Rehaussement de la mémoire de travail et de l'inhibition de la douleur par la neuromodulation du cortex préfrontal dorsolatéral gauche chez des personnes jeunes et âgées = Improving working memory and pain inhibition using neuromodulation of left dorsolateral prefrontal cortex in young and older persons
Objective: This thesis aimed to examine whether pain inhibition by working memory (WM) engagement can be enhanced by Transcranial Direct Current Stimulation (tDCS) in young and older healthy volunteers. Directing attention away from painful stimuli is under the control of WM that allows the selection of task-relevant information and directing attention towards task execution. However, top-down inhibition of nociceptive activity and pain may be altered in normal aging due to decreased WM. tDCS is a promising method in this regard since anodal tDCS of the left dorsolateral prefrontal cortex (DLPFC) was shown to improve WM performance. Methods: Two experiments were conducted on forty healthy (first study) and fifteen older volunteers (second study). They participated in two tDCS sessions (sham and anodal tDCS), in which the pain was evoked by electrical stimulation at the ankle. Participants performed an n-back task (0-back and 2-back) while they received random electrical stimulation to produce pain and the nociceptive flexion reflex, an index of spinal nociception. The experimental protocol comprised five counterbalanced conditions (0-back, 2-back, pain, 0-back with pain and 2-back with pain) that were performed twice (pre-tDCS baseline and during tDCS). Results: In both studies, neuromodulation of left DLPFC enhanced pain inhibition by WM. However, the nociceptive flexion reflex was not modulated by WM enhancement suggesting that improvement of pain inhibition by WM using tDCS is supraspinal and independent of descending inhibitory pathways. These studies improve our understanding of the interactions between cognition, pain and age and show how neuromodulation may change these interactions to improve pain inhibition. Findings support the development of neuromodulation protocols for pain management in older persons.
Neuromodulation Nociception Cognition Transcranial Direct Current Stimulation Pain Nociceptive Aging Descending modulation Working memory