Pain sensitivity and fMRI pain-related brain activity in Alzheimer's disease

Cole, Leonie J; Farrell, Michael J.; Duff, Eugene P.; Barber, Joshua B.; Egan, Gary F.; Gibson, Stephen

doi:10.1093/brain/awl228

Cited by 198 publications

(228 citation statements)

References 51 publications

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“…There are disparate findings concerning the impact of dementia on the pain experience (Cole et al, 2006;Hadjistavropoulos et al, 2011b;Hadjistavropoulos et al, 2000b;Kunz, Mylius, Schepelmann, & Lautenbacher, 2008b;Kunz et al, 2007). There is some evidence of increased pain expression (facial activity) in patients with dementia (Hadjistavropoulos et al, 2000b;Kunz et al, 2007).…”

Section: Developmental Considerations In the Communications Model Of mentioning

confidence: 99%

A biopsychosocial formulation of pain communication.

Hadjistavropoulos¹,

Craig²,

Duck³

et al. 2011

Psychological Bulletin

398

366

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We present a detailed framework for understanding the numerous and complicated interactions among psychological and social determinants of pain through examination of the process of pain communication. The focus is on an improved understanding of immediate dyadic transactions during painful events in the context of broader social phenomena. Fine-grain consideration of social transactions during pain leads to an appreciation of sociobehavioral events affecting both suffering persons as well as caregivers. Our examination considers knowledge from a variety of perspectives, including clinical health psychology, social and developmental processes, evolutionary psychology, communication studies, and behavioral neuroscience.

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Section: Developmental Considerations In the Communications Model Of mentioning

confidence: 99%

A biopsychosocial formulation of pain communication.

Hadjistavropoulos¹,

Craig²,

Duck³

et al. 2011

Psychological Bulletin

398

366

View full text Add to dashboard Cite

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“…Overall, 13 articles representing 10 unique studies were included [6,17,[30][31][32][33][34][35][36][37][38][39][40]. Three author groups [6,17,30,33,37,38] reported different pain assessment outcome measures across two separate publications within the same AD sample.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Three author groups [6,17,30,33,37,38] reported different pain assessment outcome measures across two separate publications within the same AD sample. With respect to pain modality, different pain induction methods were used as follows:…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Alzheimer's disease (AD) is the most common form of dementia, accounting for approximately 60% of cases [4]. In addition to changes in the transentorhinal cortex and hippocampus regions that occur with AD [5], neurodegenerative changes in the medial thalamic nuclei, hypothalamus, cingulate and insular cortex have been identified [6]. These areas are key components of the medial pain system, which is integral to the processing of the affective-motivational dimension of pain [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…These areas are key components of the medial pain system, which is integral to the processing of the affective-motivational dimension of pain [7,8]. Interestingly, the areas of the brain that comprise the lateral pain system, which are related to the sensory-discriminative dimension (location, sensory quality and intensity) of pain appear to be relatively unaffected in AD [6].…”

Section: Introductionmentioning

confidence: 99%

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Is pain sensitivity altered in people with Alzheimer's disease? A systematic review and meta-analysis of experimental pain research

Stubbs

Thompson

Solmi

et al. 2016

Experimental Gerontology

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Clinical studies suggest people with Alzheimer's disease (AD) have altered pain sensitivity. Experimental pain research is equivocal.\ud Conduct a meta-analysis to investigate if people with AD have altered pain sensitivity compared to healthy controls (HCs).\ud Three authors searched electronic databases from inception till November 2015 for experimental pain studies in AD vs. HCs. Outcome measures were pain threshold, tolerance, pain ratings, heart rate response to noxious stimuli and the Facial Action Coding System (FACS). Random effect meta-analysis calculating Hedges' g±95% confidence intervals (CI) was conducted.\ud Thirteen studies were identified, including 256 people with AD (74.6 (±5.6) years, 59% females with a mean mini mental state examination (MMSE) score of 19.2) and 260 HCs. Meta-analysis demonstrated no significant difference in pain threshold (g=0.025, 95% CI -0.315-0.363, p=0.88, n AD=135, n HCs=157), pain tolerance (g=-0.363, 95% CI -2.035-1.309, p=0.67, n AD=41, n HCs=53) or pain intensity ratings (g=0.03, p=0.89, n AD=138, n HCs=135). Heart rate response to pain was less pronounced in AD but not significant (g=-0.746, p=0.11). People with AD (n=90) had significantly higher FACS scores versus HCs (n=109) (g=0.442, p=0.03) indicating increased pain. Meta-regression demonstrated that an increasing percentage of AD female participants moderated pain threshold (p=0.02) whilst MMSE scores did not (p=0.19).\ud People with AD have a greater sensitivity to pain when validated observer ratings of facial expressions are used. Verbal response to painful stimuli, even under experimental conditions, may mean pain is not identified in people with AD. Clinically useful observer rated pain tools may be the most appropriate way to assess pain in AD

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