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Loss of Temporal Inhibition of Nociceptive Information Is Associated With Aging and Bodily Pain

  • Kelly M. Naugle
    Affiliations
    Department of Kinesiology, School of Physical Education and Tourism Management, Indiana University Purdue University, Indianapolis, Indiana
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  • Yenisel Cruz-Almeida
    Affiliations
    Department of Aging & Geriatric Research and Neuroscience, College of Medicine, Institute on Aging, University of Florida, Gainesville, Florida

    College of Dentistry and Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
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  • Roger B. Fillingim
    Affiliations
    College of Dentistry and Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
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  • Joseph L. Riley III
    Correspondence
    Address reprint requests to Joseph L. Riley, III, PhD, Pain Research & Intervention Center of Excellence, University of Florida, Clinical and Translational Research Building, Room 2227, 2004 Mowry Road, Gainesville, FL 32610.
    Affiliations
    College of Dentistry and Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
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Published:August 25, 2017DOI:https://doi.org/10.1016/j.jpain.2017.08.003

      Highlights

      • Older adults showed reduced offset analgesia compared with younger adults.
      • No sex differences in offset analgesia were evident in any age group.
      • A reduction stimuli as small as .4°C resulted in significant offset analgesia.
      • Reduced offset analgesia was associated with pain in daily life for all age groups.

      Abstract

      An age-related decline in endogenous pain inhibitory processes likely places older adults at an increased risk for chronic pain. Limited research indicates that older adults may be characterized by deficient offset analgesia, an inhibitory temporal sharpening mechanism that increases the detectability of minor decreases in noxious stimulus intensity. The primary purpose of the study was to examine age differences in offset analgesia in community-dwelling younger, middle-aged, and older adults. An additional aim of the study was to determine whether the magnitude of offset analgesia predicted self-reported bodily pain. Eighty-seven younger adults, 42 middle-aged adults, and 60 older adults completed 4 offset analgesia trials and 3 constant temperature trials in which a noxious heat stimulus was applied to the volar forearm for 40 seconds. The offset trials consisted of 3 continuous phases: an initial 10-second painful stimulus, either a 1.0°C or .4°C increase in temperature from the initial 10-second painful stimulus for 10 seconds, and either a 1.0°C or .4°C decrease back to the initial testing temperature for 20 seconds. During each trial, subjects rated pain intensity continuously using an electronic visual analog scale (0–100). All subjects also completed the Short-Form Health Survey-36 including the Bodily Pain subscale. The results indicated that older and middle-aged adults showed reduced offset analgesia compared with younger adults in the 1.0°C and .4°C offset trials. Furthermore, the magnitude of offset analgesia predicted self-reported bodily pain, with those exhibiting reduced offset analgesia reporting greater bodily pain. Dysfunction of this endogenous inhibitory system could increase the risk of developing chronic pain for middle-aged and older adults.

      Perspective

      Older and middle-aged adults showed reduced offset analgesia compared with younger adults. The significant association between reduced offset analgesia and pain in daily life supports the notion that pain modulatory deficits are associated with not just a chronic pain condition but with the experience of pain in general.

      Key words

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