Age-related differences in endogenous pain modulation: a comparison of diffuse noxious inhibitory controls in healthy older and younger adults
Age-related differences in endogenous pain modulation: a comparison of diffuse noxious inhibitory controls in healthy older and younger adults
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DOI：
10.1016/s0304-3959(02)00324-x
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发表时间：
2003-01-01
期刊：
影响因子：
7.4
通讯作者：
Ness, TJ
中科院分区：
文献类型：
--
作者：
Edwards, RR;Fillingim, RB;Ness, TJ
尽管经过数十年的研究，数百项研究和一些最近的评论，衰老对疼痛体验的影响仍然知之甚少。许多先前的研究者已经报道了老年人中持续性疼痛状况的增加和对某些类型的实验室引起的疼痛的耐受性降低。虽然这些影响的解释往往提出衰老递减内源性镇痛系统作为一种可能的贡献机制，几乎没有直接的经验证据，这一假设尚未出现在人体研究。本研究旨在评估内源性疼痛抑制中这些假定的年龄相关差异的存在和性质。健康的年轻（n = 45，平均年龄= 21.6岁，范围= 18-25）和老年（n = 48，平均年龄= 63.1岁，范围= 55-67）成人组参加了一个受控的，两个阶段的实验室评估弥漫性有害抑制控制（DNIC），内源性疼痛抑制的措施。在这项研究中，我们研究了年龄差异的影响，同时冷疼痛的评级异位提出重复伤害性热刺激。有趣的是，老年人在同时进行的有害冷刺激期间表现出对热疼痛的促进而不是抑制，而年轻人则表现出一些预期的DNIC效应（即在有害冷的异位刺激期间热疼痛评分降低）。总的来说，本研究的结果表明，年龄相关的递减至少有一种形式的内源性镇痛反应。如果重复的话，老年人疼痛调节能力降低的发现可能部分解释了慢性疼痛的患病率、严重程度和影响的年龄相关差异。(C)2002年国际疼痛研究协会。由Elsevier Science B. V.出版，版权所有。
Despite decades of research, hundreds of studies, and a number of recent reviews, the effects of aging on the experience of pain remain poorly understood. Many prior investigators have reported increases in persistent pain conditions and diminished tolerance for certain types of laboratory-induced pain among the elderly. While explanations for these effects often propose senescent decrements in endogenous analgesic systems as a possible contributory mechanism, almost no direct empirical evidence for this hypothesis has yet emerged in human studies. The present investigation was designed to evaluate the existence and nature of these putative age-related differences in endogenous pain inhibition. Groups of healthy younger (n = 45, mean age = 21.6 years, range = 18-25) and older (n = 48, mean age = 63.1 years, range = 55-67) adults participated in a controlled, two-session laboratory assessment of diffuse noxious inhibitory controls (DNIC), a measure of endogenous pain inhibition. In this study, we examined age differences in the effects of concurrent cold pain on ratings of heterotopically presented repetitive noxious thermal stimuli. Interestingly, older adults demonstrated facilitation rather than inhibition of thermal pain during concurrent noxious cold stimulation while younger adults demonstrated some expected DNIC effects (i.e. a reduction in thermal pain ratings during heterotopic stimulation with noxious cold). Collectively, the findings of the present study suggest age-associated decrements in at least one form of endogenous analgesic response. If replicated, such findings of reduced pain-modulatory capacity in the elderly may partially explain age-related differences in the prevalence, severity, and impact of chronic pain. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.