Interaction between local blood flow and tolerance to prolonged pain in the elderly.

PURPOSE: We aimed to explore the link between local vasodilation and pain perception in elderly subjects, testing the hypothesis that altered local cutaneous blood flow participates in the decrease in pain tolerance with age. METHOD: Sixty-eight young and 83 older participants performed a pain tolerance test in which they hold their hand in an airtight box in which air temperature was regulated at 65 °C until the pain became unbearable. Participants continuously estimated pain intensity. Skin temperature and local blood flow in the box-exposed hand were continuously monitored. RESULTS: In the young group, 97% of subjects resisted pain until the end of the test, whereas only 53% in the elderly group managed to do so, indicating that pain tolerance is impaired in the elderly. Among all participants, the skin temperature associated with the first pain sensation was below the threshold for nociceptor activation (43 °C). Interestingly, blood flow in the elderly group was correlated with pain judgment, whereas no such correlation was observed in the young. CONCLUSION: Our results suggest that the local vasodilator response induced by local heating may be involved in pain perception and may influence thermal pain tolerance with aging. These results could contribute to a better understanding of vascular deficits and the development of chronic pain in vascular pathologies.

Preserved distraction analgesia but greater impact of pain on task performance in older adults compared with younger subjects.

OBJECTIVE: In this study, we compared two working memory conditions to study the analgesic effect of a distraction in elderly vs young people and the effect of pain on performance on the distracting task. METHODS: Younger (n=27) and older (n= 34) subjects performed 1- and 2-Back working memory tasks, representing low and high cognitive loads, respectively. Infrequent, brief hot nociceptive and cold non-nociceptive stimulations were delivered 100 ms before visual N-Back stimuli. Contact heat-evoked and cold-evoked potentials (N2P2 component) were analyzed in the absence of cognitive tasks and during the N-Back tasks. We compared the pain and cold intensity ratings and reaction times in trials preceded by nociceptive and cold stimulations and in trials not preceded by thermal stimulations between groups and between N-Back conditions. RESULTS: In both groups, performing the 1- and 2-Back working memory tasks reduced the perceived intensity of nociceptive and cold stimuli. In elderly subjects performing 2-Back memory tasks, response times to trials after nociceptive stimulation were longer than those to trials after cold or non-stimulation. By contrast, thermal stimulations had no effect on reaction times in young subjects. The amplitude of the N2P2 component was lower in the older than in the younger group in the absence of a cognitive task. In the older group, N-Back tasks had no effect on the N2P2 amplitude, whereas they reduced N2P2 amplitude in the young. CONCLUSION: Distraction analgesia is preserved in elderly subjects. However, this successful pain modulation seems to be accompanied by performance costs in the distracting tasks.

Effect of Virtual Reality Hypnosis on Pain Threshold and Neurophysiological and Autonomic Biomarkers in Healthy Volunteers: Prospective Randomized Crossover Study.

BACKGROUND: Virtual reality hypnosis (VRH) is a promising tool to reduce pain. However, the benefits of VRH on pain perception and on the physiological expression of pain require further investigation. OBJECTIVE: In this study, we characterized the effects of VRH on the heat pain threshold among adult healthy volunteers while monitoring several physiological and autonomic functions. METHODS: Sixty healthy volunteers were prospectively included to receive nociceptive stimulations. The first set of thermal stimuli consisted of 20 stimulations at 60°C (duration 500 milliseconds) to trigger contact heat evoked potentials (CHEPs). The second set of thermal stimuli consisted of ramps (1°C/second) to determine the heat pain threshold of the participants. Electrocardiogram, skin conductance responses, respiration rate, as well as the analgesia nociception index were also recorded throughout the experiment. RESULTS: Data from 58 participants were analyzed. There was a small but significant increase in pain threshold in VRH (50.19°C, SD 1.98°C) compared to that in the control condition (mean 49.45°C, SD 1.87; P<.001, Wilcoxon matched-pairs signed-rank test; Cohen d=0.38). No significant effect of VRH on CHEPs and heart rate variability parameters was observed (all P>0.5; n=22 and n=52, respectively). During VRH, participants exhibited a clear reduction in their autonomic sympathetic tone, as shown by the lower number of nonspecific skin conductance peak responses (P<.001, two-way analysis of variance; n=39) and by an increase in the analgesia nociception index (P<.001, paired t-test; n=40). CONCLUSIONS: The results obtained in this study support the idea that VRH administration is effective at increasing heat pain thresholds and impacts autonomic functions among healthy volunteers. As a nonpharmacological intervention, VRH has beneficial action on acute experimental heat pain. This beneficial action will need to be evaluated for the treatment of other types of pain, including chronic pain.

Accurate Determination of the Cold Detection Threshold with High-Speed Cooling of the Skin.

OBJECTIVE: This study used high-speed cooling of the skin and exact control of stimulus duration to measure the cold detection threshold in healthy participants. The objective was to compare the method of limits, in which the temperature is slowly and gradually increased/decreased until the subject perceives the stimulation, and the method of levels, in which the subject must detect brief thermal stimulations close to the threshold of perception. METHODS: Twenty healthy volunteers (nine women, 11 men) aged 20-30 years participated in the study. The method of limits and method of levels were performed in all subjects in a counterbalanced order. Four cold detection thresholds were measured with the method of levels, with a temperature ramp of 300°C/sec and stimulus durations of 50 ms, 100 ms, 300 ms, and 500 ms. Three thresholds were measured with the method of limits, with temperature ramps of 1°C/sec, 2°C/sec, and 4°C/sec. RESULTS: On average, the cold detection thresholds were -0.47°C below skin temperature with the method of levels and -1.67°C the method of limits. Interindividual variability was significantly lower with the method of levels than with the method of limits. CONCLUSIONS: These results suggest that the method of levels is more accurate than the method of limits for measuring cold detection threshold. The improvement of cold detection threshold measurement may provide new perspectives to more precisely assess the function of A-delta fibers and the spino-thalamic pathway.

Thermal sensitivity in humans at the depth of thermal receptor endings beneath the skin: validation of a heat transfer model of the skin using high-temporal resolution stimuli.

PURPOSE: The bioheat transfer equation predicts temperature distribution in living tissues such as the skin. This study aimed at psychophysically validating this model in humans. METHODS: Three experiments were performed. In the first, participants were asked to judge the thermal intensity of stimuli with combinations of intensity and duration that yielded, according to the model, identical temperatures at the thermoreceptor's depth. In experiment 2, participants' thermal detection thresholds for stimuli of different durations were measured to verify whether these thresholds correspond, according to the model, to equivalent temperatures at the thermoreceptor's location. In experiment 3, an alternative forced choice method was used, in which subjects indicated which of the two consecutive thermal stimulations was more intense. RESULTS: The model predicted results that agreed with subjects' perceptions. Participants judged stimuli of different combinations of intensities and durations yielding identical temperature at the receptor level as having equivalent intensity. Moreover, although cold detection thresholds for stimuli of different durations differed for temperatures of the stimulating probe, stimulations using the model's parameters showed equivalence at the depth of the thermal receptors. Furthermore, stimuli with temperature/duration combinations for which the model predicts temperature equivalence at the depth of the receptors corresponded to subjective equalization. CONCLUSION: These findings indicate that heat transfer models provide good estimates of temperatures at the thermal receptors. Use of these models may facilitate comparisons among studies using different stimulation devices and may facilitate the establishment of standards involving all stimulation parameters.

Effects of thermosensory aging well demonstrated by cold stimulations with high temporal resolution.

INTRODUCTION: The method of limits (MLi) is the most commonly used paradigm to measure the threshold of thermal stimuli. However, the threshold measured by MLi is dependent on reaction time (RT). Because RT in adults increases with age, the inclusion of RT in the MLi paradigm may result in an overestimation of thermal threshold in the older individuals. METHODS: A device with a very rapid cooling rate (300°C/s) was employed to measure cool thresholds by using the method of levels (MLe), a method independent of RT, in 11 older patients and 14 younger adults. RESULTS: Compared with the MLi, the MLe resulted in a greater than 2°C gain in threshold measurement accuracy in older patients. DISCUSSION: The MLe confirmed that cool perception threshold is dependent on age. The use of MLe provides new opportunities for the study of mechanisms underlying age-associated alterations in thermal perception. Muscle Nerve 60: 141-146, 2019.

Observational study found that even small variations in light can wake up very preterm infants in a neonatal intensive care unit.

AIM: This prospective observational study evaluated the behavioural responses of very preterm infants to spontaneous light variations. METHODS: We measured spontaneous light variations in the incubators of 27 very preterm infants, with a median gestational age of 28 weeks (range 26-31 weeks), over 10 hours. All of them had been admitted to the neonatal care unit of the Strasbourg University Hospital, France, between April 2008 and July 2009. Two independent raters examined changes in the infants' behavioural states using video recordings. The percentage of awakenings was recorded when there were light variations and during control periods with no changes. RESULTS: We analysed 275 periods following light variations and 275 control periods. The overall percentage of awakenings was greater during periods following a change in light than during control periods (16.3% vs 11%, p = 0.03). The extent of light protection affected the percentage of awakenings. In mild light protection, there were more awakenings following changes in light than in control periods (25.6% vs 6.7%, p = 0.01). This difference was not found in high light protection. CONCLUSION: Very preterm infants can be woken up by small variations in light, when the light protection in their incubator is insufficient.

Feeling of control of an action after supra and subliminal haptic distortions.

Here we question the mechanisms underlying the emergence of the feeling of control that can be modulated even when the feeling of being the author of one's own action is intact. With a haptic robot, participants made series of vertical pointing actions on a virtual surface, which was sometimes postponed by a small temporal delay (15 or 65 ms). Subjects then evaluated their subjective feeling of control. Results showed that after temporal distortions, the hand-trajectories were adapted effectively but that the feeling of control decreased significantly. This was observed even in the case of subliminal distortions for which subjects did not consciously detect the presence of a distortion. Our findings suggest that both supraliminal and subliminal temporal distortions that occur within a healthy perceptual-motor system impact the conscious experience of the feeling of control of self-initiated motor actions.

Very preterm infants can detect small variations in light levels in incubators.

AIM: This prospective observational study was designed to improve our understanding of the responses of very preterm infants to light level variations in incubators and to evaluate what determined those reactions. METHODS: The physiological responses of 27 very preterm infants were analysed following variations in the light level environments of their incubators over 10 hours. Heart and respiratory rates, systemic oxygen saturation and regional cerebral oxygen saturations were recorded using near-infrared spectroscopy, and the variation of each parameter was analysed. RESULTS: We analysed 332 light level changes. Heart rate increased by 3.8 beats per minute (range -2.6 to 12.6), respiratory rate by six cycles per minute (-1.5 to 26) and regional cerebral oxygen saturation by 1.1% (-0.5% to 3.9%) (p < 0.05 each) when delta lux was over 50. Only respiratory rate decreased significantly, by -8.4 cycles per minute (-28 to -0.4), when delta lux was 50 or lower (p < 0.05). The initial level of illumination altered the very preterm infants' responses, with higher reactivity for higher ambient light levels. CONCLUSION: Very preterm infants reacted to moderate variations in illumination in their incubator, within recommended ranges of light levels, suggesting that they may detect even small light level variations.

Moderate acoustic changes can disrupt the sleep of very preterm infants in their incubators.

AIM: To evaluate the impact of moderate noise on the sleep of very early preterm infants (VPI). METHODS: Observational study of 26 VPI of 26-31 weeks' gestation, with prospective measurements of sound pressure level and concomitant video records. Sound peaks were identified and classified according to their signal-to-noise ratio (SNR) above background noise. Prechtl's arousal states during sound peaks were assessed by two observers blinded to the purpose of the study. Changes in sleep/arousal states following sound peaks were compared with spontaneous changes during randomly selected periods without sound peaks. RESULTS: We identified 598 isolated sound peaks (5 ≤ SNR < 10 decibel slow response A (dBA), n = 518; 10 ≤ SNR < 15 dBA, n = 80) during sleep. Awakenings were observed during 33.8% (95% CI, 24-43.7%) of exposures to sound peaks of 5-10 dBA SNR and 39.7% (95% CI, 26-53.3%) of exposures to sound peaks of SNR 10-15 dBA, but only 11.7% (95% CI, 6.2-17.1%) of control periods. The proportions of awakenings following sound peaks were higher than the proportions of arousals during control periods (p < 0.005). CONCLUSIONS: Moderate acoustic changes can disrupt the sleep of VPI, and efficient sound abatement measures are needed.

An electronical stimulator for quantitative sensory testing and evoked potential analysis of tactile Aß nerve fibers.

OBJECTIVE: We aimed to determine the ability of an innovative device, the Cutaneous Mechanical Stimulator (CMS), to evaluate touch sensory pathways in Human. METHODS: Two experiments were conducted in 23 healthy volunteers aged 20-30 years. In the first, mechanical detection thresholds (MDTs) were assessed using Semmes-Weinstein monofilaments and the CMS. In the second experiment, touch-evoked potentials (TEPs) elicited by tactile stimulation of the CMS on the left hand dorsum and left foot dorsum were recorded. Electroencephalographic (EEG) data were recorded at each cutaneous stimulation site in blocks of 20 tactile stimulations delivered by the CMS. The data were segmented into 1000-ms epochs. RESULTS: MDTs measured by monofilaments and by the CMS were equivalent. Analyses of TEPs showed N2 and P2 components. The latencies of the N2 components on the hand dorsum and foot dorsum resulted in an estimated average conduction velocity of about 40 m.s-1, within the range of Aß fibers. CONCLUSIONS: These findings showed that the CMS could assess touch sensory pathways in young adults. SIGNIFICANCE: The CMS can offer new research perspectives, as this device allows easy assessment of the MDT and enables estimation of fiber conduction velocities after tactile stimulation by the device synchronized with EEG recordings.

Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses.

Immersive virtual reality (VR) is a promising tool to reduce pain in clinical setting. Digital scripts displayed by VR disposals can be enriched by several analgesic interventions, which are widely used to reduce pain. One of these techniques is hypnosis induced through the VR script (VRH) which is facilitated by immersive environment and particularly efficient even for low hypnotizable patients. The aim of this study is to assess the efficacy of a VRH script on experimentally induced cold pain perception (intensity and unpleasantness) and physiological expression. 41 healthy volunteers had been recruited in this within-subjects study. They received 9 stimulations of 20 s (3 non-nociceptive cold; 3 low nociceptive cold and 3 highly nociceptive cold) during a VRH session of 20 min (VRH condition) or without VRH (noVRH condition). Physiological monitoring during the cold pain stimulation protocol consisted of recording heart rate, heart rate variability and respiratory frequency. Maximum cold pain intensity perception, measured through the visual analog scale (VAS) on 10, was of 3.66 ± 1.84 (VAS score/10) in noVRH condition and 2.46 ± 1.54 in VRH (Wilcoxon, p < 0.0001). Considering pain unpleasantness perception, 3.68 ± 2.06 in noVRH and 2.21 ± 1.63 in VRH (Wilcoxon, p < 0.0001). Hypnotizability negatively correlated with the decrease in VAS intensity from noVRH to VRH (Spearman r = -0.45; p = 0.0038). In our sample, we found that 31/41 volunteers (75.6%) displayed a reduction of more than 10% of their VAS pain intensity and unpleasantness scores. Trait anxiety was the best predictor of the VRH responders, as well as heart rate variability. In addition, respiratory rate was diminished under VRH in every subgroup. VRH is an effective tool to reduced pain intensity and unpleasantness in a vast majority of healthy subjects. We further indicate in this study that heart rate variability parameter RMSSD (root mean square of successive differences) is a good predictor of this effect, as well as anxiety as a personality trait (but not state anxiety). Further studies are expected to determine more precisely to whom it will be the most useful to offer tailored, non-pharmacological pain management solutions to patients.

Infants born very preterm react to variations of the acoustic environment in their incubator from a minimum signal-to-noise ratio threshold of 5 to 10 dBA.

INTRODUCTION: Very early preterm infants (VPIs) are exposed to unpredictable noise in neonatal intensive care units. Their ability to perceive moderate acoustic environmental changes has not been fully investigated. RESULTS: Physiological values of the 598 isolated sound peaks (SPs) that were 5-10 and 10-15 dB slow-response A (dBA) above background noise levels and that occurred during infants' sleep varied significantly, indicating that VPIs detect them. Exposure to 10-15 dBA SPs during active sleep significantly increased mean heart rate and decreased mean respiratory rate and mean systemic and cerebral oxygen saturations relative to baseline. DISCUSSION: VPIs are sensitive to changes in their nosocomial acoustic environment, with a minimal signal-to-noise ratio (SNR) threshold of 5-10 dBA. These acoustic changes can alter their well-being. METHODS: In this observational study, we evaluated their differential auditory sensitivity to sound-pressure level (SPL) increments below 70-75 dBA equivalent continuous level in their incubators. Environmental (SPL and audio recording), physiological, cerebral, and behavioral data were prospectively collected over 10 h in 26 VPIs (GA 28 (26-31) wk). SPs emerging from background noise levels were identified and newborns' arousal states at the time of SPs were determined. Changes in parameters were compared over 5-s periods between baseline and the 40 s following the SPs depending on their SNR thresholds above background noise.

Investigating cold Aδ fibers in the 0-40 °C temperature range: A quantitative sensory testing and evoked potentials study.

OBJECTIVE: To evaluate the activity of cold Aδ-type fibers to thermal stimuli above human skin temperature (i.e., >32 °C). METHODS: Twenty young adults aged 20-24 years participated in this study. The cold-detection threshold was measured from a basal temperature of 40 °C using an adaptive staircase method with high-speed cooling ramps (170 °C/s). A total of 150 stimulations at 36 °C, 32 °C, 28 °C, 24 °C, 20 °C, 16 °C, 12 °C, 8 °C, 4 °C and 0 °C (15 each) were performed. After each stimulation, subjects estimated the intensity of cold sensation using a visual analog scale, and evoked potentials were recorded. RESULTS: The average cold-detection threshold was 35 °C (SD = 1.8). Regardless of the stimulation temperature, subjects reported a cooling sensation. Interestingly, reported increments in sensation were prominent for stimulation temperatures between 32 °C and 20 °C, but below this latter temperature sensations varied only very slightly. Evoked potential recordings revealed that decreasing temperature stimuli from a baseline of 40 °C induced a previously unreported N2P2 component with a mean N2 peak latency of 275 ms (SD = 13.1). The peak-to-peak amplitude of the N2P2 complex increased as the intensity of the cooling stimulation increased, exhibiting a profile comparable to subject-perceived intensity, namely, a major increase up to 20 °C, followed by a plateau to 0 °C. CONCLUSIONS: The cool sensations reported by subjects were likely conveyed by Aδ fibers rather than by slow-conducting C fibers. Moreover, our rapid stimulation technique starting from a high temperature (40 °C) was capable of a) generating cold sensations at stimulation temperatures between 36 °C and 32 °C, and b) revealing the optimal activation range of Aδ fibers (20 °C-28 °C). Any decrease in temperature below this range did not result in a significant increase in sensation and thus probably did not evoke a significant increase in Aδ fiber activity. SIGNIFICANCE: The regular assessment of cold sensation in peripheral neuropathies (i.e., with temperatures below 32 °C), could be completed by investigating cold-detection thresholds at temperatures ranging from 40 °C to 32 °C. Indeed, the absolute threshold of cold perception appears to start at 35 °C. Changes in the activation threshold of cold fibers were more easily detectable at this level.

Impact of motivation on cognitive control in the context of vigilance lowering: an ERP study.

We assessed the effects of time-on-task on cognitive control expressed by the CRN/Nc and the extent to which motivation modulates this relationship. We utilized two groups of participants, who were told that their performance would (evaluation condition) or would not (control condition) be evaluated online. Both groups performed a version of the Eriksen Flanker Task for 60 min. We observed classical vigilance lowering, manifested by a progressive performance decline with time-on-task, in the control, but not in the evaluation, condition. In the latter, performance remained stable throughout the task. ERP analysis indicated the same interaction in our main component of interest, the CRN/Nc, whose amplitude decreased from the first to the last period in the control condition but remained stable over time in the evaluation condition. To our knowledge, this study is the first to demonstrate the impact of motivation on monitoring processes as indexed by the correct response negativity, in the context of a prolonged task. Vigilance lowering caused by a repetitive and prolonged flanker task, results in compromised response control and compromised control of correct responses. Our results suggest that alterations in ACC functioning may underlie vigilance decline and can be viewed as evidence that the action monitoring functions of the ACC can be positively affected by motivation.

Dominance of vision over proprioception on motor programming: evidence from ERP.

The brain determines positions and movements of body parts from inputs arising at least from vision and proprioception. Using the brain event-related potential called the lateralized readiness potential, which reflects motor cortical activity during motor programming, we showed in a motor task that viewing one hand in a sagittal mirror-giving the impression to see the opposite hand-generated activity in the motor cortex of the seen hand (i.e., of the nonmoving hand hidden behind the mirror). The visual influence on cortical motor region occurred even when the proprioceptive input related to the real opposite effector was not aligned on the visual feedback of the hand given by the mirror. This dominance vision over proprioception was greatly reduced when the task was executed in the dark with hand position represented by small lights fixed on the moving hand, with no motor activity being recorded in the cortical area of the inactive hand. These results give new insights into how the brain weights and integrates visual and proprioceptive information in motor control.

Spinal integration of hot and cold nociceptive stimuli by wide-dynamic-range neurons in anesthetized adult rats.

INTRODUCTION: Early neuronal processing of thermal noxious information relies mostly on molecular detectors of the transient receptor potential family expressed by specific subpopulation of sensory neurons. This information may converge to second-order wide-dynamic-range (WDR) neurons located in the deep layer of the dorsal horn of the spinal cord. METHOD: Using a micro-Peltier thermode thermal contact stimulator II delivering various cold and hot noxious stimulations, we have characterized the extracellular electrophysiological responses of mechanosensitive WDR neurons in anesthetized adult male and female Wistar rats. RESULTS: Most of the WDR neurons were activated after hot and cold noxious stimulations, at mean temperature thresholds corresponding to 43 and 20°C, respectively. If the production of action potential was not different in frequency between the 2 thermal modalities, the latency to observe the first action potential was significantly different (cold: 212 ms; hot: 490 ms, unpaired Student t-test: t = 8.041; df = 32; P < 0.0001), suggesting that different fiber types and circuits were involved. The temporal summation was also different because no facilitation was seen for cold noxious stimulations contrary to hot noxious ones. CONCLUSION: Altogether, this study helps better understand how short-lasting and long-lasting hot or cold noxious stimuli are integrated by mechanosensitive WDR neurons. In our experimental conditions, we found WDR neurons to be nociceptive specific for C-fiber-mediated hot stimuli. We also found that cold nonnoxious and noxious information, triggered at glabrous skin areas, are likely taken in charge by A-type sensory neurons. This study will be helpful to establish working hypothesis explaining the thermal pain symptoms displayed by animal models and patients in a translational extent.

Pain Behavioural Response to Acoustic and Light Environmental Changes in Very Preterm Infants.

Noise and high light illumination in the neonatal intensive care unit (NICU) are recognized as stressors that could alter the well-being and development of vulnerable preterm infants. This prospective observational study evaluated the pain behaviours of very preterm infants (VPIs) to sound peaks (SPs) and light levels variations (LLVs) in the NICU. We measured spontaneously occurring SPs and LLVs in the incubators of 26 VPIs over 10 h. Their behavioural responses were analysed through video recordings using the "Douleur Aigue du Nouveau-né" (DAN) scale. We compared the maximum DAN scores before and after environmental stimuli and the percentage of VPIs with a score ≥ 3 according to the type of stimuli. A total of 591 SPs and 278 LLVs were analysed. SPs of 5 to 15 dBA and LLVs significantly increased the maximum DAN scores compared to baseline. The occurrence of DAN scores ≥ 3 increased with both stressors, with a total of 16% of SPs and 8% of LLVs leading to quantifiable pain behaviour. Altogether, this study shows that VPIs are sensitive to SPs and LLVs, with a slighter higher sensitivity to SPs. The mechanisms leading to pain behaviours induced by noise and light changes should be evaluated further in the context of VPIs brain development. Our results provide further arguments to optimize the NICU sensory environment of neonatal units and to adapt it to the expectations and sensory abilities of VPIs.

Volatility of subliminal haptic feedback alters the feeling of control in schizophrenia.

It has been proposed that agency disorders found in schizophrenia rely on aberrant processing of prediction error. Overreactivity to nonpertinent prediction errors may lead to the attribution of one's own actions to an external source. When applied to perception, this could explain hallucinations. However, experiments in motor control or perception have mainly suggested deficient prediction errors. Using a novel approach based on the manipulation of temporal delays, 23 patients with schizophrenia, 18 patients with bipolar disorder, and 22 healthy participants performed a pointing task with a haptic device that provided haptic feedback without or with delays, which were processed consciously (65 ms) or unconsciously (15 ms). The processing of prediction errors was measured via the adaptation of the hand trajectory, that is, the deceleration in anticipation of the surface, and its modulation as a function of recent history (stable or unstable sensory feedback). Agency was evaluated by measuring the participants' feeling of controlling the device. Only patients with schizophrenia reported a decrease in the feeling of control following subliminally delayed haptic feedback and adapted deceleration durations following subliminally delayed haptic feedback. This effect was correlated with positive symptoms. The overreactivity to subliminal delays was present only when delays occurred repeatedly in an unpredictable way, that is, with a volatile distribution. The results suggest that small temporal uncertainties that should be held as negligible, trigger an aberrant overreactivity which could account for hallucinations and alterations of the patients' conscious feeling of control. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Involvement of Frontal Functions in Pain Tolerance in Aging: Evidence From Neuropsychological Assessments and Gamma-Band Oscillations.

Reduced pain tolerance may be one of the possible explanations for high prevalence of chronic pain among older people. We hypothesized that age-related alterations in pain tolerance are associated with functioning deterioration of the frontal cortex during normal aging. Twenty-one young and 41 elderly healthy participants underwent a tonic heat pain test, during which cerebral activity was recorded using electroencephalography (EEG). Elderly participants were divided into two subgroups according to their scores on executive tests, high performers (HPs; n = 21) and low performers (LPs; n = 20). Pain measures [exposure times (ETs) and perceived pain ratings] and cerebral activity were compared among the three groups. ETs were significantly lower in elderly LPs than in young participants and elderly HPs. Electroencephalographic analyses showed that gamma-band oscillations (GBOs) were significantly increased in pain state for all subjects, especially in the frontal sites. Source analysis showed that GBO increase in elderly LPs was contributed not only by frontal but also by central, parietal, and occipital regions. These findings suggest that better preservation of frontal functions may result in better pain tolerance by elderly subjects.