Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20220040-en
Brazilian Journal of Pain
Original Article

People with amputation and musculoskeletal pain show reduced electrical activity of Alpha brain waves: cross-sectional study

Pessoas com amputação e relato de dor musculoesquelética apresentam redução da atividade elétrica das ondas cerebrais Alpha: estudo transversal

Débora Pinheiro Aguiar; Paulo Cezar do Nascimento Filho; Amanda Guerra Moreira; Gabriella Coelho Vieira de Melo Alves; Gisele Harumi Hotta; Francisco Fleury Uchoa Santos-Júnior

http://dx.doi.org/10.5935/2595-0118.20220040-en BrJP, vol.5, n3, p.226-232, 2022
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Abstract

BACKGROUND AND OBJECTIVES: Amputation causes associated clinical conditions, such as musculoskeletal pain (MSP), which causes sufering and interferes in the patient’s life. Therefore, the development of diagnostic methods to measure these changes are encouraged, such as quantitative electroencephalography (qEEG). The aim of the study was to compare the electroencephalographic pattern of Alpha brain waves (8-12 Hz) in individuals with amputation with MSP unrelated to phantom limb pain and without MSP.

METHODS: Study conducted between January and February 2022, with 20 people with amputations divided equally into two groups (Control Group and with MSP report not related to the amputated segment). Pain intensity and interference were evaluated (Brief Pain Inventory), as well as the presence of central sensitization (CS) signs and symptoms (CS inventory) and qEEG (assessed with eyes open) with spectral analysis to measure the amplitude of the Alpha wave, standardized Low Resolution brain electromagnetic Tomography (sLORETA) to identify the differential generation site of said wave and Phase-Amplitude Coupling (PAC) to identify its interaction with fast waves.

RESULTS: People with amputation and MSP reported mild pain severity and interference. No diference was identifed between individuals regarding the presence of signs and symptoms associated with CS. Regarding electrical activity, the Pain Group had lower Alpha wave amplitude compared to the Control Group (p=0.01), specifically in the parieto-occipital region.

CONCLUSION: People with amputation and reported MSP unrelated to the phantom limb had reduced electrical activity (activation) of the Alpha brain wave in the sensory cortex.

HIGHLIGHTS

  • People with amputation and pain present reduced Alpha brain wave activity.
  • Quantitative electroencephalography can be a tool for monitoring patients with musculoskeletal pain report.

Keywords

Amputees, Electroencephalography, Musculoskeletal pain

Resumo

JUSTIFICATIVA E OBJETIVOS: A amputação acarreta quadros clínicos associados, como a dor musculoesquelética (DME), que causa sofrimento e interfere na vida do paciente. Por isso, o desenvolvimento de métodos diagnósticos para mensurar essas alterações são incentivados, como a eletroencefalografia quantitativa (EEGq). O objetivo deste estudo foi comparar o padrão eletroencefalográfico das ondas cerebrais Alpha (8-12 Hz) em pessoas com amputação com DME não relacionada à dor no membro fantasma e sem DME.

MÉTODOS: Estudo realizado entre janeiro e fevereiro de 2022, com 20 pessoas com amputação divididas igualmente em dois grupos (Grupo Controle e Grupo com relato de DME não relacionada ao segmento amputado). Avaliou-se intensidade e interferência da dor (Inventário Breve de Dor), presença de sinais e sintomas de sensibilização central (SC) (Inventário de SC) e a EEGq (avaliados com olhos abertos) com análise espectral para medir a amplitude da onda Alpha, standardized Low Resolution brain electromagnetic Tomography (sLORETA) para identificar o local de geração diferencial da referida onda e Phase-Amplitude Coupling (PAC) para identificar sua interação com ondas rápidas.

RESULTADOS: As pessoas com amputação e relato de DME apresentaram baixa gravidade e interferência de dor. Não se identificou diferença entre os indivíduos em relação a presença de sinais e sintomas associados à SC. Quanto à atividade elétrica, o Grupo Dor apresentou menor amplitude da onda Alpha em relação ao Grupo Controle (p=0,01), especificamente na região parieto-occipital.

CONCLUSÃO: Pessoas com amputação e relato de DME não relacionada ao membro fantasma apresentaram atividade elétrica (ativação) reduzida da onda cerebral Alpha no córtex sensorial.

DESTAQUES

  • Pessoas com amputação e relato de dor apresentam redução de atividade da onda cerebral Alpha.
  • A eletroencefalografia quantitativa pode ser uma ferramenta para acompanhamento de pacientes com relato de dor musculoesquelética.

Palavras-chave

Amputados, Dor musculoesquelética, Eletroence-falografia

References

Diretrizes de atenção à pessoa amputada / Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Ações Programáticas Estratégicas [Diretriz Online]. 2013:1-38.

Barbosa BMB, Monteiro RA, Sparano LF, Bareiro RFN, Passos ADC, Engel EE. Incidence and causes of lower-limb amputations in the city of Ribeirão Preto from 1985 to 2008: evaluation of the medical records from 3,274 cases. Rev Bras Epidemiol. 2016;19(2):317-25.

TabNet DataSUS [acesso em 20 fev 2022]. NORDIC SEMICONDUCTOR. nRF24LE1: Ultra-low Power Wireless System On-ChipSolution. 2010.

Spichler D, Miranda JF, Spichler ES, Franco LJ. Major lower extremity amputations related to peripheral arterial disease and diabetes mellitus in the city of Rio de Janeiro. J Vasc Bras. 2004;3(2):111-22.

Ostler C, Ellis-Hill C, Donovan-Hall M. Expectations of rehabilitation following lower limb amputation: a qualitative study. Disabil Rehabil. 2014;36(14):1169-75.

Gozaydinoglu S, Hosbay Z, Durmaz H. Body image perception, compliance with a prosthesis and cognitive performance in transfemoral amputees. Acta Orthop Traumatol Turc. 2019;53(3):221-5.

Siler S, Borneman T, Ferrell B. Pain and sufering. seminars in oncology nursing. 2019;35(3):310-4.

Silva AL, Smaidi K, Pires MHR, Pires OC. Prevalence of chronic pain and associated factors among medical students. Rev Dor. 2017;18(2):108-11.

Ephraim PL, Wegener ST, MacKenzie EJ, Dillingham TR, Pezzin LE. Phantom pain, residual limb pain, and back pain in amputees: results of a national survey. Arch Phys Med Rehabil. 2005;86(10):1910-9.

Stankevicius A, Wallwork SB, Summers SJ, Hordacre B, Stanton TR. Prevalence and incidence of phantom limb pain, phantom limb sensations and telescoping in amputees: A systematic rapid review. Eur J Pain. 2021;25(1):23-38.

Ostlie K, Franklin RJ, Skjeldal OH, Skrondal A, Magnus P. Musculoskeletal pain and overuse syndromes in adult acquired major upper-limb amputees. Arch Phys Med Rehabil. 2011;92(12):1967-73.

Idowu OP, Ilesanmi AE, Li X, Samuel OW, Fang P, Li G. An integrated deep learning model for motor intention recognition of multi-class EEG Signals in upper limb amputees. Computer Methods and Programs in Biomedicine. 2021;206:106121.

Li X, Samuel OW, Zhang X, Wang H, Fang P, Li G. A motion-classification strategy based on sEMG-EEG signal combination for upper-limb amputees. J Neuroeng Rehabil. 2017;14(1):2.

Hasan SMS, Siddiquee MR, Atri R, Ramon R, Marquez JS, Bai O. Prediction of gait intention from pre-movement EEG signals: a feasibility study. J Neuroeng Rehabil. 2020;17(50(1)):1-16.

Abiri R, Borhani S, Sellers EW, Jiang Y, Zhao X. A comprehensive review of EEG-based brain-computer interface paradigms. J Neural Eng. 2019;16(1):011001.

Gonçalves OF, Boggio PS. Neuromodulação autorregulatória: princípios e prática. 2016.

Santos Júnior FFU, Santana JR. A relação entre memória e aprendizado motor e o perfil de ondas cerebrais. Pesquisas Pós-Doutorais em História e Memória da Educação. 2018:37-48.

Stankevicius A, Wallwork SB, Summers SJ, Hordacre B, Stanton TR. Prevalence and incidence of phantom limb pain, phantom limb sensations and telescoping in amputees: A systematic rapid review. Eur J Pain. 2021;25:23-38.

Bao BB, Zhu HY, Wei HF, Li J, Wang ZB, Li YH, Hua XY, Zheng MX, Zheng XY. Altered intra- and inter-network brain functional connectivity in upper-limb amputees revealed through independent component analysis. Neural Regen Res. 2022;17(12):2725-9.

Makin TR, Flor H. Brain (re)organisation following amputation: Implications for phantom limb pain. Neuroimage. 2020;218:116943.

Lyu Y, Guo X, Wang Z, Tong S. Resting-state EEG network change in alpha and beta bands after upper limb amputation. Annu Int Conf IEEE Eng Med Biol Soc. 2016;2016:49-52.

Wiech K, Preissl H, Birbaumer N. Neuroimaging of chronic pain: phantom limb and musculoskeletal pain. Scand J Rheumatol Suppl. 2000;113:13-8.

Fitzgibbon BM, Enticott PG, Giummarra MJ, Tomson RH, Georgiou-Karistianis N, Bradshaw JL. Atypical electrophysiological activity during pain observation in amputees who experience synaesthetic pain. Soc Cogn Afect Neurosci. 2012;7(3):357-68.

Vase L, Egsgaard LL, Nikolajsen L, Svensson P, Jensen TS, Arendt-Nielsen L. Pain catastrophizing and cortical responses in amputees with varying levels of phantom limb pain: a high-density EEG brain-mapping study. Exp Brain Res. 2012;218(3):407-17.

Malta M, Cardoso LO, Bastos FI, Magnanini MMF, Silva CMFP. Iniciativa STROBE: subsídios para a comunicação de estudos observacionais. Revista de Saúde Pública [online]. 2010;44(3):559-65.

Malachias MVB, Souza WKSB, Plavnik FL, Rodrigues CIS, Brandão AA, Neves MFT. 7ª Diretriz Brasileira de Hipertensão Arterial. Sociedade Brasileira de Cardiologia. 2016;107(3^sSuppl. 3):1-103.

Ferreira KA, Teixeira MJ, Mendonza TR, Cleeland CS. Validation of brief pain inventory to Brazilian patients with pain. Support Care Cancer. 2011;19(4):505-11.

Kregel J, Vuijk PJ, Descheemaeker F, Keizer D, Van Der Noord R, Nijs J. The Dutch Central Sensitization Inventory (CSI). Factor Analysis, Discriminative Power, and Test-Retest Reliability. Clin J Pain. 2016;32(7):624-30.

Caumo W, Antunes LC, Elkfury JL, Herbstrith EG, Busanello Sipmann R, Souza A. The Central Sensitization Inventory validated and adapted for a Brazilian population: psychometric properties and its relationship with brain-derived neurotrophic factor. J Pain Res. 2017;10:2109-22.

Montenegro MA, Cendes F, Guerreiro MM, Guerreiro CAM. EEG na prática clínica. 2018:424.

Kayser J, Tenke CE. Issues and considerations for using the scalp surface Laplacian in EEG/ERP research: A tutorial review. Int J Psychophysiol. 2015;97(3):189-209.

Tadel F, Baillet S, Mosher JC, Pantazis D, Leahy RM. Brainstorm: a user-friendly application for MEG/EEG analysis. Comput Intell Neurosci. 2011;2011(879716):1-13.

Samiee S, Donoghue T, Tadel F, Baillet S. Phase-Amplitude Coupling. .

Pascual-Marqui RD. Standardized low-resolution brain electromagnetic tomography (sLORETA): technical details. Methods Find Exp Clin Pharmacol. 2002;24(5-12^sSuppl D):1-16.

Melo HM, Nascimento LM, Mello VO, Takase E. Infuência do ritmo Alfa (8-12Hz) no tempo de reação em uma tarefa de controle inibitório. Rev Neuropsicol Latinoam. 2017;9(2):33-43.

Babiloni C, Del Percio C, Arendt-Nielsen L, Soricelli A, Romani GL, Rossini PM, Capotosto P. Cortical EEG alpha rhythms reflect task-specific somatosensory and motor interactions in humans. Clin Neurophysiol. 2014;125(10):1936-45.

Nickel MM, May ES, Tiemann L, Schmidt P, Postorino M, Ta Dinh S, Gross J, Ploner M. Brain oscillations diferentially encode noxious stimulus intensity and pain intensity. Neuroimage. 2017;148:141-7.

Lim M, Kim JS, Kim DJ, Chung CK. Increased low- and high-frequency oscillatory activity in the prefrontal cortex of fibromyalgia patients. Front Hum Neurosci. 2016;10:111.

Lozano-Soldevilla D. On the physiological modulation and potential mechanisms underlying parieto-occipital Alpha oscillations. Front Comput Neurosci. 2018;12:23.

Tomaidou MA, Blythe JS, Houtman SJ, Veldhuijzen DS, van Laarhoven AIM, Evers AWM. Temporal structure of brain oscillations predicts learned nocebo responses to pain. Sci Rep. 2021;11(1):9807.

Camferman D, Moseley GL, Gertz K, Pettet MW, Jensen MP. Waking EEG cortical markers of chronic pain and sleepiness. Pain Med. 2017;18(10):1921-31.

De Ridder D, Vanneste S, Smith M, Adhia D. Pain and the triple network model. Front Neurol. 2022;13:757241.

Aguiar DP, Souza CP, Barbosa WJ, Santos Júnior FF, Oliveira AS. Prevalência de dor crônica no Brasil: revisão sistemática. BrJP. 2021;4(3):257-67.

Patel K, Henshaw J, Sutherland H, Taylor JR, Casson AJ, Lopez-Diaz K, Brown CA, Jones AKP, Sivan M, Trujillo-Barreto NJ. Using EEG Alpha States to understand learning during Alpha neurofeedback training for chronic pain. Front Neurosci. 2021;14:620666.

Merege CAA, Alves CRR, Sepúlveda CA, Costa AS, Lancha Junior AH, Gualano B. Infuência do exercício físico na cognição: uma atualização sobre mecanismos fisiológicos. Rev Bras Med Esporte. 2014;20(3):237-41.

Toutain TGLO, Rosário R, Mendes CMC, Sena EP. Alfa no estado alterado de consciência: meditação raja yoga. Rev Ciênc Méd Biol. 2019;18(1):38-43.

Nakano H, Kodama T, Ueda T, Mori I, Tani T, Murata S. Efect of hand and foot massage therapy on psychological factors and EEG activity in elderly people requiring long-term care: a randomized cross-over study. Brain Sci. 2019;9(3):54.

Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. 2021:1-36.

Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;1(1):1-68.

Ploner M, Sorg C, Gross J. Brain rhythms of pain. Trends Cogn Sci. 2017;21(2):100-10.

Liu CC, Chien JH, Kim JH, Chuang YF, Cheng DT, Anderson WS, Lenz FA. Cross-frequency coupling in deep brain structures upon processing the painful sensory inputs. Neuroscience. 2015;303:412-21.

Wang J, Li D, Li X, Liu FY, Xing GG, Cai J. Phase-amplitude coupling between θ and γ oscillations during nociception in rat electroencephalography. Neurosci Lett. 2011;499(2):84-7.

Submitted date:
04/20/2022

Accepted date:
08/29/2022

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