Fonds Léon FredericqWallonie-Bruxelles International1R01HD082302-01A1, RO1grant

Available on ORBi :

since 27 December 2020

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