Pain, Brain and Mobility Study (PBAM)

Inclusion Criteria:

• Age 65 years and older
• Willingness to participate in all study procedures
• Cognitively intact as defined by 3MS score > 80

Exclusion Criteria:

• Failure to provide informed consent;
• Contraindications to MRI, such as claustrophobia, heart pacemaker / defibrillator, heart valve prosthesis, aneurysm clip, metallic stent, neurostimulation system, cochlear implants or inner ear prosthesis, insulin pump or other infusion pump, metal slivers in the orbital area/eye socket
• Active treatment for cancer or history of cancer in the past year
• Severe cardiac disease, including New York Heart Association (NYHA) Class III or IV congestive heart failure, clinically significant aortic stenosis, history of cardiac arrest or stroke, use of a cardiac defibrillator, or uncontrolled angina;
• Previous stroke with upper and/or lower extremities involvement within the last 6 months
• History of life-threatening cardiac arrhythmias, stroke, severe Parkinson's disease or severe neurological disorders likely to interfere with physical function
• Renal disease requiring dialysis
• Lung disease requiring steroids
• Inability to reliably rate pain intensity
• Current use of tobacco products
• Uncontrolled hypertension (BP of greater than 150/99 mm Hg)
• Serious systemic disease that restrict normal daily activities
• Neurological problems with significant changes in somatosensory and pain perception at the intended stimulation sites,
• Uncontrolled psychiatric condition (e.g., experiencing symptoms of schizophrenia, bipolar disorder, etc.) or hospitalization within the preceding year for psychiatric illness
• Daily use of narcotic medication
• Lower extremity amputation
• Uncontrolled diabetes (self-reported medication use and/or HA1C value)
• A known diagnosis of dementia
• Inability to communicate because of severe hearing loss or speech disorder;
• Severe visual impairment, which would preclude completion of the assessments and/or intervention.