Analgesic Effects of Compression at Trigger Points Are Associated With Reduction of Frontal Polar Cortical Activity as Well as Functional Connectivity Between the Frontal Polar Area and Insula in Patients With Chronic Low Back Pain: A Randomized Trial

Kodama, Kanae; Takamoto, Kouichi; Nishimaru, Hiroshi; Matsumoto, Jumpei; Takamura, Yusaku; Sakai, Shigekazu; Ono, Taketoshi; Nishijo, Hisao

doi:10.3389/fnsys.2019.00068

Cited by 16 publications

(12 citation statements)

References 116 publications

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“…The initial search retrieved 15,071 studies, from which 37 RCTs26,37–72 involving a total sample of 1574 participants aged from 18 to 76 years were included in this NMA (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Comparative Effectiveness of Manual Therapy Interventions on Pain and Pressure Pain Threshold in Patients With Myofascial Trigger Points

Pavon

Redondo

Vizcaíno

et al. 2022

The Clinical Journal of Pain

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Objectives: Myofascial trigger points (MTPs) are one of the most important causes of musculoskeletal pain. Evidence has suggested a positive effect of manual therapy in the treatment of MTPs. However, a comprehensive review comparing the effect of different manual therapy techniques are lacking. Thus, we conducted a network meta-analysis of randomized controlled trials to determine the type of manual therapy technique that has the greatest positive influence in patients with MTPs.Materials and Methods: PubMed, Web of Science, Cochrane Library, and Scopus databases were searched to identify direct and indirect evidence comparing the effectiveness of different types of manual therapy interventions on pain intensity and pressure pain threshold (PPT) in patients with MTPs. Risk of bias was assessed using the Cochrane RoB2 tool. A pairwise meta-analysis for direct and indirect comparisons between intervention and control/nonintervention groups was carried out.Results: A total of 37 studies were eligible for analysis. Combined interventions had the highest effect size for pain (−1.40; 95% CI, −2.34, −0.47), and the highest probability to be the best intervention and the highest Surface Under the Cumulative Ranking (64.7% and 87.9%, respectively). Afferent reduction techniques, understood as the interventions aimed to restore muscle spindles helping to dictate sarcomere length and tone in MTPs, had the highest effect size for PPT (0.93; 95% CI, 0.47, 1.39), and the highest probability to be the best intervention and the highest Surface Under the Cumulative Ranking (34.7% and 71.2%, respectively). The results were consistent in sensitivity analyses, with minimal inconsistencies between direct and indirect results.Discussion: Manual therapy interventions should be considered an effective strategy for pain and PPT in patients with MTPs. The results suggest that among the different manual therapy modalities, combined and afferent reduction techniques are the most effective for pain and PPT, respectively.

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“…The initial search retrieved 15,071 studies, from which 37 RCTs26,37–72 involving a total sample of 1574 participants aged from 18 to 76 years were included in this NMA (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Comparative Effectiveness of Manual Therapy Interventions on Pain and Pressure Pain Threshold in Patients With Myofascial Trigger Points

Pavon

Redondo

Vizcaíno

et al. 2022

The Clinical Journal of Pain

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“…Interestingly, insula activity tracks subacute back pain intensity before back pain is chronic 43 and tracks periods of change in CLBP intensity, 5 suggesting its activity to be closely linked to early processing of afferent input. In addition, insula connectivity to the medial prefrontal cortex is consistently increased in patients with CLBP 4,49,91 and decreases after successful treatment. 49 The anatomical distribution of ALFF pattern predictive of CLBP suggest therefore an expansion of the limbic circuitry involved to include striatum, hippocampus, or ventromedial prefrontal cortex in the older group compared with the younger group as peripheral nociceptive input increasingly engages affective processing brain areas.…”

Section: Discussionmentioning

confidence: 97%

Functional brain mapping in patients with chronic back pain shows age-related differences

Baran

Lin

Geha

2021

Pain

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Low back pain is the most common pain condition and cause for disability in older adults. Older adults suffering from low back pain are more disabled than their healthy peers, are more predisposed to frailty, and tend to be undertreated. The cause of increased prevalence and severity of this chronic pain condition in older adults is unknown. Here, we draw on accumulating data demonstrating a critical role for brain limbic and sensory circuitries in the emergence and experience of chronic low back pain (CLBP) and the availability of resting-state brain activity data collected at different sites to study how brain activity patterns predictive of CLBP differ between age groups. We apply a data-driven multivariate searchlight analysis to amplitude of low-frequency fluctuation brain maps to classify patients with CLBP with .70% accuracy. We observe that the brain activity pattern including the paracingulate gyrus, insula/secondary somatosensory area, inferior frontal, temporal, and fusiform gyrus predicted CLBP. When separated by age groups, brain patterns predictive of older patients with CLBP showed extensive involvement of limbic brain areas including the ventromedial prefrontal cortex, the nucleus accumbens, and hippocampus, whereas only anterior insula paracingulate and fusiform gyrus predicted CLBP in the younger patients. In addition, we validated the relationships between back pain intensity ratings and CLBP brain activity patterns in an independent data set not included in our initial patterns' identification. Our results are the first to directly address how aging affects the neural signature of CLBP and point to an increased role of limbic brain areas in older patients with CLBP.

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“…This is congruent with an assumption of homeostatic regulations in response to both types of intervention. Due to its proactive nature, FR might engage to a greater degree frontal region during the intervention, whereas MM might put a specific emphasis on parietal networks specialized in the sensory integration of peripheral feedbacks [ 62 , 63 , 64 ]. EEG data thus indicated that the proactive nature of FR could result in qualitatively different relaxation brain states, compared to MM.…”

Section: Discussionmentioning

confidence: 99%

Foam Rolling Elicits Neuronal Relaxation Patterns Distinct from Manual Massage: A Randomized Controlled Trial

et al. 2021

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The present double-blinded, randomized controlled study sought to compare the effects of a full-body manual massage (MM) and a foam rolling (FR) intervention on subjective and objective indexes of performance and well-being. A total of 65 healthy individuals were randomly allocated to an FR, MM, or a control group who received a cognitively oriented relaxation routine. Self-report ratings of perceived anxiety, muscle relaxation, and muscle pain were used to index changes in affect and physical sensations. The sit-and-reach and toe-touch tests, as well as a mental calculation task, were used to index motor and cognitive performances, respectively. We also conducted resting-state electroencephalography and continuous skin conductance recordings before and after the experimental intervention. Both FR and MM groups exhibited neural synchronization of alpha and beta oscillations during the posttest. Skin conductance increased from the pretest to the posttest in the relaxation group, but decreased in the FR group. All interventions improved range of motion, although only the MM group outperformed the relaxation group for the toe-touch performance. MM was associated with reduced muscle pain and increased muscle relaxation. Reduced perceived anxiety after the intervention was observed in the FR group only. Overall, MM and FR both improved objective and subjective indexes of performance and well-being. Differences between the two massage interventions are discussed in relation to the effects of pressure stimulation on autonomic regulations and the proactive vs. retroactive nature of FR, compared to MM.

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Analgesic Effects of Compression at Trigger Points Are Associated With Reduction of Frontal Polar Cortical Activity as Well as Functional Connectivity Between the Frontal Polar Area and Insula in Patients With Chronic Low Back Pain: A Randomized Trial

Cited by 16 publications

References 116 publications

Comparative Effectiveness of Manual Therapy Interventions on Pain and Pressure Pain Threshold in Patients With Myofascial Trigger Points

Comparative Effectiveness of Manual Therapy Interventions on Pain and Pressure Pain Threshold in Patients With Myofascial Trigger Points

Functional brain mapping in patients with chronic back pain shows age-related differences

Foam Rolling Elicits Neuronal Relaxation Patterns Distinct from Manual Massage: A Randomized Controlled Trial

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