Riley Joseph L, Cruz-Almeida Yenisel, Staud Roland, Fillingim Roger B
Department of Community Dentistry, College of Dentistry, University of Florida, Gainesville, FL, USA.
Pain Research and Intervention Center of Excellence, Clinical and Translational Science, Institute, Gainesville, FL, USA.
Pain Rep. 2019 Dec 24;5(1):e796. doi: 10.1097/PR9.0000000000000796. eCollection 2020 Jan-Feb.
Conditioned pain modulation (CPM) is a laboratory test resulting in pain inhibition through activation of descending inhibitory mechanisms. Older adults consistently demonstrate reduced CPM compared with younger samples; however, studies of sex differences in younger cohorts have shown mixed results.
This study tested for sex differences in CPM within samples of younger and older adults.
Participants were 67 younger adults (mean age = 25.4 years) and 50 older adults (66.4 years). Study conditioning paradigms were the cold-pressor test and contact heat pain administered in separate sessions. Pressure pain threshold and ramping suprathreshold heat were the test stimuli across three time points after presentation of the conditioning stimuli (CS).
Significant inhibition was observed during both testing sessions. The hypothesis for sex differences across both age cohorts was supported only for ∆PPTh. However, sex differences did not reach significance for either paradigm using ascending suprathreshold heat as the test stimuli. The overall trend was that younger males experienced the strongest CPM and older females the weakest. From a methodological perspective, duration differences were seen in CPM, with inhibition decaying more quickly for PPTh than for suprathreshold heat pain. Furthermore, there were no differences in inhibition induced by cold-pressor test and contact heat pain as CS.
Sex differences were similar across both age cohorts with males experiencing greater inhibition than females. Cross-sectional associations were also demonstrated between CPM inhibition and measures of recent pain, further supporting CPM as an experimental model with clinical utility.
条件性疼痛调制(CPM)是一种实验室测试,通过激活下行抑制机制来抑制疼痛。与年轻样本相比,老年人的CPM始终表现出降低;然而,对年轻人群体中性别差异的研究结果不一。
本研究测试了年轻和老年成年人样本中CPM的性别差异。
参与者为67名年轻成年人(平均年龄 = 25.4岁)和50名老年成年人(66.4岁)。研究的条件范式是冷压痛试验和接触热痛试验,在不同的时间段进行。压力痛阈值和递增的阈上热刺激是在给予条件刺激(CS)后的三个时间点的测试刺激。
在两个测试阶段均观察到显著的抑制作用。仅在∆PPTh方面支持了两个年龄组中性别差异的假设。然而,使用递增的阈上热刺激作为测试刺激时,两种范式的性别差异均未达到显著水平。总体趋势是年轻男性的CPM最强,老年女性的CPM最弱。从方法学角度来看,CPM存在持续时间差异,PPTh的抑制作用比阈上热痛衰减得更快。此外,冷压痛试验和接触热痛试验作为CS所诱导的抑制作用没有差异。
两个年龄组的性别差异相似,男性比女性经历更大的抑制作用。CPM抑制与近期疼痛测量之间也存在横断面关联,进一步支持CPM作为具有临床实用性的实验模型。