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ACTIVATION OF THE PERIGENUAL ACC AND ORBITOFRONTAL CORTEX REPRESENTING PAIN-RELATED UNPLEASANTNESS LED TO HIGHER PAIN RATINGS IN INDIVIDUALS WITH LOW COMPARED TO HIGH TESTOSTERONE LEVELS
Author(s): ,
Choi, J.C.*
Affiliations:
Yonsei University Wonju College of Medicine, Department of Anesthesiology and Pain Medicine, Wonju, Republic of Korea
,
Park, Y.H.
Affiliations:
Hanyang University, Department of Biomedical Engineering, Seoul, Republic of Korea
,
Park, S.K.
Affiliations:
Yonsei Danaa Pain Clinic, Yonsei Danaa Pain Clinic, Seoul, Republic of Korea
,
Lee, J.S.
Affiliations:
Hanyang University, Department of Biomedical Engineering, Seoul, Republic of Korea
Lee, J.M.
Affiliations:
Hanyang University, Department of Biomedical Engineering, Seoul, Republic of Korea
ESRA Academy. Choi J. Sep 13, 2017; 190787
Topic: Physiology - Pathophysiology
Prof. Jae Chan Choi
Prof. Jae Chan Choi

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Abstract
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Background and Aims:

Men with low levels of testosterone tend to be more anxious and irritable than men with normal testosterone levels. This study investigated whether activation of brain regions that represent pain intensity [primary somatosensory cortex (S1)] and pain-related unpleasantness [perigenual anterior cingulate cortex (pACC) and orbitofrontal cortex (OFC)] were affected by blood testosterone levels.

Methods:

Local Ethics Committee approval was obtained. Twenty-six healthy men were recruited. Before fMRI scanning, Blood testosterone levels were measured. The participants were classified into two groups (high vs. low testosterone) according to their blood testosterone level (each group n = 13). To induce identical noxious stimulation in all participants, the middle finger was immersed in a 50°C water bath (50°C, 30 s, five times).

Results:

Pain, unpleasantness, anxiety, and fear ratings were statistically significantly higher in the low testosterone group compared to the high testosterone group. Fear rating increased as pain rating rose and as testosterone level decreased. During noxious stimulation, the pACC and OFC were statistically significantly more highly activated in the low testosterone group compared to the high testosterone group. Activation of S1, a brain region that represents pain intensity, did not differ between groups.  

Conclusions:

Activation of the perigenual ACC and orbitofrontal cortex representing pain-related unpleasantness led to higher pain ratings in individuals with low compared to high testosterone levels. These findings indicate that the effects of testosterone level should be considered when treating patients and also suggest that acute clinical pain may be relieved by managing and controlling testosterone levels.

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