Tonic Pain Experienced during Locomotor Training Impairs Retention Despite Normal Performance during Acquisition
Tonic Pain Experienced during Locomotor Training Impairs Retention Despite Normal Performance during Acquisition
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DOI：
10.1523/jneurosci.5303-13.2014
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发表时间：
2014-07-09
影响因子：
5.3
通讯作者：
Mercier, Catherine
中科院分区：
文献类型：
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作者：
Bouffard, Jason;Bouyer, Laurent J.;Mercier, Catherine
许多患者在康复期间接受步态训练时会感到疼痛。基于动物研究，已经提出与伤害感受相关的中枢敏化（适应不良可塑性）和与感觉运动学习相关的可塑性（适应可塑性）具有相似的神经机制并且彼此竞争。本研究的目的是评估实验性强直性疼痛是否会影响新运动任务的运动学习（获得和次日保持）。30名健康的人类受试者连续2天进行运动适应任务（使用机器人矫形器在摆动期间施加到脚踝的扰动力场）。使用运动学测量（峰值和平均绝对跖屈误差）和肌电图（EMG）活动评估学习。一半的参与者在第1天进行疼痛的运动适应任务（脚踝周围的辣椒素霜），而所有受试者在第2天进行无痛任务以评估保留。疼痛对基线步态参数和第1天运动适应任务（运动学或EMG测量）期间的表现均无显著影响。尽管运动获得明显正常，但疼痛组的无痛第2天表现明显受损，表明训练期间的疼痛对运动记忆的保留有影响（干扰巩固和/或检索）。这些结果表明，如果在疼痛的情况下进行同样的运动康复干预，效果可能会降低。
Many patients are in pain when they receive gait training during rehabilitation. Based on animal studies, it has been proposed that central sensitization associated to nociception (maladaptive plasticity) and plasticity related to the sensorimotor learning (adaptive plasticity) share similar neural mechanisms and compete with each other. The aim of this study was to evaluate whether experimental tonic pain influences motor learning (acquisition and next-day retention) of a new locomotor task. Thirty healthy human subjects performed a locomotor adaptation task (perturbing force field applied to the ankle during swing using a robotized orthosis) on 2 consecutive days. Learning was assessed using kinematic measures (peak and mean absolute plantarflexion errors) and electromyographic (EMG) activity. Half of the participants performed the locomotor adaptation task with pain on Day 1 (capsaicin cream around the ankle), while the task was performed pain-free for all subjects on Day 2 to assess retention. Pain had no significant effect on baseline gait parameters nor on performance during the locomotor adaptation task (for either kinematic or EMG measures) on Day 1. Despite this apparently normal motor acquisition, pain-free Day 2 performance was markedly and significantly impaired in the Pain group, indicating that pain during training had an impact on the retention of motor memories (interfering with consolidation and/or retrieval). These results suggest that the same motor rehabilitation intervention could be less effective if administered in the presence of pain.