Todd B Monroe1,2,3,4, Paul A Beach5, Stephen P Bruehl6, Mary S Dietrich1,6, Baxter P Rogers2, John C Gore2, Sebastian W Atalla1,2,3, Ronald L Cowan3,6. 1. School of Nursing, Vanderbilt University, Nashville, TN, USA. 2. Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA. 3. Psychiatric Neuroimaging Program, Vanderbilt University Medical Center, Nashville, TN, USA. 4. Department of Psychiatry and Behavioral Sciences, Vanderbilt University, Nashville, TN, USA. 5. Department of Neurology & Ophthalmology, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA. 6. School of Medicine, Vanderbilt University, Nashville, TN, USA.
Abstract
BACKGROUND: It is currently unknown why people with Alzheimer's disease (AD) receive less pain medication and report pain less frequently. OBJECTIVE: The purpose of this study was to determine the impact of AD on thermal psychophysics and resting-state functional connectivity (RSFC) among sensory, affective, descending modulatory, and default mode structures. METHODS: Controls (n = 23, 13 = female) and age-matched people with AD (n = 23, 13 = females) underwent psychophysical testing to rate perceptions of warmth, mild, and moderate pain and then completed resting-state fMRI. Between groups analysis in psychophysics and RSFC were conducted among pre-defined regions of interest implicated in sensory and affective dimensions of pain, descending pain modulation, and the default mode network. RESULTS: People with AD displayed higher thermal thresholds for warmth and mild pain but similar moderate pain thresholds to controls. No between-group differences were found for unpleasantness at any percept. Relative to controls, people with AD demonstrated reduced RSFC between the right posterior insula and left anterior cingulate and also between right amygdala and right secondary somatosensory cortex. Moderate pain unpleasantness reports were associated with increased RSFC between right dorsolateral prefrontal cortex and left ACC in controls only. CONCLUSIONS: While AD had little effect on unpleasantness, people with AD had increased thermal thresholds, altered RSFC, and no association of psychophysics with RSFC in pain regions. Findings begin to elucidate that in people with AD, altered integration of pain sensation, affect, and descending modulation may, in part, contribute to decreased verbal pain reports and thus decreased analgesic administration.
BACKGROUND: It is currently unknown why people with Alzheimer's disease (AD) receive less pain medication and report pain less frequently. OBJECTIVE: The purpose of this study was to determine the impact of AD on thermal psychophysics and resting-state functional connectivity (RSFC) among sensory, affective, descending modulatory, and default mode structures. METHODS: Controls (n = 23, 13 = female) and age-matched people with AD (n = 23, 13 = females) underwent psychophysical testing to rate perceptions of warmth, mild, and moderate pain and then completed resting-state fMRI. Between groups analysis in psychophysics and RSFC were conducted among pre-defined regions of interest implicated in sensory and affective dimensions of pain, descending pain modulation, and the default mode network. RESULTS:People with AD displayed higher thermal thresholds for warmth and mild pain but similar moderate pain thresholds to controls. No between-group differences were found for unpleasantness at any percept. Relative to controls, people with AD demonstrated reduced RSFC between the right posterior insula and left anterior cingulate and also between right amygdala and right secondary somatosensory cortex. Moderate pain unpleasantness reports were associated with increased RSFC between right dorsolateral prefrontal cortex and left ACC in controls only. CONCLUSIONS: While AD had little effect on unpleasantness, people with AD had increased thermal thresholds, altered RSFC, and no association of psychophysics with RSFC in pain regions. Findings begin to elucidate that in people with AD, altered integration of pain sensation, affect, and descending modulation may, in part, contribute to decreased verbal pain reports and thus decreased analgesic administration.
Authors: J L Lancaster; M G Woldorff; L M Parsons; M Liotti; C S Freitas; L Rainey; P V Kochunov; D Nickerson; S A Mikiten; P T Fox Journal: Hum Brain Mapp Date: 2000-07 Impact factor: 5.038
Authors: N Tzourio-Mazoyer; B Landeau; D Papathanassiou; F Crivello; O Etard; N Delcroix; B Mazoyer; M Joliot Journal: Neuroimage Date: 2002-01 Impact factor: 6.556
Authors: Karine Ostrowsky; Michel Magnin; Philippe Ryvlin; Jean Isnard; Marc Guenot; François Mauguière Journal: Cereb Cortex Date: 2002-04 Impact factor: 5.357
Authors: G Fein; V Di Sclafani; J Tanabe; V Cardenas; M W Weiner; W J Jagust; B R Reed; D Norman; N Schuff; L Kusdra; T Greenfield; H Chui Journal: Neurology Date: 2000-12-12 Impact factor: 9.910
Authors: Sebastian W Atalla; Laura Beth Kalvas; Jenna L Campbell; Alison R Anderson; Ronald L Cowan; Kathy Wright; Angela C Humbel; Todd B Monroe Journal: Nurs Res Date: 2020 May/Jun Impact factor: 2.381
Authors: Jinjiao Wang; Todd B Monroe; Adam Simning; Yeates Conwell; Thomas V Caprio; Xueya Cai; Helena Temkin-Greener; Ulrike Muench; Fang Yu; Song Ge; Yue Li Journal: Pain Manag Nurs Date: 2020-07-14 Impact factor: 1.929
Authors: Alison R Anderson; W Larkin Iversen; Michael A Carter; Karen O Moss; Ronald L Cowan; Todd B Monroe Journal: J Am Assoc Nurse Pract Date: 2021-03-12 Impact factor: 1.495
Authors: Ana M González-Roldán; Juan L Terrasa; Carolina Sitges; Marian van der Meulen; Fernand Anton; Pedro Montoya Journal: Front Aging Neurosci Date: 2020-05-07 Impact factor: 5.750
Authors: Raymond R Romano; Alison R Anderson; Michelle D Failla; Mary S Dietrich; Sebastian Atalla; Michael A Carter; Todd B Monroe Journal: J Alzheimers Dis Date: 2019 Impact factor: 4.160
Authors: Ronald L Cowan; Paul A Beach; Sebastian W Atalla; Mary S Dietrich; Stephen P Bruehl; Jie Deng; Jinjiao Wang; Paul A Newhouse; John C Gore; Todd B Monroe Journal: J Alzheimers Dis Date: 2017 Impact factor: 4.472