Interactions between pain and the motor cortex : insights from research on phantom limb pain and complex regional pain syndrome

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Publication date
2011Author(s)
Mercier, Catherine; Léonard, Guillaume
Editor(s)
Centre interdisciplinaire de recherche en réadaptation et intégration sociale
Université Laval. Département de réadaptation
Subject
PainAbstract
Abstract : Purpose: Pain is a significantly disabling problem that often interacts with other deficits during
the rehabilitation process. The aim of this paper is to review evidence on interactions between
pain and the motor cortex in order to attempt to answer the following questions: (1) Does acute
pain interfere with motor cortex activity? (2) Does chronic pain interfere with motor cortex
activity and, conversely, does motor cortex plasticity contribute to chronic pain? (3) Can the
induction of motor plasticity by means of motor cortex stimulation decrease pain? (4) Can motor
training result in both motor cortex reorganization and pain relief? Summary of Key Points:
Acute experimental pain was clearly shown to exert an inhibitory influence over the motor
cortex, which can interfere with motor learning capacities. Current evidence also suggests a
relationship between chronic pain and motor cortex reorganization, but it is still unclear whether
one causes the other. However, there is growing evidence to the effect that interventions that aim
to normalize motor cortex organization can lead to pain relief. Conclusions: Interactions
between pain and the motor cortex are complex, and more studies are needed to understand these
interactions in our patients, as well as to develop optimal rehabilitative strategies.