The Effect of Theta Burst Stimulation Over the Primary Motor Cortex on Experimental Hamstring Pain: A Randomized, Controlled Study

Moukhaiber, Nadia; Summers, Simon J; Opar, David A.; Imam, Jawwad; Thomson, Daniel; Chang, Wei-Ju; Andary, Toni; Cavaleri, Rocco

doi:10.1016/j.jpain.2022.11.013

Cited by 8 publications

(2 citation statements)

References 82 publications

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“…As such, techniques aimed at restoring corticomotor excitability, and therefore mechanical sensitivity, may aid the rehabilitation process following a hamstring injury. Indeed, the use of noninvasive brain stimulation has shown promise as a means of expediting recovery of experimental and clinical musculoskeletal pain (Borovskis et al., 2021; Cavaleri et al., 2019; Moisset et al., 2016; Moukhaiber et al., 2022; O'Connell et al., 2018) and mechanical sensitivity has been suggested as a potential marker for evaluating the success of such strategies (Pedersini et al., 2020). However, given that numerical ratings of pain and function in the present study were not impacted by changes in corticomotor excitability, these clinical implications remain speculative.…”

Section: Discussionmentioning

confidence: 99%

Investigating interindividual variability in corticomotor reorganization during sustained hamstring pain: A randomized experimental study

et al. 2023

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Background: Increasing evidence suggests that pain drives maladaptive corticomotor changes that may increase susceptibility to injury and promote symptom recurrence.However, few studies have evaluated the influence of interindividual corticomotor responses to musculoskeletal pain. Existing research in this area has also been limited largely to the upper limb. This is a pertinent point, given the functional and neurophysiological differences between upper and lower limb muscles, as well as the fact that most acute sporting injuries occur in the lower limb. Accordingly, this study explored the variability of corticomotor responses to experimentally-induced sustained hamstring pain and whether specific patterns of corticomotor reorganization were associated with poorer outcomes (mechanical sensitivity, pain, or functional limitation).Method: Thirty-six healthy individuals participated. Following random allocation on Day 0, the experimental group performed an eccentric exercise protocol of the right hamstring muscles to induce delayed onset muscle soreness. The control group performed repetition-matched concentric exercise that did not induce soreness. Measures of mechanical sensitivity, pain, function, and corticomotor organization were collected at baseline and on Day 2. Results and conclusions:Corticomotor responses to sustained hamstring pain were variable. Individuals who developed corticomotor facilitation in response to hamstring pain experienced greater mechanical sensitivity than those who developed corticomotor depression. These novel data could have implications for rehabilitation following lower limb pain or injury.

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Section: Discussionmentioning

confidence: 99%

Investigating interindividual variability in corticomotor reorganization during sustained hamstring pain: A randomized experimental study

et al. 2023

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“…This ‘excitatory’ protocol was selected as high frequency (excitatory) rTMS over the left DLPFC has previously been shown to decrease motion perception and induce reductions in long-range intrinsic functional connectivity (correlating with symptom improvement) in people with MdDS [ 33 , 34 ]. Stimuli were delivered at 90% of the resting motor threshold (rMT) determined during the first treatment day [ 70 , 71 ]. Resting motor threshold was defined as the minimum intensity at which 5 out of 10 stimuli, delivered to the “hotspot” of the first dorsal interosseous muscle (FDI) representation, evoked a peak-to-peak motor evoked potential (identified using electromyography) of at least 0.05 mV in the resting muscle [ 72 ].…”

Section: Methodsmentioning

confidence: 99%

Assessing the synergistic effectiveness of intermittent theta burst stimulation and the vestibular ocular reflex rehabilitation protocol in the treatment of Mal de Debarquement Syndrome: a randomised controlled trial

Browne,

Sheeba,

Astill

et al. 2024

J Neurol

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Introduction Mal de Debarquement Syndrome (MdDS) is a rare central vestibular disorder characterised by a constant sensation of motion (rocking, swaying, bobbing), which typically arises after motion experiences (e.g. sea, air, and road travel), though can be triggered by non-motion events. The current standard of care is non-specific medications and interventions that only result in mild-to-moderate improvements. The vestibular ocular reflex (VOR) rehabilitation protocol, a specialised form of rehabilitation, has shown promising results in reducing symptoms amongst people with MdDS. Accumulating evidence suggests that it may be possible to augment the effects of VOR rehabilitation via non-invasive brain stimulation protocols, such as theta burst stimulation (TBS). Methods The aim of this randomised controlled trial was to evaluate the effectiveness of intermittent TBS (iTBS) over the dorsolateral prefrontal cortex in enhancing the effectiveness of a subsequently delivered VOR rehabilitation protocol in people with MdDS. Participants were allocated randomly to receive either Sham (n = 10) or Active (n = 10) iTBS, followed by the VOR rehabilitation protocol. Subjective outcome measures (symptom ratings and mental health scores) were collected 1 week pre-treatment and for 16 weeks post-treatment. Posturography (objective outcome) was recorded each day of the treatment week. Results Significant improvements in subjective and objective outcomes were reported across both treatment groups over time, but no between-group differences were observed. Discussion These findings support the effectiveness of the VOR rehabilitation protocol in reducing MdDS symptoms. Further research into iTBS is required to elucidate whether the treatment has a role in the management of MdDS. TRN: ACTRN12619001519145 (Date registered: 04 November 2019).

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Bilateral Corticomotor Reorganization and Symptom Development in Response to Acute Unilateral Hamstring Pain: A Randomized, Controlled Study

Suhood,

Summers,

Opar

et al. 2024

The Journal of Pain

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The Effect of Theta Burst Stimulation Over the Primary Motor Cortex on Experimental Hamstring Pain: A Randomized, Controlled Study

Cited by 8 publications

References 82 publications

Investigating interindividual variability in corticomotor reorganization during sustained hamstring pain: A randomized experimental study

Investigating interindividual variability in corticomotor reorganization during sustained hamstring pain: A randomized experimental study

Assessing the synergistic effectiveness of intermittent theta burst stimulation and the vestibular ocular reflex rehabilitation protocol in the treatment of Mal de Debarquement Syndrome: a randomised controlled trial

Bilateral Corticomotor Reorganization and Symptom Development in Response to Acute Unilateral Hamstring Pain: A Randomized, Controlled Study

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