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对伤害性刺激反应的年龄相关差异。

Age-associated differences in responses to noxious stimuli.

作者信息

Edwards R R, Fillingim R B

机构信息

Department of Psychology, University of Alabama at Birmingham, USA.

出版信息

J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M180-5. doi: 10.1093/gerona/56.3.m180.

Abstract

BACKGROUND

Although population-based studies typically report age-associated increases in clinical pain, laboratory-based pain assessment procedures generally indicate diminished pain sensitivity with age. The majority of these studies have utilized noxious thermal stimuli as the method of pain induction. However, other pain assessment methodologies, including ischemic pain induction, may have a more meaningful relationship to clinical pain. The present study examined the effects of age on responses to a variety of experimental noxious stimuli. In addition, relationships between cardiovascular measures and pain responses were investigated in both older and younger subjects.

METHODS

Responses to thermal, mechanical, and ischemic pain were assessed in 34 younger (mean age, 22.4 years) and 34 older adults (mean age, 62.2 years). In addition, relationships between resting blood pressure and pain responses were assessed separately for older and younger participants.

RESULTS

Although group differences in thermal and mechanical pain responses did not achieve statistical significance, older individuals demonstrated substantially lower ischemic pain thresholds and tolerances assessed via the modified submaximal effort tourniquet procedure (ps < .01). Overall, higher resting arterial blood pressures were associated with increased pain thresholds and tolerances, although relationships between blood pressure and ischemic pain variables were evident only for the younger group.

CONCLUSIONS

These findings indicate that age-related differences in responses to experimental noxious stimuli vary as a function of the pain induction task, with older individuals showing greater sensitivity to clinically relevant stimuli. In addition, the absence of a relationship between blood pressure and ischemic pain responses in older adults may suggest potential functional decrements in at least one endogenous pain-modulatory system.

摘要

背景

尽管基于人群的研究通常报告临床疼痛随年龄增长而增加,但基于实验室的疼痛评估程序一般表明疼痛敏感性随年龄下降。这些研究大多使用有害热刺激作为疼痛诱发方法。然而,其他疼痛评估方法,包括缺血性疼痛诱发,可能与临床疼痛有更有意义的关系。本研究考察了年龄对各种实验性有害刺激反应的影响。此外,还在老年和年轻受试者中研究了心血管指标与疼痛反应之间的关系。

方法

对34名年轻成年人(平均年龄22.4岁)和34名老年成年人(平均年龄62.2岁)进行了热、机械和缺血性疼痛反应评估。此外,还分别评估了老年和年轻参与者静息血压与疼痛反应之间的关系。

结果

尽管热痛和机械痛反应的组间差异未达到统计学显著性,但通过改良的次极量用力止血带程序评估,老年人的缺血性疼痛阈值和耐受性显著较低(p<0.01)。总体而言,静息动脉血压较高与疼痛阈值和耐受性增加相关,尽管血压与缺血性疼痛变量之间的关系仅在年轻组中明显。

结论

这些发现表明,对实验性有害刺激的反应中与年龄相关的差异因疼痛诱发任务而异,老年人对临床相关刺激表现出更高的敏感性。此外,老年人血压与缺血性疼痛反应之间缺乏关联可能表明至少一种内源性疼痛调节系统存在潜在的功能减退。

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