Chronic Musculoskeletal Pain Moderates the Association between Sleep Quality and Dorsostriatal-Sensorimotor Resting State Functional Connectivity in Community-Dwelling Older Adults

Abstract

Aging is associated with poor sleep quality, and greater chronic pain prevalence with age-related changes in brain function as potential underlying mechanisms. The following cross-sectional study aimed to determine whether self-reported chronic musculoskeletal pain in community-dwelling older adults moderates the association between sleep quality and resting state functional brain connectivity (rsFC). Community-dwelling older individuals (mean age=73.29 years) part of the NEPAL study who completed the Pittsburg Sleep Quality Index (PSQI) and an rsFC scan were included (n=48) in the present investigation. To that end, we tested the effect of chronic pain-by-PSQI interaction on rsFC among atlas-based brain regions-of-interest, controlling for age and sex. A significant network connecting the bilateral putamen and left caudate with bilateral precentral gyrus, postcentral gyrus and juxtapositional lobule cortex, survived global multiple comparisons (FDR; q<0.05) and threshold-free network-based-statistics. Greater PSQI scores were significantly associated with greater dorsostriatal-sensorimotor rsFC in the no-pain group, suggesting that a state of somatomotor hyperarousal may be associated with poorer sleep quality in this group. However, in the pain group greater PSQI scores were associated with less dorsostriatal-sensorimotor rsFC, possibly due to a shift of striatal functions toward regulation sensorimotor aspects of the pain experience, and/or aberrant cortico-striatal loops in the presence of chronic pain. This preliminary investigation advances knowledge about the neurobiology underlying the associations between chronic pain and sleep in community-dwelling older adults that may contribute to the development of effectitractve therapies to decrease disability in geriatric populations. This work was supported by the National Institutes of Aging (NIAK01AG048259, R01AG059809, R01AG067757, and T32AG049673). A portion of this work was performed in the McKnight Brain Institute at the National High Magnetic Field Laboratory's Advanced Magnetic Resonance Imaging and Spectroscopy (AMRIS) Facility, which is supported by National Science Foundation Cooperative Agreement No. DMR-1644779 and DMR-1157490, and the State of Florida and the University of Florida Claude D. Pepper Older Americans Independence Center.