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      Moving in an Environment of Induced Sensorimotor Incongruence Does Not Influence Pain Sensitivity in Healthy Volunteers: A Randomised Within-Subject Experiment

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          Abstract

          Objectives

          It has been proposed that in the same way that conflict between vestibular and visual inputs leads to motion sickness, conflict between motor commands and sensory information associated with these commands may contribute to some chronic pain states. Attempts to test this hypothesis by artificially inducing a state of sensorimotor incongruence and assessing self-reported pain have yielded equivocal results. To help clarify the effect sensorimotor incongruence has on pain we investigated the effect of moving in an environment of induced incongruence on pressure pain thresholds (PPT) and the pain experienced immediately on completion of PPT testing.

          Methods

          Thirty-five healthy subjects performed synchronous and asynchronous upper-limb movements with and without mirror visual feedback in random order. We measured PPT over the elbow and the pain evoked by testing. Generalised linear mixed-models were performed for each outcome. Condition (four levels) and baseline values for each outcome were within-subject factors.

          Results

          There was no effect of condition on PPT (p = 0.887) or pressure-evoked pain (p = 0.771). A sensitivity analysis using only the first PPT measure after each condition confirmed the result (p = 0.867).

          Discussion

          Inducing a state of movement related sensorimotor incongruence in the upper-limb of healthy volunteers does not influence PPT, nor the pain evoked by testing. We found no evidence that sensorimotor incongruence upregulates the nociceptive system in healthy volunteers.

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          Most cited references34

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          Neural basis of the spontaneous optokinetic response produced by visual inversion.

          R Sperry (1950)
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            Towards a theory of chronic pain.

            In this review, we integrate recent human and animal studies from the viewpoint of chronic pain. First, we briefly review the impact of chronic pain on society and address current pitfalls of its definition and clinical management. Second, we examine pain mechanisms via nociceptive information transmission cephalad and its impact and interaction with the cortex. Third, we present recent discoveries on the active role of the cortex in chronic pain, with findings indicating that the human cortex continuously reorganizes as it lives in chronic pain. We also introduce data emphasizing that distinct chronic pain conditions impact on the cortex in unique patterns. Fourth, animal studies regarding nociceptive transmission, recent evidence for supraspinal reorganization during pain, the necessity of descending modulation for maintenance of neuropathic behavior, and the impact of cortical manipulations on neuropathic pain is also reviewed. We further expound on the notion that chronic pain can be reformulated within the context of learning and memory, and demonstrate the relevance of the idea in the design of novel pharmacotherapies. Lastly, we integrate the human and animal data into a unified working model outlining the mechanism by which acute pain transitions into a chronic state. It incorporates knowledge of underlying brain structures and their reorganization, and also includes specific variations as a function of pain persistence and injury type, thereby providing mechanistic descriptions of several unique chronic pain conditions within a single model.
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              Pain and the brain: specificity and plasticity of the brain in clinical chronic pain.

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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                7 April 2014
                : 9
                : 4
                : e93701
                Affiliations
                [1 ]School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
                [2 ]Floreat Physiotherapy, Floreat, Western Australia, Australia
                [3 ]Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
                [4 ]Centre for Research in Rehabilitation, School of Health Sciences and Social Care, Brunel University, Uxbridge, United Kingdom
                [5 ]The Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
                University of Montreal, Canada
                Author notes

                Competing Interests: LS is an employee of Floreat Physiotherapy. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

                Conceived and designed the experiments: BMW LS PJG MKB NEO GLM. Performed the experiments: BMW LS PJG. Analyzed the data: MKB BMW LS. Wrote the paper: BMW LS PJG MKB NEO GLM.

                Article
                PONE-D-13-36780
                10.1371/journal.pone.0093701
                3977875
                24709995
                f72b3e5b-68e6-4712-948a-81d5cd58ad9c
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 16 August 2013
                : 10 March 2014
                Page count
                Pages: 7
                Funding
                GLM is supported by the National Health & Medical Research Council of Australia (ID 579010). Floreat Physiotherapy provided support in the form of a salary for author LS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Anatomy
                Nervous System
                Neuroscience
                Cognitive Neuroscience
                Motor Reactions
                Sensory Systems
                Physiology
                Sensory Physiology
                Medicine and Health Sciences
                Anesthesiology
                Health Care
                Physiotherapy
                Neurology
                Pain Management
                Sports and Exercise Medicine

                Uncategorized
                Uncategorized

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