Distraction from Pain in Aging – the Impact of Acute Stress

While older people report acute and chronic pain more often than younger people, and, therefore,
would benefit significantly from non-pharmacological pain treatment, little is known about how age
affects psychological strategies of pain modulation. Distraction from pain by cognitive engagement,
an efficient pain modulation strategy, relies on the prefrontal cortex (PFC). The PFC, however, is
an area affected by age-related cognitive decline, which might lead to reduced pain relief through
distraction in older adults. Acute stress, a common concomitant phenomenon of pain, might
additionally reduce the pain relief effect by its negative impact on PFC and PFC-based executive
functions.
Healthy young (18-30 years) and older participants (65+ years) performed a pain distraction
task before and after acute stress induction using the Trier Social Stress Test, or a respective
control condition. An n-Back working memory task with low and high cognitive load served as
the distraction paradigm, during which participants received non-painful and moderately painful
stimuli. These stimuli were individually adjusted transdermal electrical pulse trains to the inner
forearm and participants rated them regarding their intensity and unpleasantness. Pain-related
evoked potentials were recorded with a 64-channel EEG, and several saliva samples were collected
to measure hormonal stress responses. First analyses on the currently small sample suggest a
negative impact of acute stress on distraction from pain in both age groups. Our final results will
contribute to a deeper understanding on the efficacy of pain modulation in aging and potential
influencing factors, helping to optimize pain treatments in this population.