Imagine you’re on a long hike, trying to distract yourself from the pain in your legs by focusing on the beautiful scenery around you. Well, it turns out that older adults might have a harder time using distraction to modulate their pain compared to younger adults. A recent fMRI study explored the relationship between executive functions – which involve skills like attention, working memory, and self-control – and cognitive pain modulation in older adults. The researchers found that older adults displayed less efficient pain modulation compared to younger adults. Specifically, when faced with a high cognitive load task, older adults showed increased activation in the anterior cingulate cortex, a brain region involved in processing pain. On the other hand, younger adults demonstrated stronger de-activation of pain processing regions, suggesting a more effective use of distraction. Interestingly, the study also revealed that better executive functions were associated with enhanced neural pain modulation in older adults. This means that individuals with sharper cognitive abilities may be better equipped to regulate their pain through distraction. The findings highlight the importance of preserving executive functions for optimizing pain management strategies among older adults. To dive deeper into this fascinating research, check out the full article!

Growing evidence suggests that aging is associated with less efficient endogenous pain modulation as demonstrated by reduced conditioned pain modulation, and that these changes may be mediated by differences in frontal functioning. Yet, little is known about potential age-related changes in cognitive pain modulation, such as distraction from pain. In a first session, 30 healthy young (19–35 years) and 30 healthy older (59–82 years) adults completed a battery of neuropsychological tests. In a second session, we acquired functional brain images while participants completed a working memory task with two levels of cognitive load (high vs. low) and concurrently received individually adjusted heat stimuli (warm vs. painful). In both age groups, completing the high load task was associated with a significant reduction in the perceived intensity and unpleasantness of painful stimuli and a reduction in activation of brain regions involved in pain processing. Group comparisons revealed that young adults showed a stronger de-activation of brain regions involved in pain processing during the high load vs. the low load task, such as the right insula, right mid cingulate cortex and left supramarginal gyrus, compared to older adults. Older adults, on the other hand, showed an increased activation in the anterior cingulate cortex during the high load vs. low load task, when compared to young adults. Covariate analyses indicated that executive functions significantly predicted neural pain modulation in older adults: Better executive functions were associated with a more pronounced de-activation of the insula, thalamus and primary somatosensory cortex and increased activation of prefrontal regions during the high vs. low load task. These findings suggest that cognitive pain modulation is altered in older age and that the preservation of executive functions may have beneficial effects on the efficacy of distraction from pain.

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