La préparation motrice est une étape complexe, à l’interface entre les aspects cognitifs et moteurs et qui met en jeu des processus neurophysiologiques excitateurs et inhibiteurs qui interagissent ensemble. Les travaux réalisés dans le cadre de la thèse révèlent que le contexte dans lequel le mouvement est préparé s’avère primordial. En effet, la revue systématique a permis de préciser le rôle de cinq régions corticales lors des différentes composantes inhérentes à la préparation motrice et a soulevé l’importance du choix du paradigme de temps de réaction utilisé. L’étude de la modulation de l’excitabilité corticospinale et des mouvements évoqués par la TMS a démontré des différences dans le contrôle corticospinal des muscles fléchisseurs et extenseurs du coude tout au long de la phase de la préparation motrice. L’étude 3 a mis en évidence pour la première fois un effet de l’anticipation de la douleur associée à un mouvement sur les changements d’excitabilité corticospinale associés à la préparation d’un mouvement. Ces résultats ont confirmé les prédictions de la théorie d’adaptation du contrôle moteur en présence de douleur qui suggère la mise en place de stratégies de protection se reflétant à travers une augmentation de l’excitabilité corticospinale du muscle antagoniste et à l’inverse une diminution du muscle agoniste au mouvement douloureux. Ces résultats démontrent finalement qu’une composante cognitive de l’expérience de douleur suffit à la mise en place de ces stratégies de protection. Compte tenu de l’importance de ces stratégies, bénéfiques à court terme mais néfastes à long terme, il apparaît nécessaire de poursuivre la caractérisation des mécanismes neurophysiologiques qui les sous-tendent afin de pouvoir être un jour en mesure d’identifier et de prévenir cette transition.
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