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Primary Motor Cortex Organization Is Altered in Persistent Patellofemoral Pain

Maxine Te¹, Abrahão F Baptista², Lucy S Chipchase¹

¹School of Science and Health, Western Sydney University, Campbelltown, Sydney, New South Wales, Australia.

Pain Medicine (Malden, Mass.)

|March 25, 2017

Summary

Persistent patellofemoral pain (PFP) is linked to altered primary motor cortex (M1) organization. Studies show reduced M1 map volumes and anterior shifts in quadriceps representation in PFP patients.

Area of Science:

Neuroscience
Human Physiology
Pain Research

Background:

Persistent patellofemoral pain (PFP) is a common musculoskeletal condition.
The role of central nervous system changes, specifically in the primary motor cortex (M1), is increasingly recognized in chronic pain.
Previous research has not investigated M1 organization in individuals with PFP.

Purpose of the Study:

To investigate the organization of the M1 representation of quadriceps muscles in individuals with PFP.
To compare M1 organization in PFP patients with that of healthy controls.

Main Methods:

A cross-sectional study design was employed.
Transcranial magnetic stimulation (TMS) was used to map the M1 representation of the rectus femoris, vastus lateralis, and vastus medialis.
The study included 11 individuals with PFP and 11 healthy controls.

Main Results:

Individuals with PFP exhibited significantly reduced M1 map volumes compared to controls (P < 0.001).
Anterior shifts in the M1 representation of quadriceps muscles were observed in the PFP group (P = 0.03).
Greater overlap of M1 representation (P = 0.02) and fewer discrete cortical peaks (P = 0.009) were found in individuals with PFP.

Conclusions:

The findings provide evidence of altered M1 organization in individuals experiencing PFP.
No significant differences in M1 organization were noted for the medial and lateral quadriceps heads in the PFP group.
These results contribute to understanding PFP pathophysiology and may inform the development of targeted M1 therapies.

Keywords:

Motor Cortex Organisation Patellofemoral Pain Quadriceps Muscles Transcranial Magnetic Stimulation

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