Cognitive Modulation Of Pain By Attention: The Role Of Executive Functioning In Aging

Attention is acknowledged as an effective strategy to modulate pain, as shown by
various studies of acute and chronic pain. Here executive functioning (EF) plays a
key role, with poorer EF related to less successful inhibition of pain, both relying
on the prefrontal cortex (PFC). With age, structural and volume changes in the
PFC are accompanied by age-related cognitive decline. So far, only a few studies
investigated how age-related cognitive decline affect cognitive distraction from
pain.In a two-session design, healthy young (18-30 years) and older participants
(60+ years) performed four EF tasks shown to either reveal age-related cognitive
decline or not. Afterwards, participants performed a pain distraction task, a n-Back
working memory task with low and high cognitive load, during which participants
received individually adjusted transdermal electrical pulse trains in non-painful and
moderately painful intensities to the inner forearm. Participants rated them regarding
their intensity and unpleasantness. Stimulus-related (EF tasks) and pain-related
evoked potentials were recorded with a 64-channel EEG.Preliminary results suggest
a similar effective subjective pain relief during high and low working memory load in
both age groups, which is reflected in a similar reduced N1-P2 pain-related ERPs
in older but not in younger participants. However, including executive functioning
showing age-related cognitive decline, revealed less successful pain reduction in the
high working memory load condition in older adults. These findings could lead to
a better understanding how to adapt pain treatments in the older population by
including selective cognitive trainings, optimizing pain modulation settings.