J C Choi1, Y-H Park2, S K Park3, J S Lee2, J Kim4, J I Choi5, K B Yoon6, S Lee7, D E Lim8, J Y Choi9, M H Kim10, G Park10, S S Choi11, J-M Lee2. 1. Department of Anesthesiology and Pain Medicine, Intensive Care Unit, Brain Research Group, Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, South Korea. 2. Department of Biomedical Engineering, Hanyang University, Seoul, South Korea. 3. Yonsei Danaa Pain Clinic, Seoul, South Korea. 4. Department of Psychology, Kangwon National University, Chuncheon, Gangwon-do, South Korea. 5. Dr. Choi's Rehab & Pain Clinic, Ansan, Gyeonggi-do, South Korea. 6. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. 7. Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital, Inje University, Busan, South Korea. 8. Department of Orthopaedic surgery, Modu Hospital, Incheon, South Korea. 9. Department of Neurosurgery, Gangbuk 21st Century Hospital, Seoul, South Korea. 10. Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, South Korea. 11. Department of Anaesthesiology and Pain Medicine, Guro Hospital, Korea University, Seoul, South Korea.
Abstract
BACKGROUND: This study investigated whether pain and pain-related unpleasantness ratings were altered by blood testosterone levels. We also investigated whether activation of brain regions that represent pain intensity [primary somatosensory cortex (S1)] and pain-related unpleasantness [perigenual ACC (pACC) and orbitofrontal cortex (OFC)] were affected by blood testosterone levels. METHODS: Twenty-six healthy men were recruited. Blood testosterone levels were measured before fMRI scanning. The participants were classified into two groups (high vs. low testosterone) according to their blood testosterone level (each group n = 13). The middle finger was immersed in a 50°C water bath (50°C, 30 s, five times) to induce identical noxious stimulation in all participants. RESULTS: The low testosterone group showed statistically significantly higher pain (P = 0.047), unpleasantness (P = 0.047), anxiety (P = 0.015), and fear ratings (P = 0.01) than the high testosterone group. Fear rating increased as pain rating rose and as testosterone level decreased (P < 0.001). When participants received noxious stimulation, the pACC and OFC were more highly activated in the low testosterone group compared to the high testosterone group. Activation of S1, a region related to pain intensity, did not differ between both groups. CONCLUSION: Compared to the high testosterone group, the low testosterone group had significant activation in the pACC and OFC, regions that represent pain-related unpleasantness, but not in S1 that represents pain intensity, leading to higher pain ratings. These findings emphasize the importance of considering the effects of testosterone levels when treating patients.
BACKGROUND: This study investigated whether pain and pain-related unpleasantness ratings were altered by blood testosterone levels. We also investigated whether activation of brain regions that represent pain intensity [primary somatosensory cortex (S1)] and pain-related unpleasantness [perigenual ACC (pACC) and orbitofrontal cortex (OFC)] were affected by blood testosterone levels. METHODS: Twenty-six healthy men were recruited. Blood testosterone levels were measured before fMRI scanning. The participants were classified into two groups (high vs. low testosterone) according to their blood testosterone level (each group n = 13). The middle finger was immersed in a 50°C water bath (50°C, 30 s, five times) to induce identical noxious stimulation in all participants. RESULTS: The low testosterone group showed statistically significantly higher pain (P = 0.047), unpleasantness (P = 0.047), anxiety (P = 0.015), and fear ratings (P = 0.01) than the high testosterone group. Fear rating increased as pain rating rose and as testosterone level decreased (P < 0.001). When participants received noxious stimulation, the pACC and OFC were more highly activated in the low testosterone group compared to the high testosterone group. Activation of S1, a region related to pain intensity, did not differ between both groups. CONCLUSION: Compared to the high testosterone group, the low testosterone group had significant activation in the pACC and OFC, regions that represent pain-related unpleasantness, but not in S1 that represents pain intensity, leading to higher pain ratings. These findings emphasize the importance of considering the effects of testosterone levels when treating patients.
Authors: Eva M Sobas; Amanda Vázquez; Sebastián Videla; Roberto Reinoso; Itziar Fernández; Carmen Garcia-Vazquez; Miguel J Maldonado; J Carlos Pastor Journal: Clin Ophthalmol Date: 2020-03-03