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Telesca A, Vergallito A, Consonni M, Mattavelli G, Ferrario A, Grazzi L, Usai S, Romero Lauro LJ. Social cognition abilities in patients with primary and secondary chronic pain. Front Psychol 2024; 15:1315682. [PMID: 38596340 PMCID: PMC11002902 DOI: 10.3389/fpsyg.2024.1315682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/06/2024] [Indexed: 04/11/2024] Open
Abstract
Previous evidence suggested that chronic pain is characterized by cognitive deficits, particularly in the social cognition domain. Recently, a new chronic pain classification has been proposed distinguishing chronic primary pain (CPP), in which pain is the primary cause of patients' disease, and chronic secondary pain (CSP), in which pain is secondary to an underlying illness. The present study aimed at investigating social cognition profiles in the two disorders. We included 38 CPP, 43 CSP patients, and 41 healthy controls (HC). Social cognition was assessed with the Ekman-60 faces test (Ekman-60F) and the Story-Based Empathy Task (SET), whereas global cognitive functioning was measured with the Montreal Cognitive Assessment (MoCA). Pain and mood symptoms, coping strategies, and alexithymia were also evaluated. Correlations among clinical pain-related measures, cognitive performance, and psychopathological features were investigated. Results suggested that CSP patients were impaired compared to CPP and HC in social cognition abilities, while CPP and HC performance was not statistically different. Pain intensity and illness duration did not correlate with cognitive performance or psychopathological measures. These findings confirmed the presence of social cognition deficits in chronic pain patients, suggesting for the first time that such impairment mainly affects CSP patients, but not CPP. We also highlighted the importance of measuring global cognitive functioning when targeting chronic pain disorders. Future research should further investigate the cognitive and psychopathological profile of CPP and CSP patients to clarify whether present findings can be generalized as disorder characteristics.
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Affiliation(s)
- Alessandra Telesca
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
| | | | - Monica Consonni
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
| | - Giulia Mattavelli
- ICoN Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
| | - Alessia Ferrario
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
| | - Licia Grazzi
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
| | - Susanna Usai
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
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Melum TA, Steingrímsdóttir ÓA, Jacobsen HB, Johnsen B, Stubhaug A, Schirmer H, Mathiesen EB, Nielsen CS. Associations between cognitive test scores and pain tolerance: The Tromsø study. Scand J Pain 2024; 24:sjpain-2023-0082. [PMID: 38495000 DOI: 10.1515/sjpain-2023-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/16/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES Previous studies have suggested that experimental pain sensitivity is associated with cognitive function. The aim of this study is to assess this relationship in a large population-based sample. METHODS We included 5,753 participants (aged 40-84 years) from the seventh wave of the population-based Tromsø Study who had been examined with cognitive tests and experimental pain assessments, and for whom information on covariates were available. Cox regression models were fitted using standardized scores on cognitive tests (12-word immediate recall test, digit symbol coding test, and Mini-Mental State Examination [MMS-E]) as the independent variable and cold pressor or cuff pressure pain tolerance as the dependent variables. Statistical adjustment was made for putative confounders, namely, age, sex, education, smoking, exercise, systolic blood pressure, body mass index, symptoms indicating anxiety or depression, analgesic use, and chronic pain. RESULTS In multivariate analysis, cold pressor tolerance time was significantly associated with test scores on the 12-word immediate recall test (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.90-0.97, p < 0.001), the digit symbol coding test (HR 0.94, 95% CI 0.89-0.98, p = 0.004), and the MMS-E (HR 0.93, 95% CI 0.90-0.96 p < 0.001). Tolerance to cuff pressure algometry was significantly associated with 12-word immediate recall (HR 0.94-0.97, p < 0.001) and Digit Symbol Coding test scores (HR 0.93, 95% CI 0.89-0.96, p < 0.001) while there was no significant association with Mini Mental State Examination test score (HR 0.98, 95% CI 0.95-1.00, p = 0.082). CONCLUSION Lower pain tolerance was associated with poorer performance on cognitive tests.
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Affiliation(s)
- Tonje Anita Melum
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Pain Clinic, University Hospital of Northern Norway, Postbox 100, 9038, Tromsø, Norway
| | - Ólöf A Steingrímsdóttir
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Research, Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway
| | - Henrik B Jacobsen
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- The Mind Body Lab, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Bente Johnsen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Audun Stubhaug
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
| | - Ellisiv B Mathiesen
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christopher S Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
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Forte G, Troisi G, Favieri F, De Pascalis V, Langher V, Casagrande M. Inhibition and Heart Rate Variability in Experimentally Induced Pain. J Pain Res 2023; 16:3239-3249. [PMID: 37790193 PMCID: PMC10542212 DOI: 10.2147/jpr.s418238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/03/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Pain is a complex experience that requires executive functions (EFs) to be processed. The autonomic outcome of the neural networks involved in the cognitive evaluation of pain is reflected by heart rate variability (HRV), an index of self-regulation abilities. Although some results suggest a relationship between HRV, EFs, and pain, studies focusing on this three-way relationship are still scarce. Objective This study aims to investigate the relationship between pain, cognitive, and autonomic mechanisms, hypothesizing an association between resting HRV and both cognitive and motor inhibition as indices of executive functioning. This relationship was investigated after an experimental-induced pain. Methods Seventy-six young adults were exposed to the Cold Pressure Arm Warp to induce experimental pain. HRV was collected, and cognitive tasks were administered to assess executive performance. Results The results showed that (1) HRV indices significantly increased during pain stimulation, (2) cognitive inhibition was positively correlated with vagal indices and with pain parameters, (3) both inhibition tasks significantly predicted pain threshold while the performance on the Stroop Task predicted pain tolerance. Conclusion Results suggest a three-way relationship. Further research would focus on the role of HRV and cognitive strategies in pain management in chronic pain conditions.
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Affiliation(s)
- Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Roma, 00185, Italy
| | - Giovanna Troisi
- Department of Psychology, Sapienza University of Rome, Roma, 00185, Italy
| | - Francesca Favieri
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Roma, 00185, Italy
| | | | - Viviana Langher
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Roma, 00185, Italy
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Roma, 00185, Italy
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Milam AL, Judah MR. The Association of Emotion Regulation with Distress Tolerance Depends on a Neural Correlate of Cognitive Control. Biol Psychol 2023; 180:108571. [PMID: 37146790 DOI: 10.1016/j.biopsycho.2023.108571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/15/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Distress tolerance is associated with transdiagnostic mental health problems. Theory and research implicate emotion regulation and cognitive control as factors in distress tolerance. But their unique contributions and interdependency have been unclear. This study tested how emotion regulation and the N2, a neural index of cognitive control, uniquely and interactively predicted distress tolerance. METHODS Undergraduate psychology students (N = 57) completed self-report measures and a Go-NoGo task, from which the N2 was extracted using PCA. The Go-NoGo task was counter-balanced to avoid confounding stimulus characteristics and frequency of stimulus presentation. RESULTS Emotion regulation predicted distress tolerance, but the N2 did not. The association of emotion regulation with distress tolerance was moderated by the N2, such that the association was larger at higher N2 amplitudes. LIMITATIONS The use of a non-clinical student sample limits the generalizability of the results. The data are cross-sectional and correlational, preventing conclusions about causality. CONCLUSIONS The findings indicate that emotion regulation is associated with better distress tolerance at higher levels of N2 amplitude, a neural correlate of cognitive control. Emotion regulation may be more effective at enabling distress tolerance in individuals with better cognitive control. This supports past work indicating that distress tolerance interventions may benefit by developing emotion regulation skills. Additional research is needed to test if such an approach is more effective in individuals with better cognitive control.
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Affiliation(s)
- Alicia L Milam
- Old Dominion University, Norfolk, VA; Virginia Consortium Program in Clinical Psychology, Norfolk, VA.
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Timm A, Schmidt-Wilcke T, Blenk S, Studer B. Altered social decision making in patients with chronic pain. Psychol Med 2023; 53:2466-2475. [PMID: 34736548 PMCID: PMC10123842 DOI: 10.1017/s0033291721004359] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 09/10/2021] [Accepted: 10/06/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Chronic pain affects up to 20% of the population, impairs quality of life and reduces social participation. Previous research reported that pain-related perceived injustice covaries with these negative consequences. The current study probed whether chronic pain patients responded more strongly to disadvantageous social inequity than healthy individuals. METHODS We administered the Ultimatum Game, a neuroeconomic social exchange game, where a sum of money is split between two players to a large sample of patients with chronic pain disorder with somatic and psychological factors (n = 102) and healthy controls (n = 101). Anonymised, and in truth experimentally controlled, co-players proposed a split, and our participants either accepted or rejected these offers. RESULTS Chronic pain patients were hypersensitive to disadvantageous inequity and punished their co-players for proposed unequal splits more often than healthy controls. Furthermore, this systematic shift in social decision making was independent of patients' performance on tests of executive functions and risk-sensitive (non-social) decision making . CONCLUSIONS Our findings indicate that chronic pain is associated with anomalies in social decision making (compared to healthy controls) and hypersensitivity to social inequity that is likely to negatively impact social partaking and thereby the quality of life.
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Affiliation(s)
- Alicja Timm
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Mauritius Hospital Meerbusch, Meerbusch, Germany
| | - Tobias Schmidt-Wilcke
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Mauritius Hospital Meerbusch, Meerbusch, Germany
| | - Sandra Blenk
- Centre for Pain Medicine, St.Vinzenz Hospital Düsseldorf, Düsseldorf, Germany
| | - Bettina Studer
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Mauritius Hospital Meerbusch, Meerbusch, Germany
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Li Y, Yang B, Wang Z, Huang R, Lu X, Bi X, Zhou S. EEG assessment of brain dysfunction for patients with chronic primary pain and depression under auditory oddball task. Front Neurosci 2023; 17:1133834. [PMID: 37034156 PMCID: PMC10079993 DOI: 10.3389/fnins.2023.1133834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
In 2019, the International Classification of Diseases 11th Revision International Classification of Diseases (ICD-11) put forward a new concept of "chronic primary pain" (CPP), a kind of chronic pain characterized by severe functional disability and emotional distress, which is a medical problem that deserves great attention. Although CPP is closely related to depressive disorder, its potential neural characteristics are still unclear. This paper collected EEG data from 67 subjects (23 healthy subjects, 22 patients with depression, and 22 patients with CPP) under the auditory oddball paradigm, systematically analyzed the brain network connection matrix and graph theory characteristic indicators, and classified the EEG and PLI matrices of three groups of people by frequency band based on deep learning. The results showed significant differences in brain network connectivity between CPP patients and depressive patients. Specifically, the connectivity within the frontoparietal network of the Theta band in CPP patients is significantly enhanced. The CNN classification model of EEG is better than that of PLI, with the highest accuracy of 85.01% in Gamma band in former and 79.64% in Theta band in later. We propose hyperexcitability in attentional control in CPP patients and provide a novel method for objective assessment of chronic primary pain.
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Affiliation(s)
- Yunzhe Li
- School of Medicine, School of Mechatronic Engineering and Automation, Research Center of Brain Computer Engineering, Shanghai University, Shanghai, China
| | - Banghua Yang
- School of Medicine, School of Mechatronic Engineering and Automation, Research Center of Brain Computer Engineering, Shanghai University, Shanghai, China
- Shanghai Shaonao Sensing Technology Ltd., Shanghai, China
- *Correspondence: Banghua Yang,
| | - Zuowei Wang
- Division of Mood Disorders, Shanghai Hongkou Mental Health Center, Shanghai, China
| | - Ruyan Huang
- Division of Mood Disorders, Shanghai Hongkou Mental Health Center, Shanghai, China
| | - Xi Lu
- Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Xiaoying Bi
- Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
- Xiaoying Bi,
| | - Shu Zhou
- Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
- Shu Zhou,
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Rischer KM, Anton F, González-Roldán AM, Montoya P, van der Meulen M. Better Executive Functions Are Associated With More Efficient Cognitive Pain Modulation in Older Adults: An fMRI Study. Front Aging Neurosci 2022; 14:828742. [PMID: 35875790 PMCID: PMC9302198 DOI: 10.3389/fnagi.2022.828742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Growing evidence suggests that aging is associated with less efficient endogenous pain modulation as demonstrated by reduced conditioned pain modulation, and that these changes may be mediated by differences in frontal functioning. Yet, little is known about potential age-related changes in cognitive pain modulation, such as distraction from pain. In a first session, 30 healthy young (19-35 years) and 30 healthy older (59-82 years) adults completed a battery of neuropsychological tests. In a second session, we acquired functional brain images while participants completed a working memory task with two levels of cognitive load (high vs. low) and concurrently received individually adjusted heat stimuli (warm vs. painful). In both age groups, completing the high load task was associated with a significant reduction in the perceived intensity and unpleasantness of painful stimuli and a reduction in activation of brain regions involved in pain processing. Group comparisons revealed that young adults showed a stronger de-activation of brain regions involved in pain processing during the high load vs. the low load task, such as the right insula, right mid cingulate cortex and left supramarginal gyrus, compared to older adults. Older adults, on the other hand, showed an increased activation in the anterior cingulate cortex during the high load vs. low load task, when compared to young adults. Covariate analyses indicated that executive functions significantly predicted neural pain modulation in older adults: Better executive functions were associated with a more pronounced de-activation of the insula, thalamus and primary somatosensory cortex and increased activation of prefrontal regions during the high vs. low load task. These findings suggest that cognitive pain modulation is altered in older age and that the preservation of executive functions may have beneficial effects on the efficacy of distraction from pain.
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Affiliation(s)
- Katharina M. Rischer
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Fernand Anton
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Ana M. González-Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences, Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences, Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
| | - Marian van der Meulen
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Gajsar H, Meyer M, Hasenbring MI, Vaegter HB. Pain and executive function: no association between remote exercise-induced hypoalgesia and cognitive inhibition in pain-free participants. Scand J Pain 2022; 22:173-185. [PMID: 34364316 DOI: 10.1515/sjpain-2021-0071] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/13/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Cognitive inhibition, which denotes the ability to suppress predominant or automatic responses, has been associated with lower pain sensitivity and larger conditioned pain modulation in humans. Studies exploring the association between cognitive inhibition and other pain inhibitory phenomena, like exercise-induced hypoalgesia (EIH), are scarce. The primary aim was to explore the association between cognitive inhibition and EIH at exercising (local) and non-exercising (remote) muscles after isometric exercise. The secondary aim was to explore the association between cognitive inhibition and pressure pain sensitivity. METHODS Sixty-six pain-free participants (28.3 ± 8.9 years old, 34 women) completed two cognitive inhibition tasks (stop-signal task and Stroop Colour-Word task), a 3-min isometric wall squat exercise, and a quiet rest control condition with pre- and post-assessments of manual pressure pain thresholds at a local (thigh) and a remote site (shoulder). In addition, cuff pressure pain thresholds, pain tolerance and temporal summation of pain were assessed at baseline. RESULTS No association was found between remote EIH and cognitive inhibition (Stroop interference score: r=0.12, [-0.15; 0.37], p=0.405, BF01=6.70; stop-signal reaction time: r=-0.08, [-0.32; 0.17], p=0.524, BF01=8.32). Unexpectedly, individuals with worse performance on the Stroop task, as indicated by a higher Stroop interference score, showed higher local EIH (r=0.33; [0.10; 0.53], p=0.007, BF01=0.29). No associations were observed between pain sensitivity and any of the cognitive inhibition performance parameters. CONCLUSIONS The present findings do not support previous evidence on positive associations between exercise-induced hypoalgesia and cognitive inhibition, as well as baseline pain sensitivity and cognitive inhibition.
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Affiliation(s)
- Hannah Gajsar
- Department of Medical Psychology and Medical Sociology, Medical Faculty, Ruhr University Bochum, Bochum, Germany
| | - Marcel Meyer
- Psychological Faculty, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Monika I Hasenbring
- Department of Medical Psychology and Medical Sociology, Medical Faculty, Ruhr University Bochum, Bochum, Germany
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Henrik B Vaegter
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Pain Research Group, Pain Center, University Hospital Odense, Odense, Denmark
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Abstract
OBJECTIVE Although it is acknowledged that pain may be modulated by cognitive factors, little is known about the effect of aging on these control processes. The present study investigated electroencephalographical correlates of pain processing and its cognitive modulation in healthy older individuals. METHODS For this purpose, the impact of distraction on pain was evaluated in 21 young (9 men; 20.71 [2.30]) and 20 older (10 men; 66.80 [4.14]) adults. Participants received individually adjusted electrical pain stimuli in a high-distraction condition (one-back task) and in a low-distraction condition (simple letter response task). Pain-related evoked potentials and pain ratings were analyzed. RESULTS Both groups rated pain as less intense (F(1,39) = 13.954, p < .001) and less unpleasant (F(1,39) = 10.111, p = .003) when it was experienced during the high- rather than the low-distraction condition. However, in comparison to younger participants, older adults gave higher unpleasantness ratings to painful stimulation (F(1,39) = 4.233, p = .046), accompanied by attenuated neural responses (N1-P1 and P3 amplitudes), regardless of the distraction condition (F(1,38) = 6.028 [p = .019] and F(1,38) = 6.669 [p = .014], respectively). CONCLUSIONS Older participants felt pain relief through distraction, like younger participants. However, we also found that aging may enhance affective aspects of pain perception. Finally, our results show that aging is characterized by reduced neural processing of painful stimuli. This phenomenon could be related to the increased vulnerability of older participants to develop chronic pain.
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González-Roldán AM, Terrasa JL, Prats-Sedano MA, Sitges C, van der Meulen M, Anton F, Montoya P. Intact pain modulation through manipulation of controllability and expectations in aging. Eur J Pain 2021; 25:1472-1481. [PMID: 33666318 DOI: 10.1002/ejp.1760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 03/03/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pain expectation and controllability can modulate pain processing. However, little is known about age-related effects on these cognitive factors involved in pain control. This study assessed age-related brain changes associated with pain expectation and controllability. METHODS 17 healthy older adults (9 men; 65.65 ± 4.34 years) and 18 healthy younger adults (8 men; 20.56 ± 5.56 years) participated in the study. Pain evoked potentials and pain ratings were recorded while participants received painful electrical stimuli under two different conditions of pain controllability over the intensity of the stimulation (self-controlled vs. computer controlled) and two conditions of pain expectations (high vs. low pain). RESULTS Although the intensity of the painful stimulation was kept constant, all participants showed reduced pain perception in the controllable and low pain expectancy conditions. However, older participants showed reduced amplitudes of pain evoked potentials in the time window between 150 and 500 ms after stimulus onset as compared to younger participants. Moreover, younger participants showed greater negative amplitudes from 80 to 150 ms after stimulus onset for uncontrollable versus controllable pain. CONCLUSIONS These results suggest that although cognitive pain modulation is preserved during ageing, neural processing of pain is reduced in older adults. SIGNIFICANCE This research describes the impact of age on cognitive pain modulation evoked by the manipulation of pain controllability and pain expectations. Our findings constitute a first step in the understanding of the greater vulnerability of older individuals to chronic pain. Moreover, we show that older adults can benefit from cognitive pain control mechanisms to increase the efficacy of pain treatments.
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Affiliation(s)
- Ana María González-Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Juan Lorenzo Terrasa
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | | | - Carolina Sitges
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Marian van der Meulen
- Department of Behavioural and Cognitive Sciences, Institute of Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Fernand Anton
- Department of Behavioural and Cognitive Sciences, Institute of Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
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Bunk S, Emch M, Koch K, Lautenbacher S, Zuidema S, Kunz M. Pain Processing in Older Adults and Its Association with Prefrontal Characteristics. Brain Sci 2020; 10:brainsci10080477. [PMID: 32722197 PMCID: PMC7465457 DOI: 10.3390/brainsci10080477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/17/2020] [Accepted: 07/22/2020] [Indexed: 02/02/2023] Open
Abstract
Aging is known to affect nociceptive processing, e.g., the ability to inhibit pain. This study aims to investigate whether pain responses in older individuals are associated with prefrontal characteristics, namely (i) executive functioning performance and (ii) structural brain variations in the prefrontal cortex. Heat and pressure stimuli were applied to assess pressure pain sensitivity and endogenous pain inhibition in 46 healthy older individuals. Executive functioning performance was assessed in three domains (i.e., cognitive inhibition, shifting, and updating) and structural brain variations were assessed in both gray and white matter. Overall pain responses were significantly associated with the executive functioning domains cognitive inhibition and shifting. However, no specific type of pain response showed an especially strong association. Endogenous pain inhibition specifically showed a significant association with gray matter volume in the prefrontal cortex and with variations in white matter structure of tracts connecting the prefrontal cortex with the periaqueductal gray. Hierarchical regression analyses showed that these variations in the prefrontal cortex can explain variance in pain inhibition beyond what can be explained by executive functioning. This might indicate that known deficits in pain inhibition in older individuals are associated with structural variations in prefrontal areas.
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Affiliation(s)
- Steffie Bunk
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands; (S.Z.); (M.K.)
- Correspondence: ; Tel.: +31-503616686
| | - Mónica Emch
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany; (M.E.); (K.K.)
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität München, 82152 Martinsried, Germany
| | - Kathrin Koch
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany; (M.E.); (K.K.)
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität München, 82152 Martinsried, Germany
| | | | - Sytse Zuidema
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands; (S.Z.); (M.K.)
| | - Miriam Kunz
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands; (S.Z.); (M.K.)
- Department of Medical Psychology and Sociology, University of Augsburg, 86159 Augsburg, Germany
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Gong W, Li J, Luo F. Time Course of Attention Interruption After Transient Pain Stimulation. THE JOURNAL OF PAIN 2020; 21:1247-1256. [PMID: 32553619 DOI: 10.1016/j.jpain.2020.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 01/08/2020] [Accepted: 02/08/2020] [Indexed: 11/28/2022]
Abstract
Although pain has been shown to affect attentional performance, little is known about the time course of attention interruption after pain stimulus perception. The present study examined the time course of the effects of transient heat pain stimulation on 2 components of attention. Three groups of subjects performed attention tasks under pain, warmth, and no-stimulation control conditions, respectively. The pain and warmth groups received brief physical stimulation. Attention tasks were presented 0 ms, 250 ms, 750 ms, or 1500 ms after the end of stimulation. The 2 attention tasks, namely the spatial cue task (Experiment 1, N = 92) and a Stroop task (Experiment 2, N = 86), were conducted separately. In Experiment 1, attentional orientation of the pain and warmth groups was significantly impaired for at least 1.5 seconds after the physical stimulation had ended. Interestingly, this effect lasted longer for the warmth group than for the pain group. In Experiment 2, pain stimulation had no effect on executive attention at any time. We concluded that attentional orientation is selectively disrupted by both pain and warmth stimuli, but recovers earlier from pain. PERSPECTIVE: This article is concerned with the subsequent interruptive effect of pain on attentional orientation and executive attention by using the spatial cue task and the Stroop task, respectively. These measures offer options for investigating the time course of attention interruption after transient pain stimulation.
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Affiliation(s)
- Wenxiao Gong
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, PR China
| | - Jifang Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, PR China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing, PR China; Sino-Danish Center for Education and Research, Beijing, PR China
| | - Fei Luo
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, PR China.
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13
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Zhou S, Lithfous S, Després O, Pebayle T, Bi X, Dufour A. Involvement of Frontal Functions in Pain Tolerance in Aging: Evidence From Neuropsychological Assessments and Gamma-Band Oscillations. Front Aging Neurosci 2020; 12:131. [PMID: 32536860 PMCID: PMC7266988 DOI: 10.3389/fnagi.2020.00131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 04/20/2020] [Indexed: 11/13/2022] Open
Abstract
Reduced pain tolerance may be one of the possible explanations for high prevalence of chronic pain among older people. We hypothesized that age-related alterations in pain tolerance are associated with functioning deterioration of the frontal cortex during normal aging. Twenty-one young and 41 elderly healthy participants underwent a tonic heat pain test, during which cerebral activity was recorded using electroencephalography (EEG). Elderly participants were divided into two subgroups according to their scores on executive tests, high performers (HPs; n = 21) and low performers (LPs; n = 20). Pain measures [exposure times (ETs) and perceived pain ratings] and cerebral activity were compared among the three groups. ETs were significantly lower in elderly LPs than in young participants and elderly HPs. Electroencephalographic analyses showed that gamma-band oscillations (GBOs) were significantly increased in pain state for all subjects, especially in the frontal sites. Source analysis showed that GBO increase in elderly LPs was contributed not only by frontal but also by central, parietal, and occipital regions. These findings suggest that better preservation of frontal functions may result in better pain tolerance by elderly subjects.
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Affiliation(s)
- Shu Zhou
- Laboratoire de Neurosciences Cognitives et Adaptatives, UMR 7364 - Université de Strasbourg - CNRS, Strasbourg, France.,Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Ségolène Lithfous
- Laboratoire de Neurosciences Cognitives et Adaptatives, UMR 7364 - Université de Strasbourg - CNRS, Strasbourg, France
| | - Olivier Després
- Laboratoire de Neurosciences Cognitives et Adaptatives, UMR 7364 - Université de Strasbourg - CNRS, Strasbourg, France
| | - Thierry Pebayle
- Centre d'Investigations Neurocognitives et Neurophysiologiques, UMS 3489 - Université de Strasbourg - CNRS, Strasbourg, France
| | - Xiaoying Bi
- Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - André Dufour
- Laboratoire de Neurosciences Cognitives et Adaptatives, UMR 7364 - Université de Strasbourg - CNRS, Strasbourg, France.,Centre d'Investigations Neurocognitives et Neurophysiologiques, UMS 3489 - Université de Strasbourg - CNRS, Strasbourg, France
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14
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González-Roldán AM, Terrasa JL, Sitges C, van der Meulen M, Anton F, Montoya P. Age-Related Changes in Pain Perception Are Associated With Altered Functional Connectivity During Resting State. Front Aging Neurosci 2020; 12:116. [PMID: 32457594 PMCID: PMC7221150 DOI: 10.3389/fnagi.2020.00116] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/07/2020] [Indexed: 01/08/2023] Open
Abstract
Aging affects pain experience and brain functioning. However, how aging leads to changes in pain perception and brain functional connectivity has not yet been completely understood. To investigate resting-state and pain perception changes in old and young participants, this study employed region of interest (ROI) to ROI resting-state functional connectivity (rsFC) analysis of imaging data by using regions implicated in sensory and affective dimensions of pain, descending pain modulation, and the default-mode networks (DMNs). Thirty-seven older (66.86 ± 4.04 years; 16 males) and 38 younger healthy participants (20.74 ± 4.15 years; 19 males) underwent 10 min’ eyes-closed resting-state scanning. We examined the relationship between rsFC parameters with pressure pain thresholds. Older participants showed higher pain thresholds than younger. Regarding rsFC, older adults displayed increased connectivity of pain-related sensory brain regions in comparison to younger participants: increased rsFC between bilateral primary somatosensory area (SI) and anterior cingulate cortex (ACC), and between SI(L) and secondary somatosensory area (SII)-(R) and dorsolateral prefrontal cortex (PFC). Moreover, decreased connectivity in the older compared to the younger group was found among descending pain modulatory regions: between the amygdala(R) and bilateral insula(R), thalamus(R), ACC, and amygdala(L); between the amygdala(L) and insula(R) and bilateral thalamus; between ACC and bilateral insula, and between periaqueductal gray (PAG) and bilateral thalamus. Regarding the DMN, the posterior parietal cortex and lateral parietal (LP; R) were more strongly connected in the older group than in the younger group. Correlational analyses also showed that SI(L)-SII(R) rsFC was positively associated with pressure pain thresholds in older participants. In conclusion, these findings suggest a compensatory mechanism for the sensory changes that typically accompanies aging. Furthermore, older participants showed reduced functional connectivity between key nodes of the descending pain inhibitory pathway.
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Affiliation(s)
- Ana M González-Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Juan L Terrasa
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Carolina Sitges
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Marian van der Meulen
- Institute for Health and Behaviour, University of Luxembourg, Luxembourg, Luxembourg
| | - Fernand Anton
- Institute for Health and Behaviour, University of Luxembourg, Luxembourg, Luxembourg
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
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15
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Gajsar H, Titze C, Konietzny K, Meyer M, Vaegter HB, Hasenbring MI. Cognitive Inhibition Correlates with Exercise-Induced Hypoalgesia After Aerobic Bicycling in Pain-Free Participants. J Pain Res 2020; 13:847-858. [PMID: 32425590 PMCID: PMC7196790 DOI: 10.2147/jpr.s238718] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/24/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Exercise-induced hypoalgesia (EIH) is the short-term reduction of pain sensitivity after a single bout of exercise. Descending pain inhibition has been proposed to at least partly underlie EIH. Cognitive inhibition is the ability to inhibit a pre-potent response and has in turn been associated with descending pain inhibition, as indexed by conditioned pain modulation. Therefore, we hypothesized that cognitive inhibition is associated with higher EIH. Methods In this cross-sectional study, 37 pain-free participants (16 male, age 27.75 ± 9.91) completed a stop-signal task assessing cognitive inhibition ability and a control condition in the first session. In the second session, pre–post-test design EIH was assessed by means of aerobic bicycling (15 min., 75% VO2max) and isometric knee extension (90 sec, 30% MVC). EIH was assessed with pressure pain thresholds (PPT) and temporal summation of pain (TSP), each at the hand and at the leg. Correlational analyses quantified the associations between cognitive inhibition and EIH change scores. Results Better cognitive inhibition correlated with EIH change scores in PPTs after aerobic bicycling at the hand (r = −0.35, 95% CI: −0.57; −0.08, p =0.021), but not at the leg (rho = −0.10, 95% CI: −0.36; 0.18, p = 0.277). No correlations between cognitive inhibition and change in PPTs after isometric knee extension at the hand (rho = −0.03, 95% CI: −0.30; 0.25, p = 0.857) nor at the leg (rho = −0.03, 95% CI: −0.25; 0.30, p = 0.857) were observed. There were no EIH effects after isometric exercise and, generally, no effects of exercise on TSP. Conclusion This study provides preliminary evidence for the notion that cognitive inhibition might play a supportive role in EIH. Although these results are clearly in need of replication, they accord well with previously reported associations between cognitive inhibition, experimental pain and descending pain inhibition.
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Affiliation(s)
- H Gajsar
- Mind and Pain in Motion Group, Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - C Titze
- Mind and Pain in Motion Group, Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - K Konietzny
- Mind and Pain in Motion Group, Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - M Meyer
- School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - H B Vaegter
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Pain Research Group, Pain Center, University Hospital Odense, Odense, Denmark
| | - M I Hasenbring
- Mind and Pain in Motion Group, Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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16
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Bunk S, Preis L, Zuidema S, Lautenbacher S, Kunz M. Executive Functions and Pain. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2019. [DOI: 10.1024/1016-264x/a000264] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. A growing body of literature suggests that chronic-pain patients suffer from problems in various neuropsychological domains, including executive functioning. In order to better understand which components of executive functioning (inhibition, shifting and/or updating) might be especially affected by pain and which mechanisms might underlie this association, we conducted a systematic review, including both chronic-pain studies as well as experimental-pain studies. The chronic-pain studies (N = 57) show that pain is associated with poorer executive functioning. The findings of experimental-pain studies (N = 28) suggest that this might be a bidirectional relationship: Pain can disrupt executive functioning, but poorer executive functioning might also be a risk factor for higher vulnerability to pain.
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Affiliation(s)
- Stefanie Bunk
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, The Netherlands
| | - Lukas Preis
- Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands
| | - Sytse Zuidema
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, The Netherlands
| | | | - Miriam Kunz
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, The Netherlands
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Jacobsen HB, Stubhaug A, Schirmer H, Inge Landrø N, Wilsgaard T, Mathiesen EB, Nielsen CS. Neuropsychological functions of verbal recall and psychomotor speed significantly affect pain tolerance. Eur J Pain 2019; 23:1608-1618. [PMID: 31355498 PMCID: PMC6790685 DOI: 10.1002/ejp.1437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 04/25/2019] [Accepted: 06/01/2019] [Indexed: 11/12/2022]
Abstract
Background Effects from cognitive performance on pain tolerance have been documented, however, sample sizes are small and confounders often overlooked. We aimed to establish that performance on neuropsychological tests was associated with pain tolerance, controlling for salient confounders. Methods This was a cross‐sectional study nested within the Tromsø‐6 survey. Neuropsychological test performance and the cold pressor test were investigated in 4,623 participants. Due to significant interaction with age, participants were divided into three age groups (<60, ≥60 to <70 and ≥70 years). Cox proportional hazard models assessed the relationship between neuropsychological tests and cold pressure pain tolerance, using hand‐withdrawal as event. The fully adjusted models controlled for sex, education, BMI, smoking status, exercise, systolic blood pressure, sleep problems and mental distress. Results In the adjusted models, participants aged ≥70 years showed a decreased hazard of hand withdrawal of 18% (HR 0.82, 95% CI (0.73, 0.92) per standard deviation on immediate verbal recall, and a decreased hazard of 23% (HR 0.77, 95% CI (0.65, 0.08) per standard deviation on psychomotor speed. Participants aged ≥60 to <70 years had a significant decreased hazard of 11% (HR 0.89, 95% CI (0.80, 0.98) per standard deviation on immediate word recall. In participants aged <60 years, there was a decreased hazard of 14% (HR 0.86 95% CI: 0.76, 0.98), per standard deviation on psychomotor speed. Conclusion Better performance on neuropsychological tests increased pain tolerance on the cold pressor test. These exposure effects were present in all age groups. Significance This paper describes substantial associations between cognitive functioning and cold pressor tolerance in 4,623 participants. Reduced psychomotor speed and poor verbal recall gave greater odds for hand‐withdrawal on the cold pressor task. The associations were stronger in older participants, indicating an interaction with age.
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Affiliation(s)
- Henrik Børsting Jacobsen
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Norwegian National Advisory Unit on Neuropathic Pain, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Norwegian National Advisory Unit on Neuropathic Pain, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Henrik Schirmer
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway.,National Competence Centre for Complex Symptom Disorders, St. Olavs University Hospital, Trondheim, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv Bøgeberg Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Christopher Sivert Nielsen
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Norwegian National Advisory Unit on Neuropathic Pain, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Division of Ageing and Health, Norwegian Institute of Public Health, Oslo, Norway
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18
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Brain Electrical Activity Associated With Visual Attention and Reactive Motor Inhibition in Patients With Fibromyalgia. Psychosom Med 2019; 81:380-388. [PMID: 31048636 DOI: 10.1097/psy.0000000000000677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Fibromyalgia (FM) is a generalized chronic pain condition associated with multiple cognitive impairments, including altered inhibitory processes. Inhibition is a key component of human executive functions and shares neural substrate with pain processing, which may explain the inhibitory deficits in FM. Here, we investigated the integrity of brain inhibitory mechanisms in these patients. METHODS We recorded the electroencephalographic activity of 27 patients with FM and 27 healthy controls (HCs) (all women) while they performed a reactive motor inhibition task (the stop-signal paradigm). We analyzed task-induced modulations in electrophysiological markers related to inhibition (N2, P3, and midfrontal theta oscillations) and visual attention (posterior alpha oscillations). RESULTS The FM group performed the task correctly, with no differences relative to HCs at the behavioral level. We did not find any between-group differences in N2 amplitude (F(1,52) = 0.01, p = .93), P3 amplitude (F(1,52) = 3.46; p = .068), or theta power (F(1,52) = 0.05; p = .82). However, modulation of posterior alpha power after presentation of either the go or stop stimuli was lower in patients than in HCs (F(1,52) = 7.98; p = .007). CONCLUSIONS N2, P3, theta power, and behavioral results indicate that the mechanisms of motor inhibition are sufficiently preserved to enable correct performance of the stop-signal task in patients with FM. Nevertheless, the lower modulation of alpha suggests greater difficulty in mobilizing and maintaining visual attentional resources, a result that may explain the cognitive dysfunction observed in FM.
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Elkana O, Conti Y, Heyman O, Hamdan S, Franko M, Vatine JJ. The associations between executive functions and different aspects of perceived pain, beyond the influence of depression, in rehabilitation setting. Neuropsychol Rehabil 2019; 30:1303-1317. [DOI: 10.1080/09602011.2019.1574590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Odelia Elkana
- Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
| | - Yael Conti
- Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
| | - Ofir Heyman
- Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
| | - Sami Hamdan
- Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
| | - Motty Franko
- Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
| | - Jean-Jacques Vatine
- Reuth Rehabilitation Hospital, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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20
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Macatee RJ, Albanese BJ, Clancy K, Allan NP, Bernat EM, Cougle JR, Schmidt NB. Distress intolerance modulation of neurophysiological markers of cognitive control during a complex go/no-go task. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 127:12-29. [PMID: 29369665 DOI: 10.1037/abn0000323] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Distress intolerance (DI), a trait-like individual difference reflective of the inability to endure aversive affective states, is relevant to multiple forms of psychopathology, but its relations to theoretically relevant neurobiological systems have received little attention. Altered cognitive control-related neurobiology has been theorized to underlie individual differences in DI, but little empirical work has been conducted. To test this hypothesis, baseline data from a large community sample with elevated high levels of emotional psychopathology and comorbidity was utilized (N = 256). Participants completed a complex go/no-go task while EEG was recorded, and P2, N2, and P3 amplitudes were measured. Based upon prior findings on the relations between these components and response inhibition, a core cognitive control function, we hypothesized that DI would predict reduced no-go N2 and P3 amplitude while controlling for current anxious/depressive symptom severity (i.e., negative affect). Peak amplitudes from the raw data and principal components analysis were used to quantify amplitude of ERP components. Partially consistent with predictions, high DI was independently associated with reduced no-go N2 peak amplitude in the raw ERP data, and was significantly related to a frontal positivity factor in the N2 time window across no-go and go trials. Contrary to predictions, no relations between DI and the P3 were found. Overall, results support the theorized relevance of cognitive control-linked neurobiology to individual differences in tolerance of distress over and above distress severity itself, and suggest specific relations between DI and alterations in early controlled attention/conflict-monitoring but not response inhibition or response inhibition-related sequelae. (PsycINFO Database Record
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Affiliation(s)
| | | | - Kevin Clancy
- Department of Psychology, Florida State University
| | | | - Edward M Bernat
- Department of Psychology, University of Maryland, College Park
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Murata S, Nakakubo S, Isa T, Tsuboi Y, Torizawa K, Fukuta A, Okumura M, Matsuda N, Ono R. Effect of Pain Severity on Executive Function Decline in Community-Dwelling Older Adults. Gerontol Geriatr Med 2018; 4:2333721418811490. [PMID: 30450370 PMCID: PMC6236482 DOI: 10.1177/2333721418811490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/04/2018] [Accepted: 10/15/2018] [Indexed: 11/21/2022] Open
Abstract
Objective: The purpose of this study was to explore the reciprocal
relationship between pain severity and executive function in community-dwelling
older adults. Method: In this prospective cohort study, 64 Japanese
community-dwelling older adults aged 60 years or older (mean age 72.8 years;
women, 68.8%) were analyzed. Pain severity was assessed by self-reported
questionnaire while executive function was assessed by the Trail Making Test at
baseline and at 1-year follow-up assessment. A mixed effect model was conducted
to analyze the effect of baseline executive function on change in pain severity
and effect of baseline pain severity on change in executive function.
Results: The effect of baseline Trail Making Test on change in
pain severity was not significant. On the contrary, the effect of high baseline
pain severity on the decline in set shifting (Trail Making Test Part B) was
significant even after adjustment with age, sex, years of education, depressive
symptoms, and analgesic drug use. Conclusion: Higher baseline pain
severity was associated with greater executive function decline in
community-dwelling older adults. Executive function decline due to severe pain
should be considered as well as pain itself.
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Affiliation(s)
- Shunsuke Murata
- Kobe University, Hyogo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Sho Nakakubo
- National Center for Geriatrics and Gerontology, Obu, Japan
| | | | | | | | | | | | | | - Rei Ono
- Kobe University, Hyogo, Japan
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23
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Calvo Lobo C, Romero Morales C, Rodríguez Sanz D, Sanz Corbalán I, Sánchez Romero EA, Fernández Carnero J, López López D. Comparison of hand grip strength and upper limb pressure pain threshold between older adults with or without non-specific shoulder pain. PeerJ 2017; 5:e2995. [PMID: 28289561 PMCID: PMC5345821 DOI: 10.7717/peerj.2995] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/16/2017] [Indexed: 11/20/2022] Open
Abstract
Background There is a high prevalence of non-specific shoulder pain associated with upper limb functional limitations in older adults. The purpose of this study was to determine the minimal clinically important differences (MCID) of grip strength and pressure pain threshold (PPT) in the upper limb between older adults with or without non-specific shoulder pain. Methods A case-control study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. A sample of 132 shoulders (mean ± SD years) with (n = 66; 76.04 ± 7.58) and without (n = 66; 75.05 ± 6.26) non-specific pain were recruited. The grip strength and PPT of the anterior deltoid and extensor carpi radialis brevis (ECRB) muscles were assessed. Results There were statistically significant differences (mean ± SD; P-value) for anterior deltoid PPT (2.51 ± 0.69 vs 3.68 ± 0.65, kg/cm2; P < .001), ECRB PPT (2.20 ± 0.60 vs 3.35 ± 0.38 kg/cm2; P < .001) and grip strength (20.78 ± 10.94 vs 24.63 ± 9.38 kg; P = .032) between shoulders with and without non-specific pain, respectively. Discussion The MCID of 1.17 kg/cm2, 1.15 kg/cm2 and 3.84 kg were proposed for anterior deltoid PPT, ECRB PPT and grip strength, respectively, to assess the upper limb of older adults with non-specific shoulder pain after treatment. In addition, univariate and multivariate (linear regression and regression trees) analyses may be used to consider age distribution, sex, pain intensity, grip strength and PPT in older adults including clinical and epidemiological studies with non-specific shoulder pain.
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Affiliation(s)
- Cesar Calvo Lobo
- Physiotherapy Department, Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Madrid , Spain
| | - Carlos Romero Morales
- Physical Therapy & Health Sciences Research Group, Physiotherapy Department, Faculty of Health, Exercise and Sport, European University , Madrid , Spain
| | - David Rodríguez Sanz
- Physical Therapy & Health Sciences Research Group, Physiotherapy Department, Faculty of Health, Exercise and Sport, European University , Madrid , Spain
| | - Irene Sanz Corbalán
- School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid , Madrid , Spain
| | - Eleuterio A Sánchez Romero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , Madrid , Spain
| | - Josué Fernández Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain; Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Autónoma University, Madrid, Spain; La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain
| | - Daniel López López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña , Ferrol , A Coruña , Spain
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Bjekić J, Živanović M, Purić D, Oosterman JM, Filipović SR. Pain and executive functions: a unique relationship between Stroop task and experimentally induced pain. PSYCHOLOGICAL RESEARCH 2017; 82:580-589. [DOI: 10.1007/s00426-016-0838-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/28/2016] [Indexed: 12/21/2022]
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Karsdorp PA, Geenen R, Kroese FM, Vlaeyen JWS. Turning Pain Into Cues for Goal-Directed Behavior: Implementation Intentions Reduce Escape-Avoidance Behavior on a Painful Task. THE JOURNAL OF PAIN 2015; 17:499-507. [PMID: 26746152 DOI: 10.1016/j.jpain.2015.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 12/06/2015] [Accepted: 12/14/2015] [Indexed: 10/22/2022]
Abstract
UNLABELLED Pain automatically elicits escape-avoidance behavior to avert bodily harm. In patients with chronic pain, long-term escape-avoidance behavior may increase the risk of chronic disability. The aim of the presents study was to examine whether implementation intentions reduce escape-avoidance behavior during painful tasks in healthy individuals. Implementation intentions are "if-then" self-statements associating situational cues with goal-directed behaviors. Seventy healthy participants performed a painful finger pressing task, preceded by either implementation intention instructions with pain or a nonpain cue as a cue for goal-directed behavior, or control instructions. Escape-avoidance behavior was operationalized as task duration and response rate. Inhibitory control was measured using the Stop Signal Task. The pain implementation intentions resulted in the longest task duration (P = .02), and thus less escape-avoidance behavior. Low inhibitory control was associated with shorter task duration (P = .03), and thus more escape-avoidance behavior. The nonpain implementation intentions resulted in the highest response rate, but only when inhibitory control was low (P = .04). Implementation intentions referring to pain or nonpain reduce escape-avoidance behavior on a painful task. It is worthwhile to examine whether individuals in pain and with low inhibitory control benefit from interventions that incorporate implementation intentions. PERSPECTIVE To our knowledge, this study is the first to show that forming implementation intentions reduces escape-avoidance behavior during pain and fosters nonpain goal pursuit. The use of implementation intentions is indicated to be an intervention that could be of use in patients with pain, particularly when inhibitory control is low.
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Affiliation(s)
- Petra A Karsdorp
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands; Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
| | - Rinie Geenen
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Floor M Kroese
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Johan W S Vlaeyen
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands; Research Group Health Psychology, University of Leuven, Leuven, Belgium
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Zhou S, Després O, Pebayle T, Dufour A. Age-Related Decline in Cognitive Pain Modulation Induced by Distraction: Evidence From Event-Related Potentials. THE JOURNAL OF PAIN 2015; 16:862-72. [DOI: 10.1016/j.jpain.2015.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 04/28/2015] [Accepted: 05/28/2015] [Indexed: 01/16/2023]
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