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

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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

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Submitted date:
04/20/2022

Accepted date:
08/29/2022

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