René Pelletier, Daniel Bourbonnais, Johanne Higgins

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Nociception, pain, neuroplasticity and the practice of Osteopathic Manipulative Medicine René Pelletier, Daniel Bourbonnais, Johanne Higgins International Journal of Osteopathic Medicine Volume 27, Pages 34-44 (March 2018) DOI: 10.1016/j.ijosm.2017.08.001 Copyright © 2017 Elsevier Ltd Terms and Conditions

Fig. 1 Nociception transmission and transduction and pain pathways. Abbreviations: VPM: Ventral Postero Medial; Ventral Postero Lateral; PFC: Prefrontal Cortex; DLPFC: Dorsolateral Prefrontal Cortex; MPFC: Medial Prefrontal Cortex; VLPFC: Ventrolateral Prefrontal cortex; OFC: Orbital Frontal Cortex; NACC: Nucleus Accumbens; VTA: Ventral Tegmental Area; S1: Primary Somatosensory Cortex; SII: Secondary Somatosensory Cortex; M1: Primary Motor Cortex. International Journal of Osteopathic Medicine 2018 27, 34-44DOI: (10.1016/j.ijosm.2017.08.001) Copyright © 2017 Elsevier Ltd Terms and Conditions

Fig. 2 Neurophysiological changes associated with chronic musculoskeletal disorders and chronic pain states. International Journal of Osteopathic Medicine 2018 27, 34-44DOI: (10.1016/j.ijosm.2017.08.001) Copyright © 2017 Elsevier Ltd Terms and Conditions

Fig. 3 Osteopathic Manipulative Medicine and neurophysiological changes associated with chronic musculoskeletal disorders: The context of application of OMT and the neurophysiological responses associated with the mechanical application of OMT may result in distributed changes in neurophysiological function locally at the site of application, but also within the spinal cord, sensorimotor cortical areas, forebrain (prefrontal cortex, limbic, and mesolimbic structures), and descending modulatory pathways. These different regions may interact to result in changes in sensorimotor processes, but also engage the autonomic nervous system and the neuroendocrine systems that in turn may influence descending pain modulatory systems and inflammatory responses. The neurophysiological changes may vary depending upon the type of OMT performed. Abbreviations: VPM: Ventral Posterior Medial Nuclei of the Thalamus; VPL: Ventral Posterior Lateral Nuclei of the Thalamus. International Journal of Osteopathic Medicine 2018 27, 34-44DOI: (10.1016/j.ijosm.2017.08.001) Copyright © 2017 Elsevier Ltd Terms and Conditions