Movement observation-induced modulation of pain perception and motor cortex excitability

Abstract

Objective: The observation of movements increases primary motor cortex (M1) excitability. This exploratory study examined the effects of movement observation on pressure pain threshold (PPT) and transcranial magnetic stimulation (TMS)-indexed corticospinal excitability bilaterally.

Methods: Thirty healthy right-handed subjects were randomized to a left hand-movement observation task or a control task. Statistical analyses were performed using ANOVA models and t-tests. Results were not corrected for multiple comparisons. Quantitative sensory assessments were measured in both hands, while M1 excitability has only been tested for the right (non-dominant) M1 corresponding to the observed left hand movements.

Results: Analysis of pain and cortical silent period (CSP) outcomes demonstrated a significant interaction between task (hand-movement group) versus control group and time (pre-/postintervention). PPT increased in the left hand (moving hand in the task) and declined significantly in the contralateral hand (still hand) in the movement-observation-task-group, whereas PTT in the control group remained unchanged. CSP was significantly shorter in the movement-observation group indicating decreased intracortical inhibition (results uncorrected for multiple comparisons).

Conclusions: The observation of hand-movements led to a side-specific reduction in pain perception and a decrease in intracortical inhibition.

Significance: These exploratory findings support the notion that M1 is a robust modulator of pain-related neural networks. This effect might be mediated through modulation of the GABAergic system and appears to differ from what is observed in chronic pain.

Keywords: Corticospinal excitability; M1; Motor cortex; Movement observation; Pain.