Accepted Articles                   Back to the articles list | Back to browse issues page

XML Print

1- Medical Science Faculty, Tarbiat Modares University, Tehran, Iran.
2- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA.
Background: Chronic low back pain (CLBP) is a global burden with an unknown etiology. It has been suggested that Reorganization of the cortical representation of paraspinal muscles in the primary motor cortex (M1) may be related to the pathology. Single-pulse transcranial magnetic stimulation (TMS), commonly used to map the functional organization of M1, is not potent enough to stimulate the cortical maps of paraspinal muscles in M1 in CLBP patients with reduced corticospinal excitability (CSE) with intensities even as high as maximum stimulator output (100% MSO). This makes TMS mapping impractical for these patients.
Objective: The aim of this study was to increase the practicality of TMS mapping for people with CLBP.
Methods: This study included eight men and ten women who had CLBP for over three months. A biphasic paired-pulse TMS paradigm, conjunct anticipatory postural adjustment (APA) and maximal voluntary activation of paraspinal muscles (MVC) were used to facilitate TMS mapping. 
Results:  TMS mapping was possible in all CLBP participants, with TMS intensities less than 50% of the MSO. Reorganization in terms of an anterior and lateral shift of the center of gravity (COG) of the cortical maps of paraspinal muscles was observed in all participants with CLBP, and a reduced number of discrete peaks was found in 33%.
Conclusion: The facilitation of the CSE to paraspinal muscles makes TMS mapping more practical and tolerable in people with CLBP, lowering the risk of seizure and discomfort associated with high-intensity TMS pulses. 
Type of Study: Original | Subject: Clinical Neuroscience
Received: 2022/07/15 | Accepted: 2023/01/15

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2023 CC BY-NC 4.0 | Basic and Clinical Neuroscience

Designed & Developed by : Yektaweb