Testosterone effects on pain and brain activation patterns

J. C. Choi, Y. H. Park, S. K. Park, J. S. Lee, J. Kim, J. I. Choi, K. B. Yoon, S. Lee, D. E. Lim, J. Y. Choi, M. H. Kim, G. Park, Sang Sik Choi, J. M. Lee

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Abstract

Background: This study investigated whether pain and pain-related unpleasantness ratings were altered by blood testosterone levels. We also investigated whether activation of brain regions that represent pain intensity [primary somatosensory cortex (S1)] and pain-related unpleasantness [perigenual ACC (pACC) and orbitofrontal cortex (OFC)] were affected by blood testosterone levels. Methods: Twenty-six healthy men were recruited. Blood testosterone levels were measured before fMRI scanning. The participants were classified into two groups (high vs. low testosterone) according to their blood testosterone level (each group n = 13). The middle finger was immersed in a 50°C water bath (50°C, 30 s, five times) to induce identical noxious stimulation in all participants. Results: The low testosterone group showed statistically significantly higher pain (P = 0.047), unpleasantness (P = 0.047), anxiety (P = 0.015), and fear ratings (P = 0.01) than the high testosterone group. Fear rating increased as pain rating rose and as testosterone level decreased (P < 0.001). When participants received noxious stimulation, the pACC and OFC were more highly activated in the low testosterone group compared to the high testosterone group. Activation of S1, a region related to pain intensity, did not differ between both groups. Conclusion: Compared to the high testosterone group, the low testosterone group had significant activation in the pACC and OFC, regions that represent pain-related unpleasantness, but not in S1 that represents pain intensity, leading to higher pain ratings. These findings emphasize the importance of considering the effects of testosterone levels when treating patients.

Original languageEnglish
Pages (from-to)668-675
Number of pages8
JournalActa Anaesthesiologica Scandinavica
Volume61
Issue number6
DOIs
Publication statusPublished - 2017 Jul 1

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Choi, J. C., Park, Y. H., Park, S. K., Lee, J. S., Kim, J., Choi, J. I., Yoon, K. B., Lee, S., Lim, D. E., Choi, J. Y., Kim, M. H., Park, G., Choi, S. S., & Lee, J. M. (2017). Testosterone effects on pain and brain activation patterns. Acta Anaesthesiologica Scandinavica, 61(6), 668-675. https://doi.org/10.1111/aas.12908