HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Zimmerman, M. E. Articles by Lipton, R. B. PubMed PubMed Citation Articles by Zimmerman, M. E. Articles by Lipton, R. B. Related Collections MRI MRS Volumetric MRI All Pain Cognitive aging

Hippocampal correlates of pain in healthy elderly adults

A pilot study

From the Department of Neurology (M.E.Z., K.B., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Neurosurgery (J.W.P., H.P.H.), Yale University School of Medicine, New Haven, CT; and Departments of Radiology, Psychiatry and Behavioral Sciences and the Gruss Magnetic Resonance Research Center (M.L.L.), Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.

Address correspondence and reprint requests to Dr. Molly E. Zimmerman, Albert Einstein College of Medicine, Saul R. Korey Department of Neurology, 1165 Morris Park Avenue, Room 343, Bronx, NY 10461 molly.zimmerman{at}einstein.yu.edu

Background: Few neuroimaging investigations of pain in elderly adults have focused on the hippocampus, a brain structure involved in nociceptive processing that is also subject to involution associated with dementing disorders. The goal of this pilot study was to examine MRI- and magnetic resonance spectroscopy (MRS)–derived hippocampal correlates of pain in older adults.

Methods: A subset of 20 nondemented older adults was drawn from the Einstein Aging Study, a community-based sample from the Bronx, NY. Pain was measured on 3 time scales: 1) acute pain right now (pain severity); 2) pain over the past 4 weeks (Short Form–36 Bodily Pain); 3) chronic pain over the past 3 months (Total Pain Index). Hippocampal data included volume data normalized to midsagittal area and N-acetylaspartate to creatine ratios (NAA/Cr).

Results: Smaller hippocampal volume was associated with higher ratings on the Short Form–36 Bodily Pain (r_s = 0.52, p = 0.02) and a nonsignificant trend was noted for higher ratings of acute pain severity (r_s = –0.44, p = 0.06). Lower levels of hippocampal NAA/Cr were associated with higher acute pain severity (r_s = –0.45, p = 0.05). Individuals with chronic pain had a nonsignificant trend for smaller hippocampal volumes (t = 2.00, p = 0.06) and lower levels of hippocampal NAA/Cr (t = 1.71, p = 0.10).

Conclusions: Older adults who report more severe acute or chronic pain have smaller hippocampal volumes and lower levels of hippocampal N-acetylaspartate/creatine, a marker of neuronal integrity. Future studies should consider the role of the hippocampus and other brain structures in the development and experience of pain in healthy elderly and individuals with Alzheimer disease.

Abbreviations: BIMC = Blessed Information Memory Concentration Test; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; MRS = magnetic resonance spectroscopy; NAA/Cr = N-acetylaspartate/creatine ratios; SF-36 BP = SF-36 Bodily Pain; TPI = Total Pain Index.

Disclosure: Author disclosures are provided at the end of the article.

Received March 4, 2009. Accepted in final form August 6, 2009.