Sensorimotor Function In Pathological Pain

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There is substantial evidence that some chronic pain conditions involve changes to the cortical motor system. Most insights about the motor system in chronic pain concern the primary motor cortex (M1). For example, non-invasive brain stimulation has revealed changes in the parts of M1 connecting to affected body parts in people with chronic limb or back pain. However, treatments targeting M1 for chronic limb pain require intense training, and only a few patients benefit. People with chronic pain not only have difficulties with movements but also take longer to mentally rotate and identify pictures corresponding to their affected limb, suggesting problems with representing (not just executing) movements. Consequently, I suspect there are also changes to 'higher order' motor areas, those used for planning and interpreting movements. My project will use behavioural, neuropsychological tests and non-invasive brain stimulation methods to provide a more in-depth understanding of cortical motor contributions to chronic pain, to discover potential new targets for treatment. I will conduct four studies:1) A network analysis of secondary data to identify key target chronic pain symptoms and how those relate to one another. 2) A large-scale, online study of action perception and comprehension in multiple chronic pain conditions versus pain-free controls with the specific goal to reach a wider, heterogeneous population as participants. This will include using neuropsychological tests to provide insights into possible changes within higher-order motor functions and how these vary by condition, and by pain location, severity, and duration.3) A more specific lab-based study on higher-order motor functions and movements comparing pain free controls to patients with Complex Regional Pain Syndrome, a specific pain condition associated with movement difficulties. 4) A lab-based study using non-invasive brain stimulation (Transcranial Magnetic Stimulation) to investigate the cortical interaction between M1 and a higher-order motor area in patients with Complex Regional Pain Syndrome.The studies together will improve understanding of chronic pain conditions and find potential new targets for treatment. Chronic pain is a large human health problem that varies in different countries affecting 8% to 55.2% of the population also using considerable healthcare resources. Finding new therapies is therefore important and relevant to the research council.