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Correspondence to Author: Lais Oliveira de Almeida ¹ (ORCID: 0009-0001-3053-9985), Luciane Aparecida Pascucci Sande de Souza², (ORCID: 0000-0002-7160-9556). 

1. Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.
2. Department of Applied Physical Therapy, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.

DOI: 10.52338/Appr.2025.4653

Abstract:

Chronic neck pain is one of the leading causes of disability worldwide, resulting in functional deficits and significant public health impacts. Its long-term presence leads to proprioceptive difficulties, muscle fatigue, and impaired sensorimotor integration, both peripherally and centrally. This study investigated changes in prefrontal cortex activation during cervical movements and its association with verticality perception in individuals with chronic neck pain. A cross-sectional study was conducted with 16 volunteers (8 with pain and 8 healthy controls), aged 18 to 59, matched by age and sex. Assessments included prefrontal cortex activation using fNIRS during cervical movements, subjective visual vertical (SVV) test, joint position sense (JPE) test, pain intensity, and neck disability index (NDI). No significant differences were found in prefrontal cortex activation, SVV, or JPE between groups. However, the healthy group showed a high correlation (R > 0.7) between brain activation and cervical movements, a pattern absent in the pain group, which had a median pain score of 6.25 (VAS) and mild to moderate disability (NDI = 15.87). The absence of intragroup correlation in individuals with pain suggests compensatory neuromuscular or sensory adaptations, which may be detrimental over time. These findings indicate that individuals with chronic neck pain and mild to moderate disability do not exhibit changes in prefrontal cortex activation or verticality perception, but may develop adaptive mechanisms that warrant further investigation.

Citation:

Lais Oliveira de Almeida, Chronic Cervical Pain And The Prefrontal Cortex: Impacts On Cervical Movements And Verticality Perception. Annals of Physical Medicine & Rehabilitation 2025.