Highlights
- •Pain modulation induced by a simple cognitive task worsened rather than ameliorated pain in elderly participants.
- •Increased pain perception during distraction in elderly participants is associated with limited working memory capacity with aging, which may result in insufficient resources to “control pain.”
- •Inhibition processes were related to conscious distraction estimation in both elderly and younger groups.
- •Functional degeneration of frontal cerebral networks may contribute to the age-related decline in cognitive pain modulation.
Abstract
Distraction is known to reduce perceived pain but not always efficiently. Overlapping
cognitive resources play a role in both pain processing and executive functions. We
hypothesized that with aging, the analgesic effects of cognitive modulation induced
by distraction would be reduced as a result of functional decline of frontal networks.
Twenty-eight elderly and 28 young participants performed a tonic heat pain test with
and without distraction (P + D vs P condition), and 2 executive tasks involving the
frontal network (1-back [working memory] and go/no-go [response inhibition]), during
which event-related potentials were recorded. A significant age-related difference
in modulatory effect was observed during the pain-distraction test, with the older
group reporting higher pain perception than the younger group during the P + D than
during the P condition. Greater brain activity of early processes (P2 component) in
both go/no-go and 1-back tasks correlated with less perceived pain during distraction
in younger participants. For later processes, more cognitive control and attentional
resources (increased N2 and P3 amplitude) needed for working memory processes were
associated with greater pain perception in the older group. Inhibition processes were
related to conscious distraction estimation in both groups. These findings indicate
that cognitive processes subtended by resources in the frontal network, particularly
working memory processes, are elicited more in elderly than in younger individuals
for pain tolerance when an irrelevant task is performed simultaneously.
Perspective
This study suggests that age-related declines in pain modulation are caused by functional
degeneration of frontal cerebral networks, which may contribute to a higher prevalence
of chronic pain. Analyzing the impact of frontal network function on pain modulation
may assist in the development of more effective targeted treatment plans.
Key words
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Article info
Publication history
Published online: June 13, 2015
Accepted:
May 28,
2015
Received in revised form:
April 28,
2015
Received:
January 8,
2015
Footnotes
The authors declare that they have no conflicts of relevant financial interests regarding this article.
This work was supported by the China Scholarship Council (CSC).
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.
