Discrepancy between stimulus response and tolerance of pain in Alzheimer disease

Neurology
Christina Jensen-DahmGunhild Waldemar

Abstract

Affective-motivational and sensory-discriminative aspects of pain were investigated in patients with mild to moderate Alzheimer disease (AD) and healthy elderly controls using the cold pressor test tolerance and repetitive stimuli of warmth and heat stimuli, evaluating the stimulus-response function. A case-control design was applied examining 33 patients with mild to moderate AD dementia and 32 healthy controls with the cold pressor test (4°C). Warmth detection threshold (WDT) and heat pain threshold (HPT) were assessed using 5 stimulations. A stimulus-response function was estimated using 4 incrementally increasing suprathreshold heat stimuli. Cold pressor tolerance was lower in patients with AD dementia than in controls (p = 0.027). There were no significant differences between groups regarding WDT and HPT. Significant successive increases in HPT assessments indicated habituation (p < 0.0001), which was similar in the 2 groups (p = 0.85). A mixed model for repeated measures demonstrated that pain rating of suprathreshold stimuli depended on HPT (p = 0.0004) and stimulus intensity (p < 0.0001). Patients with AD dementia had significantly lower increases in pain ratings than controls during suprathreshold stimulation (p = 0.00...Continue Reading

Citations

Sep 18, 2015·The Clinical Journal of Pain·Paul A BeachAndrea C Bozoki
Jul 12, 2016·Expert Review of Neurotherapeutics·Marina de TommasoMassimiliano Valeriani
Oct 11, 2017·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Tarik T BinnekadeJoukje M Oosterman
Oct 21, 2020·European Journal of Pain : EJP·Céline BorgIsabelle Rouch

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