Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms Than Placebo and Sham Mindfulness Meditation-Induced Analgesia
| Autor: | Suzan R. Farris, Youngkyoo Jung, John G. McHaffie, Robert C. Coghill, Jenna Ray, Nichole M. Emerson, Fadel Zeidan |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
Mindfulness Image Processing Medical and Health Sciences Computer-Assisted psychophysics Image Processing Computer-Assisted Meditation media_common Pain Measurement Brain Mapping General Neuroscience Respiration fMRI Pain Research Brain Articles Magnetic Resonance Imaging medicine.anatomical_structure Neurological Regression Analysis Female Chronic Pain Psychology Clinical psychology Adult Pain Threshold medicine.medical_specialty media_common.quotation_subject Clinical Trials and Supportive Activities Analgesic Pain Context (language use) Placebo Insular cortex Basic Behavioral and Social Science Young Adult mindfulness meditation Physical medicine and rehabilitation Clinical Research Physical Stimulation Behavioral and Social Science Complementary and Integrative Health Threshold of pain medicine Psychophysics Humans Neurology & Neurosurgery Psychology and Cognitive Sciences Neurosciences Placebo Effect arterial spin labeling Dorsolateral prefrontal cortex Oxygen placebo Mind and Body |
| Zdroj: | The Journal of neuroscience : the official journal of the Society for Neuroscience, vol 35, iss 46 |
| Popis: | Mindfulness meditation reduces pain in experimental and clinical settings. However, it remains unknown whether mindfulness meditation engages pain-relieving mechanisms other than those associated with the placebo effect (e.g., conditioning, psychosocial context, beliefs). To determine whether the analgesic mechanisms of mindfulness meditation are different from placebo, we randomly assigned 75 healthy, human volunteers to 4 d of the following: (1) mindfulness meditation, (2) placebo conditioning, (3) sham mindfulness meditation, or (4) book-listening control intervention. We assessed intervention efficacy using psychophysical evaluation of experimental pain and functional neuroimaging. Importantly, all cognitive manipulations (i.e., mindfulness meditation, placebo conditioning, sham mindfulness meditation) significantly attenuated pain intensity and unpleasantness ratings when compared to rest and the control condition (p< 0.05). Mindfulness meditation reduced pain intensity (p= 0.032) and pain unpleasantness (p< 0.001) ratings more than placebo analgesia. Mindfulness meditation also reduced pain intensity (p= 0.030) and pain unpleasantness (p= 0.043) ratings more than sham mindfulness meditation. Mindfulness-meditation-related pain relief was associated with greater activation in brain regions associated with the cognitive modulation of pain, including the orbitofrontal, subgenual anterior cingulate, and anterior insular cortex. In contrast, placebo analgesia was associated with activation of the dorsolateral prefrontal cortex and deactivation of sensory processing regions (secondary somatosensory cortex). Sham mindfulness meditation-induced analgesia was not correlated with significant neural activity, but rather by greater reductions in respiration rate. This study is the first to demonstrate that mindfulness-related pain relief is mechanistically distinct from placebo analgesia. The elucidation of this distinction confirms the existence of multiple, cognitively driven, supraspinal mechanisms for pain modulation.SIGNIFICANCE STATEMENTRecent findings have demonstrated that mindfulness meditation significantly reduces pain. Given that the “gold standard” for evaluating the efficacy of behavioral interventions is based on appropriate placebo comparisons, it is imperative that we establish whether there is an effect supporting meditation-related pain relief above and beyond the effects of placebo. Here, we provide novel evidence demonstrating that mindfulness meditation produces greater pain relief and employs distinct neural mechanisms than placebo cream and sham mindfulness meditation. Specifically, mindfulness meditation-induced pain relief activated higher-order brain regions, including the orbitofrontal and cingulate cortices. In contrast, placebo analgesia was associated with decreased pain-related brain activation. These findings demonstrate that mindfulness meditation reduces pain through unique mechanisms and may foster greater acceptance of meditation as an adjunct pain therapy. |
| Databáze: | OpenAIRE |
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