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Similar alteration of motor unit recruitment strategies during the anticipation and experience of pain

Tucker, Kyliea,*; Larsson, Anna-Karinb; Oknelid, Stinab; Hodges, Paula

doi: 10.1016/j.pain.2011.11.024

Summary Motoneuron discharge is altered during anticipation of pain as well as pain itself, does not fully resolve after pain has ceased, and may underlie long-term musculoskeletal changes.

A motor unit consists of a motoneurone and the multiple muscle fibres that it innervates, and forms the final neural pathway that influences movement. Discharge of motor units is altered (decreased discharge rate and/or cessation of firing; and increased discharge rate and/or recruitment of new units) during matched-force contractions with pain. This is thought to be mediated by nociceptive (pain) input on motoneurones, as demonstrated in animal studies. It is also possible that motoneurone excitability is altered by pain related descending inputs, that these changes persist after noxious stimuli cease, and that direct nociceptive input is not necessary to induce pain related changes in movement. We aimed to determine whether anticipation of pain (descending pain related inputs without nociceptor discharge) alters motor unit discharge, and to observe motor unit discharge recovery after pain has ceased. Motor unit discharge was recorded with fine-wire electrodes in the quadriceps of 9 volunteers. Subjects matched isometric knee-extension force during anticipation of pain (anticipation: electrical shocks randomly applied over the infrapatellar fat-pad); pain (hypertonic saline injected into the fat-pad); and 3 intervening control conditions. Discharge rate of motor units decreased during pain (P < .001) and anticipation (P < .01) compared with control contractions. De-recruitment of 1 population of units and new recruitment of another population were observed during both anticipation and pain; some changes in motor unit recruitment persisted after pain ceased. This challenges the fundamental theory that pain-related changes in muscle activity result from direct nociceptor discharge, and provides a mechanism that may underlie long-term changes in movement/chronicity in some musculoskeletal conditions.

aSchool of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia

bDepartment of Community Medicine and Rehabilitation, University of Umeå, Umeå, Sweden

*Corresponding author. Address: NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld 4072, Australia. Tel.: +61 7 3365 4589.


Submitted August 8, 2011; revised November 20, 2011; accepted November 22, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.
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