Journal of Pain Research (Sep 2020)

Cortical Thickness Mediates the Association Between Self-Reported Pain and Sleep Quality in Community-Dwelling Older Adults

  • Montesino-Goicolea S,
  • Valdes-Hernandez PA,
  • Hoyos L,
  • Woods AJ,
  • Cohen R,
  • Huo Z,
  • Riley JL III,
  • Porges EC,
  • Fillingim RB,
  • Cruz-Almeida Y

Journal volume & issue
Vol. Volume 13
pp. 2389 – 2400

Abstract

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Soamy Montesino-Goicolea,1,2 Pedro A Valdes-Hernandez,1,2 Lorraine Hoyos,3 Adam J Woods,2,4,5 Ronald Cohen,2,5 Zhiguang Huo,6 Joseph L Riley III,1,7 Eric C Porges,2,5 Roger B Fillingim,1,7 Yenisel Cruz-Almeida1,2,4,7 1Department of Community Dentistry & Behavioral Sciences, University of Florida, Gainesville, FL, USA; 2Center for Cognitive Aging and Memory, McKnight Brain Foundation, University of Florida, Gainesville, FL, USA; 3University of Central, Florida College of Medicine, Orlando, FL, USA; 4Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA; 5Department of Clinical and Health Psychology, College of Health Professions, University of Florida, Gainesville, FL, USA; 6Department of Biostatistics, College of Public Health and Health Professions College of Medicine, University of Florida, Gainesville, FL, USA; 7Institute on Aging, University of Florida, Gainesville, FL, USACorrespondence: Yenisel Cruz-AlmeidaPain Research and Intervention Center of Excellence, University of Florida, PO BOX 112610, Gainesville, FL 326010, USATel +1 352-294-5845Fax +1 352-273-5920Email [email protected]: Musculoskeletal pain is prevalent in older adults representing the leading cause of disability in this population. Similarly, nearly half of older adults complain of difficulty sleeping. We aimed to explore the relationship between sleep quality with self-reported musculoskeletal pain, somatosensory and pain thresholds in community-dwelling older adults and further explore brain regions that may contribute to this association.Methods: Older adults (> 60 years old, n=69) from the NEPAL study completed demographic, pain and sleep assessments followed by a quantitative sensory testing battery. A subset (n=49) also underwent a 3T high-resolution, T1-weighted anatomical scan.Results: Poorer sleep quality using the Pittsburgh Sleep Quality Index was positively associated with self-reported pain measures (all p’s > 0.05), but not somatosensory and pain thresholds (all p’s > 0.05). Using a non-parametric threshold-free cluster enhancement (TFCE) approach, worse sleep quality was significantly associated with lower cortical thickness in the precentral, postcentral, precuneus, superior parietal, and lateral occipital regions (TFCE-FWE-corrected at p < 0.05). Further, only postcentral cortical thickness significantly mediated the association between sleep quality and self-reported pain intensity using bootstrapped mediation methods.Conclusion: Our findings in older adults are similar to previous studies in younger individuals where sleep is significantly associated with self-reported pain. Specifically, our study implicates brain structure as a significant mediator of this association in aging. Future larger studies are needed to replicate our findings and to further understand if the brain can be a therapeutic target for both improved sleep and pain relief in older individuals.Keywords: chronic pain, sleep quality, sleep, brain, aging

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