Title
Understanding intracortical excitability in phantom limb pain: A multivariate analysis from a multicenter randomized clinical trial
Date Issued
01 March 2021
Access level
open access
Resource Type
journal article
Author(s)
Teixeira P.E.P.
Gunduz M.E.
Gianlorenço A.C.
Castelo-Branco L.
Fregni F.
Publisher(s)
Elsevier Masson s.r.l.
Abstract
Objectives: To explore associations of intracortical excitability with clinical characteristics in a large sample of subjects with phantom limb pain (PLP). Methods: Ancillary study using baseline and longitudinal data from a large multicenter randomized trial that investigated the effects of non-invasive brain stimulation combined with sensorimotor training on PLP. Multivariate regression modeling analyses were used to investigate the association of intracortical excitability, measured by percentages of intracortical inhibition (ICI) and facilitation (ICF) with clinical variables. Results: Ninety-eight subjects were included. Phantom sensation of itching was positively associated with ICI changes and at baseline in the affected hemisphere (contralateral to PLP). However, in the non-affected hemisphere (ipsilateral to PLP), the phantom sensation of warmth and PLP intensity were negatively associated with ICI (both models). For the ICF, PLP intensity (baseline model only) and age (longitudinal model) were negatively associated, while time since amputation and amputation level (both for longitudinal model only) were positively associated in the affected hemisphere. Additionally, use of antidepressants led to lower ICF in the non-affected hemisphere for the baseline model while higher amputation level also led to less changes in the ICF. Conclusion: Results revealed clear associations of clinical variables and cortical excitability in a large chronic pain sample. ICI and ICF changes appear not to be mainly explained by PLP intensity. Instead, other variables associated with duration of neuroplasticity changes (such as age and duration of amputation) and compensatory mechanisms (such as itching and phantom limb sensation) seem to be more important in explaining these variables.
Start page
161
End page
173
Volume
51
Issue
2
Language
English
OCDE Knowledge area
Neurología clínica
Subjects
Scopus EID
2-s2.0-85101719340
PubMed ID
Source
Neurophysiologie Clinique
ISSN of the container
09877053
Sponsor(s)
All named authors meet the International Committee of Medical Journal Editors criteria for authorship for this article, take responsibility for the integrity of the work, and have given their approval for this version to be published. This study was supported by the National Institutes of Health ( NINDS-NIH 1R01HD082302-01A1 ).
Sources of information:
Directorio de Producción Científica
Scopus