Pain And Aging

Roughly one in two elderly individuals suffers from chronic pain, compared to 30% in other age groups. An interesting avenue for explaining this vulnerability to chronic pain in seniors is the observed link, noted by several authors, between executive functions (inhibition, attention, flexibility, decision-making) and endogenous pain inhibition. Indeed, individuals with high executive performance resist prolonged painful stimulation longer than those with low performance. As the prefrontal cortex is the seat of executive functions, its structural and functional alteration in the elderly could be a cause of deficient endogenous pain inhibition. Functionally, the mechanisms involved in descending inhibition are complex, and deficits observed in the elderly may operate at various levels. One possibility is a decrease in the elderly person’s attentional capacities involved in cognitive pain inhibition processes. Our goal is to verify this hypothesis by assessing resistance to tonic pain (an experimental model of chronic pain) in relation to subjects’ cognitive levels.

Our experimental studies on pain in humans also aim to improve pain assessment methods. Our research focuses on both subjective methods such as quantitative sensory measures and objective techniques such as somatosensory evoked potentials obtained through electroencephalographic recordings.

The issue of pain assessment also lies in the tools used for stimulation. Indeed, temperature detection thresholds are generally expressed as temperature or output power of the stimulation device, mainly because it is very difficult to accurately measure the exact temperature of the stimulated skin area. Moreover, the temperature of the stimulated skin area depends on several factors, including the initial temperature of the skin, the exchange coefficient between the skin and the stimulation surface, and the skin’s ability to dissipate heat through tissues. Using different models, we are trying to characterize more precisely the functioning of thermo-nociceptive fibers with the aim of identifying age-related modifications.

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