Pain processing in older adults with dementia-related cognitive impairment is associated with frontal neurodegeneration

Steffie Bunk*, Sytse Zuidema, Kathrin Koch, Stefan Lautenbacher, Peter P De Deyn, Miriam Kunz

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
31 Downloads (Pure)

Abstract

Experimental pain research has shown that pain processing seems to be heightened in dementia. It is unclear which neuropathological changes underlie these alterations. This study examined whether differences in pressure pain sensitivity and endogenous pain inhibition (conditioned pain modulation (CPM)) between individuals with a dementia-related cognitive impairment (N = 23) and healthy controls (N = 35) are linked to dementia-related neurodegeneration. Pain was assessed via self-report ratings and by analyzing the facial expression of pain using the Facial Action Coding System. We found that cognitively impaired individuals show decreased CPM inhibition as assessed by facial responses compared to healthy controls, which was mediated by decreased gray matter volume in the medial orbitofrontal and anterior cingulate cortex in the patient group. This study confirms previous findings of intensified pain processing in dementia when pain is assessed using non-verbal responses. Our findings suggest that a loss of pain inhibitory functioning caused by structural changes in prefrontal areas might be one of the underlying mechanisms responsible for amplified pain responses in individuals with a dementia-related cognitive impairment. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )

Original languageEnglish
Pages (from-to)139-152
Number of pages14
JournalNeurobiology of Aging
Volume106
Early online date18-Jun-2021
DOIs
Publication statusPublished - Oct-2021

Keywords

  • Pain
  • Dementia
  • Facial expression of pain
  • Conditioned pain modulation
  • Voxel-based morphometry
  • Diffusion tensor imaging
  • VOXEL-BASED MORPHOMETRY
  • ALZHEIMERS-DISEASE
  • FACIAL EXPRESSION
  • INHIBITION
  • MODULATION
  • MECHANISMS
  • CORTEX
  • FMRI
  • ACTIVATION
  • DIFFUSION

Cite this