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. 2021 Mar;77(3):1546-1555.
doi: 10.1111/jan.14514. Epub 2021 Jan 15.

Determining the impact of age and sex on the psychophysical and neurophysiological response to thermal pain across the adult lifespan

Sebastian W Atalla  1   2 , Ronald L Cowan  2   3   4 , Alison R Anderson  2   5 , Mary S Dietrich  5 , Larkin Iversen  1 , Laura Beth Kalvas  1 , Karen O Moss  1 , Kathy Wright  1 , Todd B Monroe  1
Affiliations

Determining the impact of age and sex on the psychophysical and neurophysiological response to thermal pain across the adult lifespan

Sebastian W Atalla et al. J Adv Nurs. 2021 Mar.

Abstract
in English, Chinese

Aims: Determine sex- and age-associated psychophysical and neurophysiological differences in the processing of pain across the adult lifespan.

Design: Preliminary, exploratory, cross-sectional study.

Methods: Using psychophysics (to measure intensity and unpleasantness) and functional magnetic resonance imaging blood oxygenation level dependent methods (to measure stimulus-evoked brain activation), we will examine sex- and age-associated differences in thermal pain processing and their underlying neurophysiology in a broad range of healthy adults (ages 30-89). We will acquire resting state functional connectivity data for secondary analyses exploring whether resting state connectivity predicts psychophysical and neurophysiological responses to thermal pain. To examine the effects of altered blood flow, we will acquire resting-state arterial spin labeling magnetic resonance imaging data to quantify resting cerebral blood flow. We will interpret findings in the context of a proposed neural model of pain, ageing, and sex. Study funding was received in June of 2014. Ethical approval was obtained from the Vanderbilt University IRB prior to study initiation.

Conclusion: Exploring the biological reasons for age- and sex-associated differences in pain processing will increase our understanding of pain in older adults. The paucity of neurobiological evidence to support best practice pain management in older adults places these individuals at risk for poor pain management.

Impact: Poorly treated pain in older adults is a critical public health problem associated with a poor quality of life and increased healthcare costs. Understanding how age and sex have an impact on central processing of pain across the lifespan is a critical step toward improving personalized pain medicine.

目的: 确定成年期疼痛处理中与性别和年龄相关的心理、生理和神经生理学差异。 设计: 初步、探索性、分类排列研究。 方法: 利用心理物理学 (测量强度和不愉快程度) 和功能磁共振成像血氧水平依赖法 (测量刺激诱发的脑激活) , 我们将在广泛的健康成年人 (30-89岁) 中研究与性别和年龄相关的热痛处理差异及其潜在的神经生理学。我们将获得静息状态功能连接数据, 用于二次分析, 以便探索静息状态连接是否能预测热痛的心理、生理和神经生理学反应。为检测血液流动改变的影响, 我们将获取静息状态动脉自旋标记磁共振成像数据, 以量化静息脑血流。我们将按照提出的疼痛、衰老和性别的神经模型解释这些发现。我们已于2014年6月收到研究资金。研究开始前, 我们已获得范德堡大学IRB的伦理批准。 结论: 探索与年龄和性别相关的疼痛处理差异的生物学原因将增加我们对老年人疼痛的了解。缺乏神经生物学证据来支持老年人疼痛管理的最佳实践, 将这些个体置于疼痛管理不善的风险之中。 影响: 老年人疼痛治疗不当是严重的公共卫生问题, 其与生活质量差和保健费用增加有关。了解年龄和性别对整个生命周期内疼痛中枢处理的影响是改善个体化疼痛医学的关键一步。.

Keywords: adult lifespan; experimental pain; functional MRI; nursing; older adults; research protocol; sex-differences.

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Conflict of interest statement

No conflicts of interest have been declared by the authors.

Figures

FIGURE 1
FIGURE 1
Proposed neural model of pain, ageing, and sex
See this image and copyright information in PMC

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