Sex differences in psychophysical and neurophysiological responses to pain in older adults: a cross-sectional study

Biology of Sex Differences

Todd B. Monroe⁷  John C. Gore⁵  Stephen P. Bruehl¹  Margaret M. Benningfield²  Mary S. Dietrich²  Li Min Chen⁵  Paul Newhouse⁶  Roger Fillingim³  BettyAnn Chodkowski²  Sebastian Atalla⁷  Julian Arrieta⁷  Stephen M. Damon⁴  Jennifer Urbano Blackford²  Ronald L. Cowan² 

[1] Vanderbilt University School of Medicine, Nashville, TN, USA

[2] Vanderbilt Psychiatric Neuroimaging Program, School of Medicine, Vanderbilt University Institute of Imaging Science, Vanderbilt University School of Medicine, Nashville, TN, USA

[3] University of Florida Pain Research and Intervention Center of Excellence, University of Florida College of Dentistry, Gainesville, FL, USA

[4] Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Institute of Imaging Science, Nashville, TN, USA

[5] Vanderbilt University Institute of Imaging Science, School of Medicine, Nashville, TN, USA

[6] Vanderbilt Center for Cognitive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA

[7] Vanderbilt Psychiatric Neuroimaging Program, Vanderbilt University School of Nursing, Vanderbilt University Institute of Imaging Science, Nashville, TN, USA

关键词: Neuroimaging;    Thermal pain;    Psychophysics;    Sex differences;    Older adults;    Pain;    Functional MRI;   

Others  :  1233446
DOI  :  10.1186/s13293-015-0041-y

 received in 2015-07-28, accepted in 2015-10-29,  发布年份 2015

【 摘 要 】

Background

Neuroimaging studies in younger adults have demonstrated sex differences in brain processing of painful experimental stimuli. Such differences may contribute to findings that women suffer disproportionately from pain. It is not known whether sex-related differences in pain processing extend to older adults.

Methods

This cross-sectional study investigated sex differences in pain reports and brain response to pain in 12 cognitively healthy older female adults and 12 cognitively healthy age-matched older male adults (age range 65–81, median = 67). Participants underwent psychophysical assessments of thermal pain responses, functional MRI, and psychosocial assessment.

Results

When compared to older males, older females reported experiencing mild and moderate pain at lower stimulus intensities (i.e., exhibited greater pain sensitivity; Cohen’s d = 0.92 and 0.99, respectively, p < 0.01) yet did not report greater pain-associated unpleasantness. Imaging results indicated that, despite the lower stimulus intensities required to elicit mild pain detection in females, they exhibited less deactivations than males in regions associated with the default mode network (DMN) and in regions associated with pain affect (bilateral dorsolateral prefrontal cortex, somatomotor area, rostral anterior cingulate cortex (rACC), and dorsal ACC). Conversely, at moderate pain detection levels, males exhibited greater activation than females in several ipsilateral regions typically associated with pain sensation (e.g., primary (SI) and secondary somatosensory cortices (SII) and posterior insula). Sex differences were found in the association of brain activation in the left rACC with pain unpleasantness. In the combined sample of males and females, brain activation in the right secondary somatosensory cortex was associated with pain unpleasantness.

Conclusions

Cognitively healthy older adults in the sixth and seventh decades of life exhibit similar sex differences in pain sensitivity compared to those reported in younger individuals. However, older females did not find pain to be more unpleasant. Notably, increased sensitivity to mild pain in older females was reflected via less brain deactivation in regions associated with both the DMN and in pain affect. Current findings elevate the rACC as a key region associated with sex differences in reports of pain unpleasantness and brain deactivation in older adults. Also, pain affect may be encoded in SII in both older males and females.

【 授权许可】

   
2015 Monroe et al.

【 图 表 】

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