Does motor cortex engagement during movement preparation differentially inhibit nociceptive processing in patients with chronic whiplash associated disorders, chronic fatigue syndrome and healthy controls? An experimental study


Lisa Goudman, André Mouraux, Liesbeth Daenen, Jo Nijs, Patrick Cras, Nathalie Roussel, Maarten Moens, Dorine Lenoir, Iris Coppieters, Eva Huysmans, Margot De Kooning


Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium


Journal of Clinical Medicine, 2020 May 18; 9(5):1520

Key findings

  • Preparing for movement is associated with inhibition of nociception – the body’s sensory response to harmful or painful stimuli
  • The extent of this inhibition was similar in patients with ME/CFS, those with chronic whiplash-associated disorders, and healthy control subjects
  • The results therefore do not support the idea that this mechanism is impaired in these patient groups



Patients with chronic fatigue syndrome (CFS) and chronic whiplash associated disorders (cWAD) present a reduced ability to activate central descending nociceptive inhibition after exercise, compared to measurements before exercise. It was hypothesised that a dysfunctional motor-induced inhibition of nociception partly explains this dysfunctional exercise-induced hypoalgesia. This study investigates if engagement of the motor system during movement preparation inhibits nociception-evoked brain responses in these patients as compared to healthy controls (HC).


The experiment used laser-evoked potentials (LEPs) during three conditions (no task, mental task, movement preparation) while recording brain activity with a 32-channel electroencephalogram in 21 patients with cWAD, 20 patients with CFS and 18 HC. Two-factor mixed design Analysis of variance were used to evaluate differences in LEP amplitudes and latencies.


No differences in N1, N2, N2P2, and P2 LEP amplitudes were found between the HC, CFS, and cWAD groups. After nociceptive stimulation, N1, N2 (only at hand location), N2P2, and P2 LEP amplitudes significantly decreased during movement preparation compared to no task (within group differences).


Movement preparation induces a similar attenuation of LEPs in patients with CFS, patients with cWAD and HC. These findings do not support reduced motor-induced nociceptive inhibition in these patients.

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