Influence Of Pain-Related Beliefs On The Modulation Of Intracortical Circuits During Experimental Pain Induced By Topical Capsaicin
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Change in Short-Interval Intracortical Inhibition
研究概览
简要总结
Pain can influence the way the motor system functions. However, responses to pain vary widely between individuals, and this variability may be partly related to pain-related beliefs such as kinesiophobia.
This study examines whether temporary experimental pain changes intracortical excitability in the motor cortex, and whether this response differs according to baseline kinesiophobia. Healthy adults will complete one experimental session. Motor cortex excitability will first be assessed at baseline using transcranial magnetic stimulation, a non-invasive brain stimulation technique. A topical capsaicin cream will then be applied to the forearm to induce temporary, moderate experimental pain. Once pain is established, the same neurophysiological assessments will be repeated.
The main objective is to measure changes in short-interval intracortical inhibition before and during capsaicin-induced pain, with particular attention to whether these changes are associated with baseline kinesiophobia.
Secondary objectives are to characterize other markers of motor cortex excitability, including long-interval intracortical inhibition, short-interval intracortical facilitation, intracortical facilitation, and corticospinal excitability assessed using input-output recruitment curves. Pain intensity will be monitored using a visual analog scale to characterize the experimental pain response. Baseline kinesiophobia will be assessed using the Tampa Scale of Kinesiophobia and examined as a factor associated with interindividual variability in neurophysiological responses to experimental pain.
The researchers expect that changes in motor cortex excitability during experimental pain will vary between individuals, and that individuals with higher kinesiophobia may show smaller changes in motor cortex excitability during capsaicin-induced pain.
详细描述
Pain is not only a sensory experience. It is also influenced by psychological, emotional, and contextual factors, including how people interpret pain and the threat they associate with movement. In the presence of pain, individuals often modify the way they move. These adaptations may be protective in the short term, but when maintained over time, they may contribute to persistent movement avoidance and disability.
Within the fear-avoidance framework, kinesiophobia, or fear of movement, is considered an important factor in the relationship between pain, movement, and disability. Individuals with higher kinesiophobia may perceive movement as threatening or potentially harmful. This may influence not only motor behavior, but also the way the nervous system prepares and controls movement. However, the neurophysiological mechanisms linking pain-related beliefs, experimental pain, and motor control remain incompletely understood.
The primary motor cortex is a key brain region involved in voluntary movement. Its excitability can be assessed using transcranial magnetic stimulation, a non-invasive brain stimulation technique. When applied over the primary motor cortex, transcranial magnetic stimulation can evoke motor responses that are recorded from a target muscle using surface electromyography. These responses provide information about corticospinal excitability and about intracortical inhibitory and facilitatory mechanisms.
Previous studies suggest that experimental pain can modify motor cortex excitability, but the direction and magnitude of these changes vary considerably between individuals. Pain-related beliefs, especially kinesiophobia, may partly explain this variability. This study therefore focuses on whether experimental pain changes intracortical excitability in the motor cortex and whether this response differs according to baseline kinesiophobia.
The main objective is to quantify changes in short-interval intracortical inhibition before and during experimental pain induced by topical capsaicin, with particular attention to whether these changes vary according to the participant's baseline level of kinesiophobia. Short-interval intracortical inhibition is used as the primary neurophysiological measure because it reflects inhibitory activity within the motor cortex.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Basic Science
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 35 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Aged 18 to 35 years, inclusive
- •Able to understand the study information and experimental procedures
- •Able to provide informed consent
排除标准
- •History of psychiatric disorders (including intellectual disability or severe cognitive, behavioral, or affective impairment) that could interfere with understanding the study or providing informed consent.
- •History of neurological disorders, including epilepsy, stroke, brain or spinal cord surgery, or any neurological disease affecting motor or sensory function.
- •Inability to provide informed consent (e.g., dementia, significant hearing impairment, insufficient language proficiency).
- •Any pain condition within the past 3 months, regardless of origin.
- •Recent musculoskeletal injury or surgery within the past 3 months.
- •Contraindications to transcranial magnetic stimulation (TMS), including a history of epilepsy or the presence of intracranial metallic objects, cochlear implants, or other non-removable metallic implants in or near the head.
- •Use of analgesic or psychotropic medications.
- •Individuals under legal guardianship or curatorship.
- •Pregnant or breastfeeding women.
- •Presence of a cardiac pacemaker or other implanted electronic medical device.
- •Known allergy or previous skin reaction to capsaicin
结局指标
主要结局
Change in Short-Interval Intracortical Inhibition
时间窗: At baseline (before capsaicin cream application); at pain stabilization (after capsaicin cream application)
Short-interval intracortical inhibition will be assessed using paired-pulse transcranial magnetic stimulation over the primary motor cortex, with electromyographic recordings from the first dorsal interosseous muscle. A subthreshold conditioning stimulus set at 80% of resting motor threshold will be followed by a suprathreshold test stimulus set at 120% of resting motor threshold, with an interstimulus interval of 3 ms. Fifteen conditioned trials will be recorded for this measure. The outcome will be expressed as the change in conditioned motor evoked potential amplitude relative to the unconditioned test response from pre- to post-application of topical capsaicin cream.
次要结局
- Change in Short-Interval Intracortical Facilitation(At baseline (before capsaicin cream application); at pain stabilization (after capsaicin cream application))
- Change in Pain Intensity(From baseline through completion of the experimental session, an average of 2 hours)
- Change in Intracortical Facilitation(At baseline (before capsaicin cream application); at pain stabilization (after capsaicin cream application))
- Change in Long-Interval Intracortical Inhibition(At baseline (before capsaicin cream application); at pain stabilization (after capsaicin cream application))
- Change from baseline in corticospinal excitability(At baseline (before capsaicin cream application); at pain stabilization (after capsaicin cream application))
研究者
Guillaume Léonard
Principal Investigator
Université de Sherbrooke