Interactions entre la douleur et la réadaptation sensorimotrice: mécanismes et implications cliniques

 

Catherine Mercier

Université Laval

 

Domaine : appareil locomoteur et arthrite

Programme Chercheurs-boursiers de mérite

Concours 2018-2019

Pain is one of the most common and disabling symptoms following injury, affecting a large proportion of patients receiving intensive motor rehabilitation to improve their motor functions. Compared to patients with similar injuries but without associated pain, patients experiencing pain exhibit poorer recovery. Obviously, people who suffers from pain sometimes restrict or modify their movements to try to minimize pain. However, the interactions between pain and motor functions are much more complex, and a better understanding of these interactions is needed in order to develop optimal rehabilitative strategies for patients suffering from both pain and motor deficits.

Basic research performed in animals have led to the hypothesis the changes in the nervous system that are involved in the development of chronic pain and in motor recovery share similarities, and that therefore these two processes could compete with each other. The overarching goal of my research program is to understand these interaction between pain and motor recovery in patients who have sustained a trauma, such as paraplegics or amputees who often feel pain arising from their missing or paralysed body parts. To attain that goal, I use a variety of approaches including robotics, virtual reality, non-invasive brain stimulation and neurophysiological measurements. We are performing studies in healthy individuals in which we induce short term experimental pain to understand how acute pain affect the way they perceive their own body and their ability to learn new motor tasks.

We are then studying similar tasks in individuals with chronic pain of various origins. Finally, we are developing and testing innovative rehabilitation treatments that could provide benefits for both pain and motor functions. The need for such non-drug treatment options for individuals with chronic pain is urgent given the rapid increase in the use of opioid drugs in Canada.