过去一个月的疼痛感知对老年人认知和运动表现期间前额叶皮层激活模式的影响。
The Effects of Perceived Pain in the Past Month on Prefrontal Cortex Activation Patterns Assessed During Cognitive and Motor Performances in Older Adults.
机构信息
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.
Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
出版信息
Pain Med. 2021 Feb 23;22(2):303-314. doi: 10.1093/pm/pnaa404.
OBJECTIVE
Pain is prevalent and functionally impactful in older adults. The prefrontal cortex is involved in pain perception, attentional control, and cortical control of locomotion. Although pain is a known moderator of attentional capacity, its moderating effect on cortical control of locomotion has not been assessed. This study aimed to examine the effects of subjective pain on changes in functional near-infrared spectroscopy-derived measurements of oxygenated hemoglobin (HbO2), gait velocity, and cognitive accuracy from single- to dual-task walking conditions among older adults.
SUBJECTS
The sample consisted of 383 healthy older adults (55% female).
METHODS
Participants completed two single tasks (Single-Task-Walk [STW] and Cognitive Interference [Alpha]) and the Dual-Task-Walk (DTW), during which participants performed the two single tasks simultaneously. The Medical Outcomes Study Pain Severity Scale and Pain Effects Scale were used to assess pain severity and interference. ProtoKinetics Movement Analysis Software was used to assess gait velocity and rate of correct letter generation to assess cognitive accuracy. Functional Near-Infrared Spectroscopy (fNIRS) was used to assess HbO2 during active walking.
RESULTS
Linear mixed-effects models revealed that HbO2 increased from single- to dual-task conditions. Perceived pain presence was associated with an attenuated increase in HbO2 from Alpha to DTW. Among those with pain, worse pain severity was associated with an attenuated increase in HbO2 from STW to DTW. Pain interference did not moderate the increase in HbO2 from single to dual tasks. Pain did not have a moderating effect on behavioral outcomes.
CONCLUSIONS
Task-related changes in the hemodynamic response in the prefrontal cortex during walking may be a sensitive marker of the effects of subjective pain on brain function in healthy older adults.
目的
疼痛在老年人中普遍存在且具有功能性影响。前额叶皮层参与疼痛感知、注意力控制和皮质控制运动。尽管疼痛是注意力容量的已知调节剂，但它对皮质控制运动的调节作用尚未得到评估。本研究旨在评估主观疼痛对健康老年人从单任务到双任务行走条件下功能性近红外光谱（fNIRS）测量的含氧血红蛋白（HbO2）、步速和认知准确性变化的影响。
受试者
该样本由 383 名健康老年人（55%为女性）组成。
方法
参与者完成了两项单任务（单任务行走[STW]和认知干扰[Alpha]）和双任务行走（DTW），在此期间参与者同时执行两项单任务。使用医疗结果研究疼痛严重程度量表和疼痛影响量表评估疼痛严重程度和干扰。ProtoKinetics 运动分析软件用于评估步速和正确字母生成率，以评估认知准确性。fNIRS 用于在主动行走时评估 HbO2。
结果
线性混合效应模型显示，HbO2 从单任务到双任务条件下增加。感知到的疼痛存在与从 Alpha 到 DTW 的 HbO2 增加减少有关。在有疼痛的人中，疼痛严重程度越差，HbO2 从 STW 到 DTW 的增加就越少。疼痛干扰并未调节从单任务到双任务 HbO2 的增加。疼痛对行为结果没有调节作用。
结论
行走过程中前额叶皮层的血流动力学反应的任务相关变化可能是主观疼痛对健康老年人大脑功能影响的敏感标志物。
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