Pain sensitivity is increased across all severities of AD when measured using the FACS. Clinical observational pain scales support the relevance of facial expression as a partial compensatory pain communication modality for AD. However, measures of pain behavior that sum across objective coding of several domains provide a better indicator of subjective pain than measures of facial expression alone.
These findings provide behavioral and subjective-report evidence of increased acute pain sensitivity in AD, which should be taken into consideration with respect to pain management across the spectrum of AD severity.
While pain behaviors are increased in Alzheimer’s disease (AD) patients compared to healthy seniors (HS) across multiple disease stages, autonomic responses are reduced with advancing AD. To better understand the neural mechanisms underlying these phenomena, we undertook a controlled cross-sectional study examining behavioral (Pain Assessment in Advanced Dementia, PAINAD scores) and autonomic (heart rate, HR) pain responses in 24 HS and 20 AD subjects using acute pressure stimuli. Resting-state fMRI was utilized to investigate how group connectivity differences were related to altered pain responses. Pain behaviors (slope of PAINAD score change and mean PAINAD score) were increased in patients vs. controls. Autonomic measures (HR change intercept and mean HR change) were reduced in severe vs. mildly affected AD patients. Group functional connectivity differences associated with greater pain behavior reactivity in patients included: connectivity within a temporal limbic network (TLN) and between the TLN and ventromedial prefrontal cortex (vmPFC); between default mode network (DMN) subcomponents; between the DMN and ventral salience network (vSN). Reduced HR responses within the AD group were associated with connectivity changes within the DMN and vSN—specifically the precuneus and vmPFC. Discriminant classification indicated HR-related connectivity within the vSN to the vmPFC best distinguished AD severity. Thus, altered behavioral and autonomic pain responses in AD reflects dysfunction of networks and structures subserving affective, self-reflective, salience and autonomic regulation.
The purpose of this laboratory study involving repeated measures of emotion as 214 undergraduates (58.4% male) learned a complex video game was to address the need for empirical research on dynamic personality constructs by examining how two aspects of affect variability-spin and pulse-explain variance in skill acquisition and adaptive performance. Spin refers to within-person fluctuations in affect pleasantness and activation potential. Pulse refers to within-person fluctuations in affect intensity. Despite research showing high affect variability reflects a personality profile of heighted reactivity to emotionally charged events and poor adjustment, little empirical research has examined their relationships with behavioral outcomes, much less aspects of skilled performance. Compared to traditional measures of personality, which yield weak effects for predicting acquisition and adaptive performance, measures of affect variability hold considerable promise because they, like performance, reflect dynamic within-person phenomena. Accordingly, the main question addressed by this study was whether spin and pulse incrementally explain acquisition and adaptive performance beyond Big Five measures of personality. In general, we expected harmful, incremental effects for both spin and pulse, and hypothesized two mechanisms for these harmful effects: (1) by undermining effort and (2) by undermining the effort-performance relationship. Using a task-change paradigm and discontinuous growth modeling that disentangled adaptation from acquisition, results showed that affect variability, independent of the Big Five, produced harmful effects via both hypothesized mechanisms. Participants higher in affect spin and pulse showed less sustained effort across performance sessions and exhibited lower performance. Furthermore, the harmful effects of spin and pulse were stronger in adaptation compared to acquisition, with pulse showing stronger direct effects on performance during adaptation and spin moderating the effort-performance relationship such that effort was only beneficial during adaptation for those lower in spin. In light of these results, one might question the common advice "keep calm and carry on," which may not be viable for persons high in affect variability. Accordingly, results are discussed in terms of the need to better understand the specific mediating processes by which high affect variability undermines success across a variety of learning and performance contexts.
Background Videogames are emerging as increasingly popular tools for training complex skills, in part due to their potential for improving the transfer of learning to changing demands. One caveat is that training outcomes are primarily influenced by a learner’s capability and willingness to engage in adaptive learning processes. The present study examined the role of epistemic curiosity as a predisposition for seeking information and resolving gaps in knowledge. Method Using a game-based learning environment with strong cognitive and perceptual-motor demands, we tested the effects of interest- and deprivation-type epistemic curiosity on performance during skill acquisition and adaptation to unforeseen change. A task-change paradigm and piecewise latent trajectory model disentangled the effects on performance trajectories corresponding to skill acquisition and adaptation. Results Interest-type epistemic curiosity, but not deprivation-type, was positively related to baseline performance, even after controlling for cognitive ability and videogame experience. Moreover, the positive effect of interest-type epistemic curiosity on post-change performance (i.e., adaptation) was fully mediated by pre-change performance. Discussion These findings indicate that interest-type epistemic curiosity is particularly important in the earlier phases of learning, but explains little variability in adaptive performance beyond its direct influence on performance acquired prior to change. This research speaks to the roles of individual differences in cognition and motivation during game-based learning.
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