Sex Differences in Pain Reports and Brain Activation in Older Adults with Alzheimers Disease

项目总结 阿尔茨海默病(AD)老年患者的疼痛治疗不当是一个严重的公共卫生问题， 了解性别和AD相关的疼痛功能差异是NIA优先考虑的领域。与健康相比 成人，在存在类似已知疼痛情况的情况下，患有阿尔茨海默病的老年人疼痛较少 药物治疗。造成这种差异的原因人们知之甚少。未得到充分治疗的疼痛会产生负面影响 提高了生活质量，增加了医疗费用。有充分的证据表明，认知健康的男性和女性 急性和慢性疼痛的体验和报告不同，但这些差异是否延伸到 患有阿尔茨海默病的老年人口。确定导致性别差异的生物学原因 疼痛处理的改变对于增加我们对老年AD患者疼痛的理解是必不可少的。在……里面 对疼痛的反应，有证据表明，大脑结构和大脑功能因性别而不同，并可能在 广告。然而，尚不清楚这些结构和功能神经系统改变如何因性别和性别而不同。 阿尔茨海默病如何影响对疼痛的心理生理和神经生理反应。 这个R01应用程序中的拟议研究将检验言语疼痛报告模式在对 患有和不患有阿尔茨海默病的老年男性和女性之间急性实验性热痛的差异，以及这些 性别差异映射到区域和网络的大脑功能变化上。实验性急性热痛 分娩很好地预测了对痛苦的医疗条件的反应。我们建议检查一下心理物理 健康男性和女性(65岁)对实验热刺激的神经生理反应 或年龄更大)和老年匹配患有AD的男性和女性(65岁或以上)。 本研究的目的是确定感官(刺激强度)和情感(刺激 在患有和不患有AD的患者中，在皮肤热刺激期间的反应因性别而异。 我们假设阿尔茨海默病与女性的敏感度增加有关，而男性阿尔茨海默病患者会 在痛苦中体验更大的不快。这些变化可能源于AD相关的大脑变化 结构和功能，以及疼痛相关大脑网络中特定性别的变化。检查基线 患有和不患有阿尔茨海默病的男性和女性之间实验性热痛的差异将提供一个 为了解可能导致未经治疗的疼痛风险的因素以及发展性行为奠定了基础 老年阿尔茨海默病患者的具体评估、预防和治疗策略。

PROJECT SUMMARY Poorly treated pain in older adults with Alzheimer's disease (AD) is a critical public health problem and understanding sex and AD-related differences in pain function is an NIA priority area. When compared to healthy adults, and in the presence of similarly known painful conditions, older adults with AD receive less pain medication. Reasons for this discrepancy are poorly understood. Inadequately treated pain negatively impacts quality of life and increases health care costs. It is well documented that cognitively healthy males and females experience and report acute and chronic pain differently, however it is unknown if these differences extend into the population of older adults with AD. Determining the biological reasons for sex-differences leading to alterations in pain processing is essential for increasing our understanding of pain in older adults with AD. In response to pain, evidence suggests that brain structure and brain function differ by sex and may be altered in AD. However, it is unknown how these structural and functional nervous system alterations differ by sex and how AD impacts psychophysical and neurophysiological responses to pain. The proposed research in this R01 application will examine how verbal pain reporting patterns in responses to acute experimental thermal pain differs between older males and females with and without AD and how these sex-differences map onto regional and network brain functional changes. Experimental acute thermal pain delivery predicts well the response to painful medical conditions. We propose to examine the psychophysical and neurophysiological response to experimental thermal stimuli between healthy males and females (aged 65 or older) and aged match males and females with AD (aged 65 or older). The aims of this study are to determine whether sensory (stimulus intensity) and affective (stimulus unpleasantness) responses differ by sex in people with and without AD during cutaneous thermal stimulation. We hypothesize that AD will be associated with an increased sensitivity in females yet males with AD will experience greater unpleasantness with pain. These changes may arise from AD-associated changes in brain structure and function as well as from sex-specific alterations in pain-related brain networks. Examining baseline differences in experimental thermal pain between males and females with and without AD will provide a foundation for understanding factors that may contribute to untreated pain risk, as well as for developing sex- specific novel assessment, prevention, and treatment strategies in the older population with AD.