Temporal dynamics of local cortical rhythms during acute pain remain largely unknown. The current study used a novel approach based on transcranial magnetic stimulation combined with electroencephalogram (TMS-EEG) to investigate evoked-oscillatory cortical activity during acute pain. Motor (M1) and dorsolateral prefrontal cortex (DLPFC) were probed by TMS, respectively, to record oscillatory power (event-related spectral perturbation and relative spectral power) and phase synchronization (inter-trial coherence) by 63 EEG channels during experimentally induced acute heat pain in 24 healthy participants. TMS-EEG was recorded before, during, and after noxious heat (Acute Pain condition) and non-noxious warm (Control condition), delivered in a randomized sequence. The main frequency bands (α, β1, and β2) of TMS-evoked potentials after M1 and DLPFC stimulation were recorded close to the TMS coil and remotely. Cold and heat pain thresholds were measured before TMS-EEG. Over M1, Acute pain decreased α-band oscillatory power locally and α-band phase synchronization remotely in parietal-occipital clusters compared with non-noxious warm (all P<0.05). The remote (parietal-occipital) decrease in α-band phase synchronization during Acute Pain correlated with the cold (P=0.001) and heat pain thresholds (P=0.023) and to local (M1) α-band oscillatory power decrease (P=0.024). Over DLPFC, Acute Pain only decreased β1-band power locally compared with non-noxious warm (P=0.015). Thus, evoked-oscillatory cortical activity to M1 stimulation is reduced by acute pain in central and parietal-occipital regions and correlated with pain sensitivity, in contrast to DLPFC, which had only local effects. This finding expands the significance of α and β band oscillations and may have relevance for pain therapies.

The authors have declared no competing interest.

The Center for Neuroplasticity and Pain (CNAP) is supported by the Danish National Research Foundation (DNRF121). This study is supported by a Novo Nordisk Grant NNF21OC0072828.

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The study was approved by the ethics committee (Videnskabsetiske Komite for Region Nordjylland: N-20220018) and was registered at ClinicalTrials.gov (NCT05566444).

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All data produced in the present study are available upon reasonable request to the authors