Information de reference pour ce titreAccession Number: | 00006396-199903010-00040.
|
Author: | Benedetti, Fabrizio *; Vighetti, Sergio; Ricco, Claudia; Lagna, Elisabetta; Bergamasco, Bruno; Pinessi, Lorenzo; Rainero, Innocenzo
|
Institution: | Department of Neuroscience, CIND Center for the Neurophysiology of Pain, and Center for Brain Electrical Activity Mapping, University of Torino Medical School, Torino, Italy
|
Title: | |
Source: | Pain. 80(1-2):377-382, March 1, 1999.
|
Abstract: | We tested both pain thresholds and pain tolerance in patients with Alzheimer's disease (AD) by means of phasic and tonic noxious stimuli. In the first case, electrical stimulation was used, whereas in the second case arm ischemia was studied. By comparing AD patients with normal subjects of the same age, we found no differences in stimulus detection and pain thresholds, whereas a clearcut increase in pain tolerance was present in AD patients. The severity of AD was assessed by means of the Mini Mental State Examination test (MMSE) and the spectral analysis of the electroencephalogram (EEG). There was a straightforward correlation between MMSE scores and pain tolerance such that the more severe the cognitive impairment the higher the tolerance to pain. In addition, analysis of the EEG power spectra indicated that patients with low alpha and high delta peaks showed an increase in pain tolerance to both electrical stimulation and ischemia. These findings show that, whereas the sensory-discriminative component of pain is maintained in AD patients, pain tolerance is altered and depends on cognitive and affective factors. Thus, pain tolerance is tightly related to the severity of the disease according to the rule, 'the more severe the MMSE and EEG changes, the higher the tolerance to pain'.
(C) 1999 Lippincott Williams & Wilkins, Inc.
|
Author Keywords: | Alzheimer's disease; Pain threshold; Tolerance; Mini mental state examination test.
|
References: | Benedetti, F., The opposite effects of the opiate antagonist naloxone and the cholecystokinin antagonist proglumide on placebo analgesia, Pain, 64 (1996) 535-543.
Benedetti, F., The sensory and affective components of pain, Behav. Brain Sci., 20 (1997) 439-440.
Benedetti, F., Vighetti, S., Amanzio, M., Casadio, C., Oliaro, A., Bergamasco, B. and Maggi, G., Dose-response relationship of opioids in nociceptive and neuropathic postoperative pain, Pain, 74 (1998a) 205-211.
Benedetti, F., Vighetti, S., Ricco, C., Amanzio, M., Bergamasco, L., Casadio, C., Cianci, R., Giobbe, R., Oliaro, A., Bergamasco, B. and Maggi, G., Neurophysiologic assessment of nerve impairment in posterolateral and muscle-sparing thoracotomy, J. Thorac. Cardiovasc. Surg., 115 (1998b) 841-847.
Blennow, K., Wallin, A. and Hager, O., Low frequency of post-lumbar puncture headache in demented patients, Acta Neurol. Scand., 88 (1993) 221-223.
Coben, L., Chi, D., Snyder, A. and Storandt, M., Replication of a study of frequency analysis of the resting awake EEG in mild probable Alzheimer's disease, Electroenceph. clin. Neurophysiol., 75 (1990) 148-154.
Cornu, F., Perturbations de la perception de la doleur chez les dements degeneratifs, Journal de Psychologie Normale et Pathologique, 72 (1975) 81-96.
Craig, K.D., Emotional aspects of pain. In: P.D. Wall and R. Melzack (Eds.), Textbook of Pain, 3rd ed., Churchill Livingstone, Edinburgh, 1994, pp. 261-274.
Farrell, M.J., Katz, B. and Helme, R.D., The impact of dementia on the pain experience, Pain, 67 (1996) 7-15.
Folstein, M.F. and Folstein, S.E., 'Mini-Mental state' - a practical method for grading the cognitive state of patients for the clinician, J. Psychiatr. Res., 12 (1975) 189-198.
Giordani, B., Boivin, M.J., Hall, A.L., Foster, N.L., Lehtinen, S.J., Bluemlein, L.A. and Berent, S., The utility and generality of Mini-Mental State Examination scores in Alzheimer's disease, Neurology, 40 (1990) 1894-1896.
Herrmann, W.M. and Irrgang, U., Characterization and classification of psychoactive drugs on a functional electrophysiological level as a basis for the interpretation of EEG effects of the two analgesics pentazocin and flupirtine. In: B. Bromm (Ed.), Pain Measurement in Man, Elsevier, Amsterdam, 1984, pp. 167-188.
Herrmann, W.M., The pharmaco-electroencephalogram of analgesic and psychotropic drugs. In: B. Bromm and J.E. Desmedt (Eds.), Pain and the Brain: from Nociception to Cognition, Advances in Pain Research and Therapy, Vol. 22, Raven Press, New York, 1995, pp. 459-471.
Hyman, B.T., Van, H.G.W., Damasio, A.R. and Barnes, C.L., Alzheimer's disease: cell-specific pathology isolates the hippocampal formation, Science, 225 (1984) 1168-1170.
Jonsson, C.O., Malhammar, G. and Waldton, S., Reflex elicitation thresholds in senile dementia, Acta Psychiatr. Scand., 55 (1977) 81-96.
Knutz, K.M., Kokmen, E., Stevens, J.C., Miller, P., Offord, K.P. and Ho, M.M., Post-lumbar puncture headaches: experience in 501 consecutive procedures, Neurology, 42 (1992) 1884-1887.
Leuchter, A.F., Spar, J., Walter, D. and Weiner, H., Electroencephalographic spectra and coherence in the diagnosis of Alzheimer's-type and multi-infarct dementia, Arch. Gen. Psychiatry, 44 (1987) 993-998.
Leuchter, A.F. and Walter, D., Diagnosis and assessment of dementia using functional brain imaging, Int. J. Psychogeriatr., 1 (1989) 63-72.
Leuchter, A.F., Cook, I.A., Newton, T.F., Dunkin, J., Walter, D.O., Rosenberg-Thompson, S., Lachenbruch, P.A. and Weiner, H., Regional differences in brain electrical activity in dementia: use of spectral power and spectral ratio measures, Electroenceph. clin. Neurophysiol., 87 (1993) 385-393.
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E.M., Clinical diagnosis of Alzheimer's disease, Neurology, 34 (1984) 939-944.
Mountjoy, C.Q., Roth, M., Evans, N.J.R. and Evans, H.M., Cortical neuronal counts in normal elderly controls and demented patients, Neurobiol. Aging, 4 (1983) 1-11.
Porter, F.L., Miller, J.P., Morris, J. and Berg, L., Pain in aging: attention, cognitive performance, perception and physiologic response, The 7th IASP World Congress on Pain, Seattle, WA, 1993, p. 99.
Porter, F.L., Malhotra, K.M., Wolf, C.M., Morris, J.C., Miller, J.P. and Smith, M.C., Dementia and response to pain in the elderly, Pain, 68 (1996) 413-421.
Rudelli, R.D., Ambler, M.W. and Wisniewski, H.M., Morphology and distribution of Alzheimer neuritic (senile) and amyloid plaques in striatum and diencephalon, Acta Neuropathol., 64 (1984) 273-281.
Smith, G.M., Egbert, L.D., Markowitz, R.A., Mosteller, F. and Beecher, H.K., An experimental pain method sensitive to morphine in man: the submaximum effort tourniquet technique, J. Pharmacol. Exp. Ther., 154 (1966) 324-332.
Smith, G.M., Lowenstein, E., Hubbard, J.H. and Beecher, H.K., Experimental pain produced by the submaximum effort tourniquet technique: further evidence of validity, J. Pharmacol. Exp. Ther., 163 (1972) 468-474.
Weisenberg, M., Cognitive aspects of pain. In: P.D. Wall and R. Melzack (Eds.), Textbook of Pain, 3rd ed., Churchill Livingstone, Edinburgh, 1994, pp. 275-289.
|
Language: | English.
|
Document Type: | Articles.
|
ISSN: | 0304-3959
|
NLM Journal Code: | opf, 7508686
|
DOI Number: | https://dx.doi.org/10.1016/S0304...- ouverture dans une nouvelle fenêtre
|
Annotation(s) | |
|
|