Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States.
Institute on Aging, University of Florida, Gainesville, FL, United States.
Pain. 2019 May;160(5):1119-1130. doi: 10.1097/j.pain.0000000000001491.
Chronic pain is associated with brain atrophy with limited evidence on its impact in the older adult's brain. We aimed to determine the associations between chronic pain and a brain aging biomarker in persons aged 60 to 83 years old. Participants of the Neuromodulatory Examination of Pain and Mobility Across the Lifespan (NEPAL) study (N = 47) completed demographic, psychological, and pain assessments followed by a quantitative sensory testing battery and a T1-weighted magnetic resonance imaging. We estimated a brain-predicted age difference (brain-PAD) that has been previously reported to predict overall mortality risk (brain-PAD, calculated as brain-predicted age minus chronological age), using an established machine-learning model. Analyses of covariances and Pearson/Spearman correlations were used to determine associations of brain-PAD with pain, somatosensory function, and psychological function. Individuals with chronic pain (n = 33) had "older" brains for their age compared with those without (n = 14; F[1,41] = 4.9; P = 0.033). Greater average worst pain intensity was associated with an "older" brain (r = 0.464; P = 0.011). Among participants with chronic pain, those who reported having pain treatments during the past 3 months had "younger" brains compared with those who did not (F[1,27] = 12.3; P = 0.002). An "older" brain was significantly associated with decreased vibratory (r = 0.323; P = 0.033) and thermal (r = 0.345; P = 0.023) detection, deficient endogenous pain inhibition (F[1,25] = 4.6; P = 0.044), lower positive affect (r = -0.474; P = 0.005), a less agreeable (r = -0.439; P = 0.020), and less emotionally stable personality (r = -0.387; P = 0.042). Our findings suggest that chronic pain is associated with added "age-like" brain atrophy in relatively healthy, community-dwelling older individuals, and future studies are needed to determine the directionality of our findings. A brain aging biomarker may help identify people with chronic pain at a greater risk of functional decline and poorer health outcomes.
慢性疼痛与脑萎缩有关，但关于其对老年人大脑影响的证据有限。我们旨在确定慢性疼痛与 60 至 83 岁人群中大脑老化生物标志物之间的关联。参与神经调节检查疼痛和移动性跨生命周期 (NEPAL) 研究（N = 47）的参与者完成了人口统计学、心理学和疼痛评估，随后进行了定量感觉测试和 T1 加权磁共振成像。我们使用已建立的机器学习模型来估计大脑预测年龄差异 (brain-PAD)，该差异先前已被报道可预测整体死亡率风险（brain-PAD，计算为大脑预测年龄减去实际年龄）。协方差分析和 Pearson/Spearman 相关性分析用于确定 brain-PAD 与疼痛、体感功能和心理功能的关联。与没有疼痛的人（n = 14）相比，患有慢性疼痛的人（n = 33）的大脑年龄比实际年龄更“大”（F[1,41] = 4.9；P = 0.033）。平均最差疼痛强度越大，大脑年龄越大（r = 0.464；P = 0.011）。在患有慢性疼痛的参与者中，过去 3 个月内有疼痛治疗的人比没有疼痛治疗的人（F[1,27] = 12.3；P = 0.002）的大脑年龄更“小”。大脑年龄更大与振动（r = 0.323；P = 0.033）和热（r = 0.345；P = 0.023）检测减少、内源性疼痛抑制不足（F[1,25] = 4.6；P = 0.044）、积极情绪降低（r = -0.474；P = 0.005）、不那么讨人喜欢（r = -0.439；P = 0.020）和情绪稳定性降低（r = -0.387；P = 0.042）有关。我们的发现表明，慢性疼痛与相对健康的社区居住的老年个体中额外的“似老化”脑萎缩有关，需要进一步的研究来确定我们发现的方向。大脑老化生物标志物可能有助于识别患有慢性疼痛且功能下降和健康状况较差风险较高的人群。
Pain Med. 2021-8-6
Clin J Pain. 2022-7-1
J Gerontol A Biol Sci Med Sci. 2024-8-1
Scand J Work Environ Health. 2017-11-29
Trends Neurosci. 2017-10-23
Mol Psychiatry. 2017-4-25
Neurology. 2017-4-4
Soc Cogn Affect Neurosci. 2017-4-1
Pain. 2015-6
Zotero 插件