Age-Related Changes in the Structure and Function of Brain Regions Involved in Pain Processing

Objective. This review summarizes the scientific literature addressing the effects of aging on pain processing in the brain. Design. A literature search was undertaken using PubMed and search terms including pain, aging, and brain. Settings and Patients. Studies including healthy older people and older people with painful disorders were reviewed. Measures. Publications reporting the outcomes of neuroimaging techniques including positron emission tomography, structural and functional magnetic resonance imaging, and electroencephalography in samples incorporating older people were reviewed. Results. Age-related decreases in regional brain volume occur in structures implicated in pain processing, and are most pronounced in the prefrontal cortex and hippocampus, whereas age-related atrophy in brainstem regions involved in pain modulation is less pronounced. Functional brain imaging has revealed decreased pain activation in the putamen and insula among older people during extrinsic stimuli, but any effects of aging on the processing of clinical pain are yet to be reported. Conclusions. The network of brain regions involved in pain processing are subject to age-related changes in structure, but that the functional implications of these changes are yet to be determined.