Chronic Musculoskeletal Pain Moderates the Association between Sleep Quality and Dorsostriatal-Sensorimotor Resting State Functional Connectivity in Community-Dwelling Older Adults

Abstract

Aging is associated with poor sleep quality and greater chronic pain prevalence, with age-related changes in brain function as potential underlying mechanisms. Objective. The following cross-sectional study aimed to determine whether self-reported chronic musculoskeletal pain in community-dwelling older adults moderates the association between sleep quality and resting state functional brain connectivity (rsFC). Methods. Community-dwelling older individuals (mean age = 73.29 years) part of the NEPAL study who completed the Pittsburg Sleep Quality Index (PSQI) and a rsFC scan were included (n = 48) in the present investigation. To that end, we tested the effect of chronic pain-by-PSQI interaction on rsFC among atlas-based brain regions-of-interest, controlling for age and sex. Results and Discussion. A significant network connecting the bilateral putamen and left caudate with bilateral precentral gyrus, postcentral gyrus, and juxtapositional lobule cortex, survived global multiple comparisons (FDR; q < 0.05) and threshold-free network-based-statistics. Greater PSQI scores were significantly associated with greater dorsostriatal-sensorimotor rsFC in the no-pain group, suggesting that a state of somatomotor hyperarousal may be associated with poorer sleep quality in this group. However, in the pain group, greater PSQI scores were associated with less dorsostriatal-sensorimotor rsFC, possibly due to a shift of striatal functions toward regulation sensorimotor aspects of the pain experience, and/or aberrant cortico-striatal loops in the presence of chronic pain. This preliminary investigation advances knowledge about the neurobiology underlying the associations between chronic pain and sleep in community-dwelling older adults that may contribute to the development of effective therapies to decrease disability in geriatric populations.

Brain-predicted age difference mediates the association between PROMIS sleep impairment, and self-reported pain measure in persons with knee pain

“…Also, aging is associated with poor sleep quality and greater chronic pain prevalence [5] , [24] , [41] , [53] , with age-related changes in brain structure [8] , [28] , [30] , [29] and function as potential underlying mechanisms [18] , [27] , [33] , [37] . Given that sleep disorders, and chronic pain in older age are both related to brain alterations [38] , [43] , [44] , [55] , [62] , the interplay between these variables is of considerable interest to researchers and clinicians.…”

“…Considering the known sleep-pain associations [1] , [3] , [11] , [21] , [33] , [37] , [43] , [44] , [48] , [49] , [60] , it is important to evaluate how sleep quality and chronic pain are interrelated in the context of brain aging processes. Using a brain aging biomarker to detect brain alterations related to certain pathologies comes with several advantages.…”