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Pain processing in dementia and its relation to neuropathology
Erik J A Scherder1, Joseph A Sergeant, Dick F Swaab
1Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, Netherlands. EJA.Scherder@psy.vu.nl
The Lancet. Neurology
|October 24, 2003
Summary
Neuropathology significantly impacts pain perception in dementia subtypes. Alzheimer's and frontotemporal dementia may decrease pain affect, while vascular dementia might increase it, guiding future pain assessment strategies.
Area of Science:
- Neuroscience
- Gerontology
- Pathology
Background:
- Clinical pain assessment in dementia often overlooks neuropathology.
- Understanding dementia's neuropathological effects on pain systems is crucial.
Purpose of the Study:
- To review the neuropathological effects of dementia on medial and lateral pain systems.
- To correlate neuropathological changes with altered pain experiences in different dementia subtypes.
Main Methods:
- Review of studies on Alzheimer's disease (AD), vascular dementia, and frontotemporal dementia.
- Brief review of Lewy-body disease and Creutzfeldt-Jakob disease neuropathology.
- Analysis of how neuropathological features like atrophy and white-matter lesions impact pain.
Main Results:
- Dementia subtypes share neuropathological features but differ in their impact on pain areas.
- Alzheimer's disease and frontotemporal dementia often show reduced motivational and affective pain components.
- Vascular dementia may present with an increased affective pain experience.
Conclusions:
- Neuropathological variations across dementia subtypes lead to distinct changes in pain perception.
- Future pain assessment in dementia should integrate experimental pain data with neuropathological findings.