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Singer T. A neuroscience perspective on the plasticity of the social and relational brain. Ann N Y Acad Sci 2025; 1547:52-74. [PMID: 40178439 PMCID: PMC12096818 DOI: 10.1111/nyas.15319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2025]
Abstract
Over the past two decades, the fields of social and contemplative neurosciences have made significant strides. Initial research utilizing fMRI identified neuronal networks involved in empathy, mentalizing, and compassion, as well as complex interactions among these networks. Subsequent studies shifted to testing the plasticity of these social skills via different types of mindfulness- or compassion-based mental training programs, demonstrating brain plasticity, enhanced social capacities and motivation, as well as improved mental health and overall well-being. Next, researchers developed scalable evidence-based online mental training programs to address the growing levels of mental health problems and loneliness, both exacerbated by the COVID-19 pandemic. Innovative approaches, such as novel relational partner-based practices and online app-based dyadic training programs, offer scalable solutions to counteract ongoing societal and mental health deterioration. Current studies are now applying the above findings to support resilience building within diverse domains of society and professional populations-such as healthcare workers and teachers-at high risk of burn-out. Future research should explore the broader impact of such training-related individual changes on larger systems, potentially leading to the development of a translational social neuroscience approach that leverages insights from social brain plasticity research to support societal needs, thereby enhancing resilience, mental health, and social cohesion.
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Affiliation(s)
- Tania Singer
- Social Neuroscience LabMax Planck SocietyBerlinGermany
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2
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Christoff Hadjiilieva K. Mindfulness as a Way of Reducing Automatic Constraints on Thought. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2025; 10:393-401. [PMID: 39522747 DOI: 10.1016/j.bpsc.2024.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 10/01/2024] [Accepted: 11/03/2024] [Indexed: 11/16/2024]
Abstract
The number of mindfulness-based wellness promotion programs offered by institutions, by governments, and through mobile apps has grown exponentially in the last decade. However, the scientific understanding of what mindfulness is and how it works is still evolving. Here, I focus on 2 common mindfulness practices: focused attention (FA) and open monitoring (OM). First, I summarize what is known about FA and OM meditation at the psychological level. While they share similar emotion regulation goals, they differ in terms of some of their attention regulation goals. Second, I turn to the neuroscientific literature, showing that FA meditation is associated with consistent activations of cortical control network regions and deactivations of cortical default network regions. In contrast, OM meditation seems to be most consistently associated with changes in the functional connectivity patterns of subcortical structures, including the basal ganglia and cerebellum. Finally, I present a novel account of the mental changes that occur during FA and OM meditation as understood from within the Dynamic Framework of Thought-a conceptual framework that distinguishes between deliberate and automatic constraints on thought. Although deliberate self-regulation processes are often emphasized in scientific and public discourse on mindfulness, here I argue that mindfulness may primarily involve changes in automatic constraints on thought. In particular, I argue that mindfulness reduces the occurrence of automatized sequences of mental states or habits of thought. In this way, mindfulness may increase the spontaneity of thought and reduce automatically constrained forms of thought such as rumination and obsessive thought.
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Bauer CCC, Atad DA, Farb N, Brewer JA. From Confound to Clinical Tool: Mindfulness and the Observer Effect in Research and Therapy. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2025; 10:402-410. [PMID: 39894252 DOI: 10.1016/j.bpsc.2025.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 01/19/2025] [Accepted: 01/24/2025] [Indexed: 02/04/2025]
Abstract
The observer effect (OE), the idea that observing a phenomenon changes it, has important implications across scientific disciplines involving measurement and observation. While often viewed as a confounding variable to control for, this paper argues that the OE should be seriously accounted for, explored, and systematically leveraged in research and clinical settings. Specifically, mindfulness practices that cultivate present-moment, nonjudgmental awareness are proposed as a platform to account for, explore, and intentionally harness the OE. In research contexts, mindfulness training may allow participants to provide more precise self-reports by minimizing reactive biases that perturb the observed phenomena. Empirical evidence suggests that mindfulness enhances interoceptive awareness and reduces automatic judgment, potentially increasing measurement sensitivity, specificity, and validity. Clinically, psychotherapies often aim to make unconscious patterns explicitly observable to the client, capitalizing on the transformative potential of observation. Mindfulness directly cultivates this capacity for meta-awareness, allowing individuals to decenter from rigid cognitive-emotional patterns fueling psychopathology. Rather than avoiding unpleasant experiences such as cravings or anxiety, mindfulness guides individuals to simply observe these phenomena, reducing identification and reactivity. Mindfulness practices may leverage components of the OE, facilitating lasting psychological change. To further study the OE, developing an OE index to code observer influence is proposed. Overall, this paper highlights the ubiquity of the OE and advocates developing methods to intentionally account for and apply observer influences across research and therapeutic contexts.
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Affiliation(s)
- Clemens C C Bauer
- Department of Psychology, Northeastern University, Boston, Massachusetts; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts; Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
| | - Daniel A Atad
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel; Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel; Edmond Safra Brain Research Center, Faculty of Education, University of Haifa, Haifa, Israel
| | - Norman Farb
- Department of Psychology, University of Toronto, Mississauga, Ontario, Canada
| | - Judson A Brewer
- School of Public Health and School of Medicine, Brown University, Providence, Rhode Island; Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
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Prakash RS, Shankar A, Tripathi V, Yang WFZ, Fisher M, Bauer CCC, Betzel R, Sacchet MD. Mindfulness Meditation and Network Neuroscience: Review, Synthesis, and Future Directions. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2025; 10:350-358. [PMID: 39561891 PMCID: PMC12096460 DOI: 10.1016/j.bpsc.2024.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 11/08/2024] [Accepted: 11/12/2024] [Indexed: 11/21/2024]
Abstract
Network neuroscience is an interdisciplinary field, which can be used to understand the brain by examining the connections between its constituent elements. In recent years, the application of network neuroscience approaches to study the intricate nature of the structural and functional relationships within the human brain has yielded unique insights into its organization. In this review, we begin by defining network neuroscience and providing an overview of the common metrics that describe the topology of human structural and functional brain networks. Then, we present a detailed overview of a limited but growing body of literature that has leveraged network neuroscience metrics to demonstrate the impact of mindfulness meditation on modulating the fundamental structural and functional network properties of segregation, integration, and influence. Although preliminary, results across studies suggest that mindfulness meditation results in a shift in connector hubs, such as the anterior cingulate cortex, the thalamus, and the mid-insula. Although there is mixed evidence regarding the impact of mindfulness training on global metrics of connectivity, the default mode network exhibits reduced intraconnectivity following mindfulness training. Our review also underscores essential directions for future research, including a more comprehensive examination of mindfulness training and its potential to influence structural and functional connections at the nodal, network, and whole-brain levels. Furthermore, we emphasize the importance of open science, adoption of rigorous study designs to improve the internal validity of studies, and the inclusion of diverse samples in neuroimaging studies to comprehensively characterize the impact of mindfulness on brain organization.
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Affiliation(s)
- Ruchika S Prakash
- Department of Psychology, The Ohio State University, Columbus, Ohio; Center for Cognitive and Behavioral Brain Imaging, The Ohio State University, Columbus, Ohio.
| | - Anita Shankar
- Department of Psychology, The Ohio State University, Columbus, Ohio; Center for Cognitive and Behavioral Brain Imaging, The Ohio State University, Columbus, Ohio
| | - Vaibhav Tripathi
- Center for Brain Science & Department of Psychology, Harvard University, Cambridge, Massachusetts; Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Winson F Z Yang
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Megan Fisher
- Department of Psychology, The Ohio State University, Columbus, Ohio; Center for Cognitive and Behavioral Brain Imaging, The Ohio State University, Columbus, Ohio
| | - Clemens C C Bauer
- Department of Psychology, Northeastern University, Boston, Massachusetts; Department of Brain and Cognitive Science, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts; Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Richard Betzel
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Heylighen F, Beigi S. Why Uncertainty Is Essential for Consciousness: Local Prospect Theory vs. Predictive Processing. ENTROPY (BASEL, SWITZERLAND) 2025; 27:140. [PMID: 40003137 PMCID: PMC11854793 DOI: 10.3390/e27020140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Revised: 01/22/2025] [Accepted: 01/24/2025] [Indexed: 02/27/2025]
Abstract
We present and develop local prospect theory (LPT), a novel framework for understanding consciousness, and, in particular, subjective experience and free will. While predictive processing (PP) theories model the brain as trying to optimize the accuracy of predictions, LPT sees uncertainty as an essential feature of conscious decision-making. This is achieved by creating a "local prospect"-a range of potential developments colored by subjective experience from which an agent can freely choose how to react. Drawing on global workspace theory, LPT conceptualizes consciousness as a self-maintaining process of circulating neural activation, creating a temporary working memory where thoughts and feelings coming from different brain modules enter into an asynchronous, non-linear interaction. This contrasts with unconscious processes, which operate automatically and deterministically. LPT proposes entropy-based measures, including the determination of actions by conditions and the breadth of prospect, to quantify the range of potential developments considered. This framework allows us to understand Buddhist practices and concepts, such as mindfulness, liberation from attachments, and meditation, which broaden consciousness and de-automatize reactions by reducing the influence of conditioning. The proposed prospect measure may be operationalized by indicators such as the variety of action, breadth of perception, and unpredictability of behavior, thus allowing for the empirical testing of the theory.
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Affiliation(s)
- Francis Heylighen
- Center Leo Apostel, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Shima Beigi
- Center Leo Apostel, Vrije Universiteit Brussel, 1050 Brussels, Belgium
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Riegner G, Dean J, Wager TD, Zeidan F. Mindfulness Meditation and Placebo Modulate Distinct Multivariate Neural Signatures to Reduce Pain. Biol Psychiatry 2025; 97:81-88. [PMID: 39216636 PMCID: PMC11608143 DOI: 10.1016/j.biopsych.2024.08.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Rather than a passive reflection of nociception, pain is shaped by the interplay between one's experiences, current cognitive-affective states, and expectations. The placebo response, a paradoxical yet reliable phenomenon, is postulated to reduce pain by engaging mechanisms shared with active therapies. It has been assumed that mindfulness meditation, practiced by sustaining nonjudgmental awareness of arising sensory events, merely reflects mechanisms evoked by placebo. Recently, brain-based multivariate pattern analysis has been validated to successfully disentangle nociceptive-specific, negative affective, and placebo-based dimensions of the subjective pain experience. METHODS To determine whether mindfulness meditation engages distinct brain mechanisms from placebo and sham mindfulness to reduce pain, multivariate pattern analysis pain signatures were applied across 2 randomized clinical trials that employed overlapping psychophysical pain testing procedures (49 °C noxious heat; visual analog pain scales) and distinct functional magnetic resonance imaging techniques (blood oxygen level-dependent; perfusion based). After baseline pain testing, 115 healthy participants were randomized into a 4-session mindfulness meditation (n = 37), placebo-cream conditioning (n = 19), sham mindfulness meditation (n = 20), or book-listening control (n = 39) intervention. After each intervention, noxious heat was administered during functional magnetic resonance imaging and each manipulation. RESULTS A double dissociation in the multivariate pattern analysis signatures supporting pain regulation was revealed by mindfulness meditation compared with placebo cream. Mindfulness meditation produced significantly greater reductions in pain intensity and pain unpleasantness ratings and nociceptive-specific and negative affective pain signatures than placebo cream, sham mindfulness meditation, and control interventions. The placebo-cream group significantly lowered the placebo-based signature. CONCLUSIONS Mindfulness meditation and placebo engaged distinct and granular neural pain signatures to reduce pain.
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Affiliation(s)
- Gabriel Riegner
- Department of Anesthesiology, University of California San Diego, La Jolla, California
| | - Jon Dean
- Department of Anesthesiology, University of California San Diego, La Jolla, California
| | - Tor D Wager
- Department of Psychological and Brain Science, Dartmouth College, Hanover, New Hampshire
| | - Fadel Zeidan
- Department of Anesthesiology, University of California San Diego, La Jolla, California.
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Ploesser M, Martin D. Mechanism of Action of Mindfulness-Based Interventions for Pain Relief-A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:1162-1178. [PMID: 39042592 PMCID: PMC11659456 DOI: 10.1089/jicm.2023.0328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Background: Currently, no systematic evidence synthesis of the mechanism of action of mindfulness-based approaches exists for pain conditions. Aim: To identify and synthesize experimental and clinical studies examining aspects of the mechanism of action of mindfulness for pain relief. Methods: The following databases and search interfaces were searched: Embase (via Embase.com) and Medline (via PubMed). Additional references were identified via bibliographies of included studies. The following were the inclusion criteria applied: (1) original studies published in peer-reviewed journals, (2) in adult populations that (3) examined the mechanism of action of mindfulness meditation on pain outcomes or (4) provided conclusions regarding the potential mechanism of action of mindfulness meditation. The studies were selected by two independent reviewers. Discrepancies were resolved by discussion. Results: A total of 21 studies published in English met the inclusion criteria, of which 5 studies were clinical studies, which included patients with chronic pain, and 16 studies used experimental pain induction. The investigation into brain mechanisms through functional magnetic resonance imaging and diffusion tensor imaging revealed mindfulness meditation's ability to modulate brain activity, particularly in the anterior cingulate cortex, anterior insula, and orbitofrontal cortex, and to enhance structural and functional connectivity in regions associated with pain perception. Regarding the role of opioids, findings across five studies indicated that the analgesic effects of mindfulness are maintained even when opioid receptors are blocked, suggesting a nonopioidergic pathway for pain modulation. Pain perception studies highlighted that mindfulness practices foster pain acceptance and modify pain control beliefs, serving as key mediators in improving pain outcomes. For experienced versus novice mindfulness practitioners, results demonstrated that long-term practice enhances pain threshold and reduces pain unpleasantness through increased activity in salience and attentional control regions. Conclusion: This systematic review highlights mindfulness meditation as a multifaceted approach to pain management, utilizing mechanisms such as cognitive and emotional reappraisal, nonopioidergic pathways, and enhanced attention in control regions. It emphasizes the role of mindfulness in fostering pain acceptance and altering pain control perceptions, showcasing its broad impact on the neurological and experiential dimensions of pain. However, the predominance of studies on healthy subjects and methodological variations across experiments necessitates careful interpretation of the findings. The review calls for further research to explore the mechanisms of mindfulness in chronic pain populations more deeply, distinguishing the specific effects of mindfulness from nonspecific effects and expanding its applicability in clinical settings for chronic pain management.
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Affiliation(s)
- Markus Ploesser
- Fakultät für Gesundheit (Department für Humanmedizin), Lehrstuhl für Medizintheorie, Integrative und Anthroposophische Medizin, Herdecke, Germany
| | - David Martin
- Fakultät für Gesundheit (Department für Humanmedizin), Lehrstuhl für Medizintheorie, Integrative und Anthroposophische Medizin, Herdecke, Germany
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Abellaneda-Pérez K, Potash RM, Pascual-Leone A, Sacchet MD. Neuromodulation and meditation: A review and synthesis toward promoting well-being and understanding consciousness and brain. Neurosci Biobehav Rev 2024; 166:105862. [PMID: 39186992 DOI: 10.1016/j.neubiorev.2024.105862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 08/16/2024] [Accepted: 08/17/2024] [Indexed: 08/28/2024]
Abstract
The neuroscience of meditation is providing insight into meditation's beneficial effects on well-being and informing understanding of consciousness. However, further research is needed to explicate mechanisms linking brain activity and meditation. Non-invasive brain stimulation (NIBS) presents a promising approach for causally investigating neural mechanisms of meditation. Prior NIBS-meditation research has predominantly targeted frontal and parietal cortices suggesting that it might be possible to boost the behavioral and neural effects of meditation with NIBS. Moreover, NIBS has revealed distinct neural signatures in long-term meditators. Nonetheless, methodological variations in NIBS-meditation research contributes to challenges for definitive interpretation of previous results. Future NIBS studies should further investigate core substrates of meditation, including specific brain networks and oscillations, and causal neural mechanisms of advanced meditation. Overall, NIBS-meditation research holds promise for enhancing meditation-based interventions in support of well-being and resilience in both non-clinical and clinical populations, and for uncovering the brain-mind mechanisms of meditation and consciousness.
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Affiliation(s)
- Kilian Abellaneda-Pérez
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.
| | - Ruby M Potash
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
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Ghaziri J, Fei P, Tucholka A, Obaid S, Boucher O, Rouleau I, Nguyen DK. Resting-State Functional Connectivity Profile of Insular Subregions. Brain Sci 2024; 14:742. [PMID: 39199437 PMCID: PMC11352390 DOI: 10.3390/brainsci14080742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 09/01/2024] Open
Abstract
The insula is often considered the fifth lobe of the brain and is increasingly recognized as one of the most connected regions in the brain, with widespread connections to cortical and subcortical structures. As a follow-up to our previous tractography work, we investigated the resting-state functional connectivity (rsFC) profiles of insular subregions and assessed their concordance with structural connectivity. We used the CONN toolbox to analyze the rsFC of the same 19 insular regions of interest (ROIs) we used in our prior tractography work and regrouped them into six subregions based on their connectivity pattern similarity. Our analysis of 50 healthy participants confirms the known broad connectivity of the insula and shows novel and specific whole-brain and intra-connectivity patterns of insular subregions. By examining such subregions, our findings provide a more detailed pattern of connectivity than prior studies that may prove useful for comparison between patients.
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Affiliation(s)
- Jimmy Ghaziri
- Département de Psychologie, Université du Québec à Montréal, Montréal, QC H2X 3P2, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Phillip Fei
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Chicoutimi, QC J4L 1C9, Canada
| | - Alan Tucholka
- BarcelonaBeta Brain Research Center, Pasqual Maragall Foundation, 08005 Barcelona, Spain
- Pixyl Medical, 38700 Grenoble, France
| | - Sami Obaid
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Olivier Boucher
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X 0A9, Canada
- Service de Neurologie, Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, QC H2X 0C1, Canada
| | - Isabelle Rouleau
- Département de Psychologie, Université du Québec à Montréal, Montréal, QC H2X 3P2, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Dang K. Nguyen
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X 0A9, Canada
- Service de Neurologie, Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, QC H2X 0C1, Canada
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Fan C, Wu M, Liu H, Chen X, Gao Z, Zhao X, Zhou J, Jiang Z. Effects of meditation on neural responses to pain: A systematic review and meta-analysis of fMRI studies. Neurosci Biobehav Rev 2024; 162:105735. [PMID: 38821153 DOI: 10.1016/j.neubiorev.2024.105735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/17/2024] [Accepted: 05/19/2024] [Indexed: 06/02/2024]
Abstract
This systematic review investigates the impact of meditation on neural responses to pain, as measured by functional magnetic resonance imaging (fMRI). Up to March 2024, we conducted searches across four databases for human studies implementing fMRI to assess the efficacy of meditation for pain relief. Eighteen studies met the inclusion criteria. Our systematic review indicates that activation of the insula, anterior cingulate cortex, and orbitofrontal cortex is positively associated with meditation for pain relief, while activity in regions like the amygdala and medial prefrontal cortex is negatively correlated with pain relief. Meta-analyses consistently reveal the involvement of various brain regions, including the insula, putamen, amygdala, anterior cingulate cortex, precentral gyrus, postcentral gyrus, inferior parietal lobule, superior temporal gyrus, inferior frontal gyrus, and caudate nucleus, in meditation-induced alleviation of pain. These findings suggest ccthat meditation acts on specific brain regions related to pain, mood, and cognition, providing insight into the potential mechanisms underlying the pain-alleviating effects of meditation on both pain sensations and emotional experiences.
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Affiliation(s)
- Cheng Fan
- The First Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Department of Rehabilitation Medicine, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China
| | - Mengjiao Wu
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Department of Rehabilitation Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
| | - Hong Liu
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
| | - Xiaolin Chen
- Department of Rehabilitation, Dongguan Songshan Lake Tungwah Hospital, DongGuan 523000, China
| | - Zhen Gao
- Department of Rehabilitation, Fuzhou Second Hospital, Fuzhou 350122, China
| | - Xin Zhao
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Jianhao Zhou
- The First Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China
| | - Zheng Jiang
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
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11
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Manuweera T, Wagenknecht A, Kleckner AS, Dorsey SG, Zhu S, Tivarus ME, Kesler SR, Ciner A, Kleckner IR. Preliminary evaluation of novel Bodily Attention Task to assess the role of the brain in chemotherapy-induced peripheral neurotoxicity (CIPN). Behav Brain Res 2024; 460:114803. [PMID: 38070689 PMCID: PMC10860373 DOI: 10.1016/j.bbr.2023.114803] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common, sometimes dose-limiting side effect of neurotoxic chemotherapy. Treatment is limited because its pathophysiology is poorly understood. Compared to research on peripheral mechanisms, the role of the brain in CIPN is understudied and it may be important to develop better treatments. We propose a novel task that assesses brain activation associated with attention to bodily sensations (interoception), without the use of painful stimulation, to understand how CIPN symptoms may be processed in the brain. The goals of this preliminary study were to assess, 1) feasibility of the task, 2) sensitivity to changes in brain activity, and 3) suitability for assessing relationships between brain activation and CIPN severity. Eleven participants with varying types of cancer completed a brain fMRI scan and rated CIPN severity (CIPN-20) before and/or 12 weeks after starting neurotoxic chemotherapy. The Bodily Attention Task is a 7.5-min long fMRI task involving attentional focus on the left fingertips, the heart, or a flashing word "target" for visual attention (reference condition). Feasibility was confirmed, as 73% of all data collected were usable and participants reported feeling or focus during 75% of the trials. Regarding brain activity, finger attention increased activation in somatosensory regions (primary sensory cortex, insula) and sensory integration regions (precuneus, dorsolateral prefrontal cortex). Exploratory analyses suggested that brain activation may be associated with CIPN severity. A larger sample size and accounting of confounding factors is needed to test for replication and to identify brain and interoceptive biomarkers to help improve the prediction, prevention, and treatment of CIPN.
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Affiliation(s)
- Thushini Manuweera
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA.
| | - Amelia Wagenknecht
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Amber S Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Susan G Dorsey
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Shijun Zhu
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Madalina E Tivarus
- Department of Imaging Sciences and Department of Neuroscience University of Rochester Medical Center, Rochester, NY, USA
| | - Shelli R Kesler
- Department of Adult Health, School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Aaron Ciner
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ian R Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
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van der Miesen MM, Joosten EA, Kaas AL, Linden DE, Peters JC, Vossen CJ. Habituation to pain: self-report, electroencephalography, and functional magnetic resonance imaging in healthy individuals. A scoping review and future recommendations. Pain 2024; 165:500-522. [PMID: 37851343 PMCID: PMC10859850 DOI: 10.1097/j.pain.0000000000003052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/02/2023] [Indexed: 10/19/2023]
Abstract
ABSTRACT Habituation to pain is a fundamental learning process and important adaption. Yet, a comprehensive review of the current state of the field is lacking. Through a systematic search, 63 studies were included. Results address habituation to pain in healthy individuals based on self-report, electroencephalography, or functional magnetic resonance imaging. Our findings indicate a large variety in methods, experimental settings, and contexts, making habituation a ubiquitous phenomenon. Habituation to pain based on self-report studies shows a large influence of expectations, as well as the presence of individual differences. Furthermore, widespread neural effects, with sometimes opposing effects in self-report measures, are noted. Electroencephalography studies showed habituation of the N2-P2 amplitude, whereas functional magnetic resonance imaging studies showed decreasing activity during painful repeated stimulation in several identified brain areas (cingulate cortex and somatosensory cortices). Important considerations for the use of terminology, methodology, statistics, and individual differences are discussed. This review will aid our understanding of habituation to pain in healthy individuals and may lead the way to improving methods and designs for personalized treatment approaches in chronic pain patients.
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Affiliation(s)
- Maite M. van der Miesen
- Department of Anesthesiology and Pain Management, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Elbert A. Joosten
- Department of Anesthesiology and Pain Management, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Amanda L. Kaas
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - David E.J. Linden
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Judith C. Peters
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Catherine J. Vossen
- Department of Anesthesiology and Pain Management, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
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13
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Tidwell TL. Life in Suspension with Death: Biocultural Ontologies, Perceptual Cues, and Biomarkers for the Tibetan Tukdam Postmortem Meditative State. Cult Med Psychiatry 2024:10.1007/s11013-023-09844-2. [PMID: 38393648 DOI: 10.1007/s11013-023-09844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 02/25/2024]
Abstract
This article presents two cases from a collaborative study among Tibetan monastic populations in India on the postdeath meditative state called tukdam (thugs dam). Entered by advanced Tibetan Buddhist practitioners through a variety of different practices, this state provides an ontological frame that is investigated by two distinct intellectual traditions-the Tibetan Buddhist and medical tradition on one hand and the Euroamerican biomedical and scientific tradition on the other-using their respective means of inquiry. Through the investigation, the traditions enact two paradigms of the body at the time of death alongside attendant conceptualizations of what constitutes life itself. This work examines when epistemologies of these two traditions might converge, under what ontological contexts, and through which correlated indicators of evidence. In doing so, this work explores how these two intellectual traditions might answer how the time course and characteristics of physiological changes during the postmortem period might exhibit variation across individuals. Centrally, this piece presents an epistemological inquiry delineating the types of valid evidence that constitute exceptional processes post-clinical death and their potential ontological implications.
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Affiliation(s)
- Tawni L Tidwell
- Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave., Madison, WI, 53703, USA.
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14
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Lu C, Moliadze V, Nees F. Dynamic processes of mindfulness-based alterations in pain perception. Front Neurosci 2023; 17:1253559. [PMID: 38027503 PMCID: PMC10665508 DOI: 10.3389/fnins.2023.1253559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Mindfulness-based processes have been shown to enhance attention and related behavioral responses, including analgesia, which is discussed as an effective method in the context of pain interventions. In the present review, we introduce the construct of mindfulness, delineating the concepts, factors, and processes that are summarized under this term and might serve as relevant components of the underlying mechanistic pathways in the field of pain. We also discuss how differences in factors such as definitions of mindfulness, study design, and strategies in mindfulness-based attention direction may need to be considered when putting the findings from previous studies into a whole framework. In doing so, we capitalize on a potential dynamic process model of mindfulness-based analgesia. In this respect, the so-called mindfulness-based analgesia may initially result from improved cognitive regulation strategies, while at later stages of effects may be driven by a reduction of interference between both cognitive and affective factors. With increasing mindfulness practice, pathways and mechanisms of mindfulness analgesia may change dynamically, which could result from adaptive coping. This is underlined by the fact that the neural mechanism of mindfulness analgesia is manifested as increased activation in the ACC and aINS at the beginner level while increased activation in the pINS and reduced activation in the lPFC at the expert level.
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Affiliation(s)
| | | | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
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15
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Voss S, Boachie DA, Nieves N, Gothe NP. Mind-body practices, interoception and pain: a scoping review of behavioral and neural correlates. Ann Med 2023; 55:2275661. [PMID: 37939212 PMCID: PMC10768869 DOI: 10.1080/07853890.2023.2275661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE Chronic pain is a significant source of suffering in the United States, and many individuals increasingly turn towards yoga for pain relief. However, little is known regarding how yoga improves pain. Herein we seek to examine the scope of the literature linking mind-body practices, pain and interoception; an emerging mechanism by which yoga may improve chronic pain. METHODS This scoping review followed the five-stage methodological framework proposed by Arksey and O'Malley to examine behavioral and neural correlates of interoception in mind-body practices and pain. A broad search of the Pubmed, CINAHL, SportDiscus, Scopus, PsychInfo, and SocIndex databases was conducted, utilizing three clusters of search terms: (1) interoceptive terms, (2) mind-body terms, and (3) pain terms. RESULTS A combined total of 690 articles were screened, and 24 findings included for analysis. Sixteen studies examined interoceptive outcomes in response to mind-body practices for chronic pain, and 8 studies examined interoceptive outcomes in response to evoked-pain tasks in experienced mind-body practitioners. Only three studies linked yoga, interoception and pain. CONCLUSION This review relied on the broader mind-body literature to inform our analyses as the literature examining yoga, pain and interoception remains limited. Interoceptive techniques including attending to and acceptance of bodily sensations, appear to be key therapeutic mechanisms in mind-body practices for chronic pain. Future yoga-based interventions would benefit examining interoceptive outcomes and integrating interoceptive strategies to facilitate the pain-modulating benefits of yoga.
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Affiliation(s)
- Stephanie Voss
- Department of Kinesiology and Community Health, University of IL Urbana-Champaign, Champaign, IL, USA
- Occupational Therapy, Shirley Ryan Ability Lab, Chicago, IL, USA
| | - Daniel A. Boachie
- Department of Kinesiology and Community Health, University of IL Urbana-Champaign, Champaign, IL, USA
| | - Norberto Nieves
- Department of Kinesiology and Community Health, University of IL Urbana-Champaign, Champaign, IL, USA
| | - Neha P. Gothe
- Department of Kinesiology and Community Health, University of IL Urbana-Champaign, Champaign, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Champaign, IL, USA
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
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16
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Cucinello-Ragland JA, Alrashed NH, Lee S, Davis EC, Edwards KN, Edwards S. Sex-specific biobehavioral regulation of persistent inflammatory pain by alcohol. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1283-1296. [PMID: 37208939 PMCID: PMC10422981 DOI: 10.1111/acer.15104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/19/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Although a large percentage of chronic pain patients consume alcohol to manage their pain, there is a significant gap in knowledge regarding the mechanisms underlying the antinociceptive effects of alcohol. METHODS To determine the longitudinal analgesic effects of alcohol, we utilized the complete Freund's adjuvant (CFA) model of inflammatory pain in adult female and male Wistar rats. Both somatic and negative motivational aspects of pain were measured using the electronic von Frey (mechanical nociception) system, thermal probe test (thermal nociception), and mechanical conflict avoidance task (pain avoidance-like behavior). Tests were conducted at baseline and 1 and 3 weeks following intraplantar CFA or saline administration. At both time points post-CFA, animals were treated with each of three doses of alcohol (intraperitoneal; 0, 0.5, and 1.0 g/kg) over separate days in a Latin square design. RESULTS Alcohol produced dose-dependent mechanical analgesia and antihyperalgesia in females but only antihyperalgesia in males. Although alcohol continued to attenuate CFA-induced decreases in both thermal and mechanical nociceptive thresholds between 1 and 3 weeks post-CFA, it appeared less effective at increasing thresholds 3 weeks after CFA induction. CONCLUSIONS These data suggest that individuals may develop tolerance to alcohol's ability to alleviate both somatic and negative motivational symptoms of chronic pain over time. We also discovered sex-specific neuroadaptations in protein kinase A-dependent phosphorylation of GluR1 subunits and extracellular signal-regulated kinase (ERK 1/2) phosphorylation in nociceptive brain centers of animals receiving an alcohol challenge 1 week post-CFA. Together, these findings illustrate a sex-specific regulation of behavioral and neurobiological indices of persistent pain by alcohol.
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Affiliation(s)
- Jessica A. Cucinello-Ragland
- Department of Physiology, LSU Health-New Orleans
- Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans
| | | | - Sumin Lee
- Department of Physiology, LSU Health-New Orleans
| | | | | | - Scott Edwards
- Department of Physiology, LSU Health-New Orleans
- Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans
- Neuroscience Center of Excellence, LSU Health-New Orleans
- Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health-New Orleans
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17
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Legon W, Strohman A, In A, Stebbins K, Payne B. Non-invasive neuromodulation of sub-regions of the human insula differentially affect pain processing and heart-rate variability. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.05.539593. [PMID: 37205396 PMCID: PMC10187309 DOI: 10.1101/2023.05.05.539593] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The insula is a portion of the cerebral cortex folded deep within the lateral sulcus covered by the overlying opercula of the inferior frontal lobe and superior portion of the temporal lobe. The insula has been parsed into sub-regions based upon cytoarchitectonics and structural and functional connectivity with multiple lines of evidence supporting specific roles for each of these sub-regions in pain processing and interoception. In the past, causal interrogation of the insula was only possible in patients with surgically implanted electrodes. Here, we leverage the high spatial resolution combined with the deep penetration depth of low-intensity focused ultrasound (LIFU) to non-surgically modulate either the anterior insula (AI) or posterior insula (PI) in humans for effect on subjective pain ratings, electroencephalographic (EEG) contact head evoked potentials (CHEPs) and time-frequency power as well as autonomic measures including heart-rate variability (HRV) and electrodermal response (EDR). N = 23 healthy volunteers received brief noxious heat pain stimuli to the dorsum of their right hand during continuous heart-rate, EDR and EEG recording. LIFU was delivered to either the AI (anterior short gyrus), PI (posterior longus gyrus) or under an inert sham condition time-locked to the heat stimulus. Results demonstrate that single-element 500 kHz LIFU is capable of individually targeting specific gyri of the insula. LIFU to both AI and PI similarly reduced perceived pain ratings but had differential effects on EEG activity. LIFU to PI affected earlier EEG amplitudes around 300 milliseconds whereas LIFU to AI affected EEG amplitudes around 500 milliseconds. In addition, only LIFU to the AI affected HRV as indexed by an increase in standard deviation of N-N intervals (SDNN) and mean HRV low frequency power. There was no effect of LIFU to either AI or PI on EDR or blood pressure. Taken together, LIFU looks to be an effective method to individually target sub-regions of the insula in humans for site-specific effects on brain biomarkers of pain processing and autonomic reactivity that translates to reduced perceived pain to a transient heat stimulus. These data have implications for the treatment of chronic pain and several neuropsychological diseases like anxiety, depression and addiction that all demonstrate abnormal activity in the insula concomitant with dysregulated autonomic function.
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Affiliation(s)
- Wynn Legon
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061, USA
- Center for Human Neuroscience Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
| | - Andrew Strohman
- Virginia Tech Carilion School of Medicine, Roanoke, VA, 24016, USA
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Roanoke, VA, 24016, USA
| | - Alexander In
- Virginia Tech Carilion School of Medicine, Roanoke, VA, 24016, USA
| | - Katelyn Stebbins
- Virginia Tech Carilion School of Medicine, Roanoke, VA, 24016, USA
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Roanoke, VA, 24016, USA
| | - Brighton Payne
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
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18
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Hunt CA, Letzen JE, Krimmel SR, Burrowes SAB, Haythornthwaite JA, Keaser M, Reid M, Finan PH, Seminowicz DA. Meditation Practice, Mindfulness, and Pain-Related Outcomes in Mindfulness-Based Treatment for Episodic Migraine. Mindfulness (N Y) 2023; 14:769-783. [PMID: 38435377 PMCID: PMC10907069 DOI: 10.1007/s12671-023-02105-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 04/07/2023]
Abstract
Objectives Mindfulness-based interventions (MBIs) have emerged as promising prophylactic episodic migraine treatments. The present study investigated biopsychosocial predictors and outcomes associated with formal, daily-life meditation practice in migraine patients undergoing MBI, and whether augmented mindfulness mechanistically underlies change. Methods Secondary analyses of clinical trial data comparing a 12-week enhanced mindfulness-based stress reduction course (MBSR + ; n = 50) to stress management for headache (SMH; n = 48) were conducted. Results Pre-treatment mesocorticolimbic system functioning (i.e., greater resting state ventromedial prefrontal cortex-right nucleus accumbens [vmPFC-rNAC] functional connectivity) predicted greater meditation practice duration over MBSR + (r = 0.58, p = 0.001), as well as the change in headache frequency from pre- to post-treatment (B = -12.60, p = 0.02) such that MBSR + participants with greater vmPFC-rNAC connectivity showed greater reductions in headache frequency. MBSR + participants who meditated more showed greater increases in mindfulness (B = 0.52, p = 0.02) and reductions in the helplessness facet of pain catastrophizing (B = -0.13, p = 0.01), but not headache frequency, severity, or impact. Augmented mindfulness mediated reductions in headache impact resulting from MBSR + , but not headache frequency. Conclusions Mesocorticolimbic system function is implicated in motivated behavior, and thus, motivation-enhancing interventions might be delivered alongside mindfulness-based training to enhance meditation practice engagement. Formal, daily-life meditation practice duration appears to benefit pain-related cognitions, but not clinical pain, while mindfulness emerges as a mechanism of MBIs on headache impact, but not frequency. Further research is needed to investigate the day-to-day effects of formal, daily-life meditation practice on pain, and continue to characterize the specific mechanisms of MBIs on headache outcomes. Preregistration This study is not preregistered.
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Affiliation(s)
- Carly A. Hunt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology, University of Virginia, VA, Charlottesville, USA
| | - Janelle E. Letzen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Samuel R. Krimmel
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Shana A. B. Burrowes
- Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA 02218, USA
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD 21201, USA
| | - Jennifer A. Haythornthwaite
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Keaser
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD 21201, USA
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD 21201, USA
| | - Matthew Reid
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patrick H. Finan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology, University of Virginia, VA, Charlottesville, USA
| | - David A. Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD 21201, USA
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD 21201, USA
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19
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A neurophenomenological approach to non-ordinary states of consciousness: hypnosis, meditation, and psychedelics. Trends Cogn Sci 2023; 27:139-159. [PMID: 36566091 DOI: 10.1016/j.tics.2022.11.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 12/24/2022]
Abstract
No contemporary unifying framework has been provided for the study of non-ordinary states of consciousness (NSCs) despite increased interest in hypnosis, meditation, and psychedelics. NSCs induce shifts in experiential contents (what appears to the experiencer) and/or structure (how it appears). This can allow the investigation of the plastic and dynamic nature of experience from a multiscale perspective that includes mind, brain, body, and context. We propose a neurophenomenological (NP) approach to the study of NSCs which highlights their role as catalysts of transformation in clinical practice by refining our understanding of the relationships between experiential (subjective) and neural dynamics. We outline the ethical implications of the NP approach for standard conceptions of health and pathology as well as the crucial role of experience-based know-how in NSC-related research and application.
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20
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Zhou D, Kang Y, Cosme D, Jovanova M, He X, Mahadevan A, Ahn J, Stanoi O, Brynildsen JK, Cooper N, Cornblath EJ, Parkes L, Mucha PJ, Ochsner KN, Lydon-Staley DM, Falk EB, Bassett DS. Mindful attention promotes control of brain network dynamics for self-regulation and discontinues the past from the present. Proc Natl Acad Sci U S A 2023; 120:e2201074119. [PMID: 36595675 PMCID: PMC9926276 DOI: 10.1073/pnas.2201074119] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 10/17/2022] [Indexed: 01/05/2023] Open
Abstract
Mindful attention is characterized by acknowledging the present experience as a transient mental event. Early stages of mindfulness practice may require greater neural effort for later efficiency. Early effort may self-regulate behavior and focalize the present, but this understanding lacks a computational explanation. Here we used network control theory as a model of how external control inputs-operationalizing effort-distribute changes in neural activity evoked during mindful attention across the white matter network. We hypothesized that individuals with greater network controllability, thereby efficiently distributing control inputs, effectively self-regulate behavior. We further hypothesized that brain regions that utilize greater control input exhibit shorter intrinsic timescales of neural activity. Shorter timescales characterize quickly discontinuing past processing to focalize the present. We tested these hypotheses in a randomized controlled study that primed participants to either mindfully respond or naturally react to alcohol cues during fMRI and administered text reminders and measurements of alcohol consumption during 4 wk postscan. We found that participants with greater network controllability moderated alcohol consumption. Mindful regulation of alcohol cues, compared to one's own natural reactions, reduced craving, but craving did not differ from the baseline group. Mindful regulation of alcohol cues, compared to the natural reactions of the baseline group, involved more-effortful control of neural dynamics across cognitive control and attention subnetworks. This effort persisted in the natural reactions of the mindful group compared to the baseline group. More-effortful neural states had shorter timescales than less effortful states, offering an explanation for how mindful attention promotes being present.
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Affiliation(s)
- Dale Zhou
- Neuroscience Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Yoona Kang
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104
| | - Danielle Cosme
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104
| | - Mia Jovanova
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104
| | - Xiaosong He
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104
- Department of Psychology, School of Humanities and Social Sciences, University of Science and Technology of China, 230026 Hefei, People’s Republic of China
| | - Arun Mahadevan
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104
| | - Jeesung Ahn
- Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104
| | - Ovidia Stanoi
- Department of Psychology, Columbia University, New York, NY 19104
| | - Julia K. Brynildsen
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104
| | - Nicole Cooper
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104
| | - Eli J. Cornblath
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104
| | - Linden Parkes
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104
| | - Peter J. Mucha
- Department of Mathematics, Dartmouth College, Hanover, NH 03755
| | - Kevin N. Ochsner
- Department of Psychology, Columbia University, New York, NY 19104
| | - David M. Lydon-Staley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104
| | - Emily B. Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104
- Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104
- Marketing Department, Wharton School, University of Pennsylvania, Philadelphia, PA 19104
| | - Dani S. Bassett
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104
- Department of Physics & Astronomy, College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA 19104
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
- Department of Electrical & Systems Engineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
- Santa Fe Institute, Santa Fe, NM 87501
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21
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Hunt CA, Letzen JE, Krimmel SR, Burrowes SAB, Haythornthwaite JA, Finan PH, Vetter M, Seminowicz DA. Is Mindfulness Associated With Lower Pain Reactivity and Connectivity of the Default Mode Network? A Replication and Extension Study in Healthy and Episodic Migraine Participants. THE JOURNAL OF PAIN 2022; 23:2110-2120. [PMID: 35934277 PMCID: PMC9729370 DOI: 10.1016/j.jpain.2022.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/11/2022] [Accepted: 07/27/2022] [Indexed: 01/04/2023]
Abstract
Formal training in mindfulness-based practices promotes reduced experimental and clinical pain, which may be driven by reduced emotional pain reactivity and undergirded by alterations in the default mode network, implicated in mind-wandering and self-referential processing. Recent results published in this journal suggest that mindfulness, defined here as the day-to-day tendency to maintain a non-reactive mental state in the absence of training, associates with lower pain reactivity, greater heat-pain thresholds, and resting-state default mode network functional connectivity in healthy adults in a similar manner to trained mindfulness. The extent to which these findings extend to chronic pain samples and replicate in healthy samples is unknown. Using data from healthy adults (n = 36) and episodic migraine patients (n = 98) and replicating previously published methods, we observed no significant association between mindfulness and heat-pain threshold, pain intensity or unpleasantness, or pain catastrophizing in healthy controls, or between mindfulness and headache frequency, severity, impactor pain catastrophizing in patients. There was no association between default mode network connectivity and mindfulness in either sample when probed via seed-based functional connectivity analyses. In post-hoc whole brain exploratory analyses, a meta-analytically derived default mode network node (ie, posterior cingulate cortex) showed connectivity with regions unassociated with pain processing as a function of mindfulness, such that healthy adults higher in mindfulness showed greater functional connectivity between the posterior cingulate cortex-and cerebellum. Collectively, these findings suggest that the relationship between mindfulness and default mode network functional connectivity may be nuanced or non-robust, and encourage further investigation of how mindfulness relates to pain. PERSPECTIVE: This study found few significant associations between dispositional mindfulness and pain, pain reactivity and default mode connectivity in healthy adults and migraine patients. The relationship between mindfulness and default mode network connectivity may be nuanced or non-robust.
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Affiliation(s)
- Carly A Hunt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | - Janelle E Letzen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Samuel R Krimmel
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Shana A B Burrowes
- Department of Medicine, Boston University School of Medicine, Section of Infectious Diseases, Boston, Maryland; Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland; Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, Maryland
| | - Jennifer A Haythornthwaite
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patrick H Finan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Maria Vetter
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David A Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland; Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, Maryland
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Smith JL, Allen JW, Fleischer CC, Harper DE. Topology of pain networks in patients with temporomandibular disorder and pain-free controls with and without concurrent experimental pain: A pilot study. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 3:966398. [PMID: 36324873 PMCID: PMC9619074 DOI: 10.3389/fpain.2022.966398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022]
Abstract
Temporomandibular disorders (TMD) involve chronic pain in the masticatory muscles and jaw joints, but the mechanisms underlying the pain are heterogenous and vary across individuals. In some cases, structural, functional, and metabolic changes in the brain may underlie the condition. In the present study, we evaluated the functional connectivity between 86 regions of interest (ROIs), which were chosen based on previously reported neuroimaging studies of pain and differences in brain morphology identified in an initial surface-based morphometry analysis. Our main objectives were to investigate the topology of the network formed by these ROIs and how it differs between individuals with TMD and chronic pain (n = 16) and pain-free control participants (n = 12). In addition to a true resting state functional connectivity scan, we also measured functional connectivity during a 6-min application of a noxious cuff stimulus applied to the left leg. Our principal finding is individuals with TMD exhibit more suprathreshold correlations (higher nodal degree) among all ROIs but fewer "hub" nodes (i.e., decreased betweenness centrality) across conditions and across all pain pathways. These results suggest is this pain-related network of nodes may be "over-wired" in individuals with TMD and chronic pain compared to controls, both at rest and during experimental pain.
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Affiliation(s)
- Jeremy L. Smith
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Jason W. Allen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States,Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
| | - Candace C. Fleischer
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States,Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Daniel E. Harper
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, United States,Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States,Correspondence: Daniel E. Harper
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23
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Chen P, Kirk U, Dikker S. Trait mindful awareness predicts inter-brain coupling but not individual brain responses during naturalistic face-to-face interactions. Front Psychol 2022; 13:915345. [PMID: 36248509 PMCID: PMC9561904 DOI: 10.3389/fpsyg.2022.915345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022] Open
Abstract
In recent years, the possible benefits of mindfulness meditation have sparked much public and academic interest. Mindfulness emphasizes cultivating awareness of our immediate experience and has been associated with compassion, empathy, and various other prosocial traits. However, neurobiological evidence pertaining to the prosocial benefits of mindfulness in social settings is sparse. In this study, we investigate neural correlates of trait mindful awareness during naturalistic dyadic interactions, using both intra-brain and inter-brain measures. We used the Muse headset, a portable electroencephalogram (EEG) device often used to support mindfulness meditation, to record brain activity from dyads as they engaged in naturalistic face-to-face interactions in a museum setting. While we did not replicate prior laboratory-based findings linking trait mindfulness to individual brain responses (N = 379 individuals), self-reported mindful awareness did predict dyadic inter-brain synchrony, in theta (~5-8 Hz) and beta frequencies (~26-27 Hz; N = 62 dyads). These findings underscore the importance of conducting social neuroscience research in ecological settings to enrich our understanding of how (multi-brain) neural correlates of social traits such as mindful awareness manifest during social interaction, while raising critical practical considerations regarding the viability of commercially available EEG systems.
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Affiliation(s)
- Phoebe Chen
- Psychology Department, New York University, New York City, NY, United States
| | - Ulrich Kirk
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Suzanne Dikker
- Psychology Department, New York University, New York City, NY, United States
- Department of Clinical Psychology, Free University Amsterdam, Amsterdam, Netherlands
- Max Planck - NYU Center for Language Music and Emotion, New York University, New York City, NY, United States
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24
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Approaching or Decentering? Differential Neural Networks Underlying Experiential Emotion Regulation and Cognitive Defusion. Brain Sci 2022; 12:brainsci12091215. [PMID: 36138951 PMCID: PMC9496919 DOI: 10.3390/brainsci12091215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022] Open
Abstract
The current study investigated the bottom-up experiential emotion regulation in comparison to the cognitiveve top down-approach of cognitive defusion. Rooted in an experiential- and client-centered psychotherapeutic approach, experiential emotion regulation involves an active, non-intervening, accepting, open and welcoming approach towards the bodily felt affective experience in a welcoming, compassionate way, expressed in ‘experiential awareness’ in a first phase, and its verbalization or ‘experiential expression’ in a second phase. Defusion refers to the ability to observe one’s thoughts and feelings in a detached manner. Nineteen healthy participants completed an emotion regulation task during fMRI scanning by processing highly arousing negative events by images. Both experiential emotion regulation and cognitive defusion resulted in higher negative emotion compared to a ‘watch’ control condition. On the neurophysiological level, experiential emotion regulation recruited brain areas that regulate attention towards affective- and somatosensorial experience such as the anterior cingulate cortex, the paracingulate gyrus, the inferior frontal gyrus, and the prefrontal pole, areas underlying multisensory information integration (e.g., angular gyrus), and linking body states to emotion recognition and awareness (e.g., postcentral gyrus). Experiential emotion regulation, relative to the control condition, also resulted in a higher interaction between the anterior insular cortex and left amygdala while participants experienced less negative emotion. Cognitive defusion decreased activation in the subcortical areas such as the brainstem, the thalamus, the amygdala, and the hippocampus. In contrast to cognitive defusion, experiential emotion regulation relative to demonstrated greater activation in the left angular gyrus, indicating more multisensory information integration. These findings provide insight into different and specific neural networks underlying psychotherapy-based experiential emotion regulation and cognitive defusion.
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25
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Ninneman JV, Gretzon NP, Stegner AJ, Lindheimer JB, Falvo MJ, Wylie GR, Dougherty RJ, Almassi NE, Van Riper SM, Boruch AE, Dean DC, Koltyn KF, Cook DB. Pain, But Not Physical Activity, Is Associated with Gray Matter Volume Differences in Gulf War Veterans with Chronic Pain. J Neurosci 2022; 42:5605-5616. [PMID: 35697521 PMCID: PMC9295831 DOI: 10.1523/jneurosci.2394-21.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/27/2022] [Accepted: 05/02/2022] [Indexed: 01/16/2023] Open
Abstract
Chronic musculoskeletal pain (CMP) is a significant burden for Persian Gulf War Veterans (GWVs), yet the causes are poorly understood. Brain structure abnormalities are observed in GWVs, however relationships with modifiable lifestyle factors such as physical activity (PA) are unknown. We evaluated gray matter volumes and associations with symptoms, PA, and sedentary time in GWVs with and without CMP. Ninety-eight GWVs (10 females) with CMP and 56 GWVs (7 females) controls completed T1-weighted magnetic resonance imaging, pain and fatigue symptom questionnaires, and PA measurement via actigraphy. Regional gray matter volumes were analyzed using voxel-based morphometry and were compared across groups using analysis of covariance (ANCOVA). Separate multiple linear regression models were used to test associations between PA intensities, sedentary time, symptoms, and gray matter volumes. Familywise cluster error rates were used to control for multiple comparisons (α = 0.05). GWVs with CMP reported greater pain and fatigue symptoms, worse mood, and engaged in less moderate-to-vigorous PA and more sedentary time than healthy GWVs (all p values < 0.05). GWVs with CMP had smaller gray matter volumes in the bilateral insula and larger volumes in the frontal pole (p < 0.05adjusted). Gray matter volumes in the left insula were associated with pain symptoms (r partial = 0.26, -0.29; p < 0.05adjusted). No significant associations were observed for either PA or sedentary time (p > 0.05adjusted). GWVs with CMP had smaller gray matter volumes within a critical brain region of the descending pain processing network and larger volumes within brain regions associated with pain sensation and affective processing, which may reflect pain chronification.SIGNIFICANCE STATEMENT The pathophysiology of chronic pain in Gulf War veterans is understudied and not well understood. In a large sample of Gulf War veterans, we report veterans with chronic musculoskeletal pain have smaller gray matter volumes in brain regions associated with pain regulation and larger volumes in regions associated with pain sensitivity compared with otherwise healthy Gulf War veterans. Gray matter volumes in regions of pain regulation were significantly associated with pain symptoms and encompassed the observed group brain volume differences. These results are suggestive of deficient pain modulation that may contribute to pain chronification.
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Affiliation(s)
- Jacob V Ninneman
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin 53706
| | - Nicholas P Gretzon
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin 53706
| | - Aaron J Stegner
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin 53706
| | - Jacob B Lindheimer
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin 53706
| | - Michael J Falvo
- War Related Illness and Injury Study Center, U.S. Department of Veterans Affairs, Veterans Affairs New Jersey Health Care System, East Orange, New Jersey 07018
- New Jersey Medical School, Rutgers University, Newark, New Jersey 08854
| | - Glenn R Wylie
- War Related Illness and Injury Study Center, U.S. Department of Veterans Affairs, Veterans Affairs New Jersey Health Care System, East Orange, New Jersey 07018
- Kessler Foundation, West Orange, New Jersey 07052
- New Jersey Medical School, Rutgers University, Newark, New Jersey 08854
| | - Ryan J Dougherty
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21287
| | - Neda E Almassi
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin 53706
| | - Stephanie M Van Riper
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California 94301
| | - Alexander E Boruch
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin 53706
| | - Douglas C Dean
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin, 53706
| | - Kelli F Koltyn
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin 53706
| | - Dane B Cook
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin 53706
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26
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Li Y, Jiang L. State and Trait Anxiety Share Common Network Topological Mechanisms of Human Brain. Front Neuroinform 2022; 16:859309. [PMID: 35811997 PMCID: PMC9260038 DOI: 10.3389/fninf.2022.859309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/04/2022] [Indexed: 12/01/2022] Open
Abstract
Anxiety is a future-oriented unpleasant and negative mental state induced by distant and potential threats. It could be subdivided into momentary state anxiety and stable trait anxiety, which play a complex and combined role in our mental and physical health. However, no studies have systematically investigated whether these two different dimensions of anxiety share a common or distinct topological mechanism of human brain network. In this study, we used macroscale human brain morphological similarity network and functional connectivity network as well as their spatial and temporal variations to explore the topological properties of state and trait anxiety. Our results showed that state and trait anxiety were both negatively correlated with the coefficient of variation of nodal efficiency in the left frontal eyes field of volume network; state and trait anxiety were both positively correlated with the median and mode of pagerank centrality distribution in the right insula for both static and dynamic functional networks. In summary, our study confirmed that state and trait anxiety shared common human brain network topological mechanisms in the insula and the frontal eyes field, which were involved in preliminary cognitive processing stage of anxiety. Our study also demonstrated that the common brain network topological mechanisms had high spatiotemporal robustness and would enhance our understanding of human brain temporal and spatial organization.
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Affiliation(s)
- Yubin Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Lili Jiang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Lili Jiang
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27
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Phan-Le NT, Brennan L, Parker L. The search for scientific meaning in mindfulness research: Insights from a scoping review. PLoS One 2022; 17:e0264924. [PMID: 35507587 PMCID: PMC9067662 DOI: 10.1371/journal.pone.0264924] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 02/18/2022] [Indexed: 11/19/2022] Open
Abstract
There are on-going debates about what is and is not 'mindfulness'. These debates are stifling rigorous academic research as scientific precision is a precursor to shared meaning. While mindfulness is a growing field of research, these divergent and conflated meanings are limiting deeper interdisciplinary research. Interventions designed in one practice context may not be useful in other contexts because meaning is not transferred between settings. This review clarifies the various research domains that study mindfulness and the conceptual and operational definitions in each domain. This two-stage study comprises a scoping review of mindfulness classifications and a comparative content mapping of mindfulness studies from 2015 to 2021. The initial comprehensive search strategy followed the preferred reporting items for scoping reviews and meta-analysis (PRISMA) method. The comparative analysis was conducted using Leximancer. Findings illustrate a complex growing research corpus on mindfulness that is somewhat confused. The results from the scoping review show three shared domains in mindfulness classifications: short-term effects of mindfulness, long-term effects of mindfulness, and mindfulness practices. The results from the content mapping show four domains of mindfulness research: mental health, behavioural change, cognitive neuroscience, and ethical mindfulness. Operational definitions of mindfulness are not articulated clearly in these domains. Conceptual and operational definitions in the 'ethical mindfulness' domain are not yet developed. To enhance scientific progress in mindfulness research, further investigations of mindfulness classifications need to be developed. Content mapping and semantic typology is a potential candidate for future classification. More attention should be paid to developing operational definitions according to specific research domains. Scholars in the ethical mindfulness domain will need solid conceptual and operational definitions to support their research efforts.
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Affiliation(s)
- Nhat Tram Phan-Le
- School of Media and Communication, RMIT University, Melbourne, Australia
| | - Linda Brennan
- School of Media and Communication, RMIT University, Melbourne, Australia
| | - Lukas Parker
- School of Media and Communication, RMIT University, Melbourne, Australia
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28
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Lee GJ, Kim YJ, Shim SW, Lee K, Oh SB. Anterior insular-nucleus accumbens pathway controls refeeding-induced analgesia under chronic inflammatory pain condition. Neuroscience 2022; 495:58-73. [DOI: 10.1016/j.neuroscience.2022.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/21/2022] [Accepted: 05/19/2022] [Indexed: 10/18/2022]
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29
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Gan Q, Ding N, Bi G, Liu R, Zhao X, Zhong J, Wu S, Zeng Y, Cui L, Wu K, Fu Y, Chen Z. Enhanced Resting-State Functional Connectivity With Decreased Amplitude of Low-Frequency Fluctuations of the Salience Network in Mindfulness Novices. Front Hum Neurosci 2022; 16:838123. [PMID: 35308619 PMCID: PMC8927720 DOI: 10.3389/fnhum.2022.838123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Mindfulness and accordant interventions are often used as complementary treatments to psychological or psychosomatic problems. This has also been gradually integrated into daily lives for the promotion of psychological well-being in non-clinical populations. The experience of mindful acceptance in a non-judgmental way brought about the state, which was less interfered by a negative effect. Mindfulness practice often begins with focused attention (FA) meditation restricted to an inner experience. We postulate that the brain areas related to an interoceptive function would demonstrate an intrinsic functional change after mindfulness training for the mindful novices along with paying more attention to internal processes. To further explore the influence of mindfulness on the organization of the brain regions, both functional connectivity (FC) in the voxel and the region of interest (ROI) level were calculated. In the current study, 32 healthy volunteers, without any meditation experiences, were enrolled and randomly assigned to a mindfulness-based stress reduction group (MBSR) or control group (CON). Participants in the MBSR group completed 8 weeks of mindfulness-based stress reduction (MBSR) and rated their mindfulness skills before and after MBSR. All subjects were evaluated via resting-state functional MRI (rs-fMRI) in both baselines and after 8 weeks. They also completed a self-report measure of their state and trait anxiety as well as a positive and negative affect. Pre- and post-MBSR assessments revealed a decreased amplitude of low-frequency fluctuations (ALFF) in the right anterior cingulate gyrus (ACC.R), left anterior and posterior insula (aIC.L, pIC.L), as well as left superior medial frontal gyrus (SFGmed.L) in MBSR practitioners. Strengthened FC between right anterior cingulate cortex (ACC.R) and aIC.R was observed. The mean ALFF values of those regions were inversely and positively linked to newly acquired mindful abilities. Along with a decreased negative affect score, our results suggest that the brain regions related to attention and interoceptive function were involved at the beginning of mindfulness. This study provides new clues in elucidating the time of evaluating the brain mechanisms of mindfulness novices.
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Affiliation(s)
- Quan Gan
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Ning Ding
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Guoli Bi
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Department of Magnetic Resonance Imaging, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Ruixiang Liu
- Department of Clinical Psychology, The Second People’s Hospital of Yunnan Province, Kunming, China
| | - Xingrong Zhao
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingmei Zhong
- Department of Clinical Psychology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Shaoyuan Wu
- Department of Clinical Psychology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yong Zeng
- Department of Clinical Psychology, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Liqian Cui
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kunhua Wu
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Department of Magnetic Resonance Imaging, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yunfa Fu
- School of Information Engineering and Automation, Kunming University of Science and Technology, Kunming, China
| | - Zhuangfei Chen
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- *Correspondence: Zhuangfei Chen,
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30
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Benevides AL, Santana G, Sá KN. Spirituality as Strategies for Coping With Tropical Spastic Paraparesis: Results of Focus Group. JOURNAL OF RELIGION AND HEALTH 2022; 61:540-551. [PMID: 33417057 DOI: 10.1007/s10943-020-01162-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
In the logic of integrality in health, one of the aspects less addressed by assistance services is the question of spirituality. This study utilized qualitative analysis from focus groups to identify whether spirituality can contribute to coping with problems arising from the HTLV-1 myelopathy associated or tropical spastic paraparesis (HAM/TSP). The testimonies were recorded and then transcribed. The information was then systematized by the analysis of thematic-categorical content. When giving voice to people who suffer from HAM/TSP, there is clear evidence that spirituality, understood broadly and not restricted to institutionalized religious practices, is expressed in narratives of feeling for others and trust in God. Through spiritual solutions, people with HAM/TSP find the strength to face their disability and pain.
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Affiliation(s)
| | - Genildes Santana
- Medical Service, Instituto Federal da Bahia, Salvador, Bahia, Brazil
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31
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How do placebo effects contribute to mindfulness-based analgesia? Probing acute pain effects and interactions using a randomized balanced placebo design. Pain 2022; 163:1967-1977. [PMID: 35082252 DOI: 10.1097/j.pain.0000000000002593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Recent sham-controlled studies suggest placebo effects contribute to acute pain relief following mindfulness interventions. However, the specific effects of mindfulness processes and their interaction with placebo effects remain unclear. This study aimed to characterize the role of mindfulness and placebo processes underlying mindfulness-based pain attenuation. Both treatment (focused-attention mindfulness vs sham) and instruction ("told mindfulness" vs "told sham") were manipulated in a balanced placebo design. Changes in acute heat pain were evaluated in 153 healthy adults randomized to receive 6 x 20 minutes of one of the four treatment by instruction interventions or no treatment. Participants receiving any intervention demonstrated improved pain outcomes (unpleasantness, intensity and tolerance) relative to no treatment. The instruction manipulation increased expectation for pain relief in those told mindfulness relative to told sham, but there were no main effects or interactions of treatment or instruction on pain outcomes. However, irrespective of actual intervention received, the belief of receiving mindfulness predicted increased pain threshold and tolerance, with expectancy fully mediating the effect on pain tolerance. These findings suggest a lack of specific effects of mindfulness and instruction on acute pain. Nonetheless, participants' expectancies and beliefs about the treatment they received did predict pain relief. Together with the overall improvement following any intervention, these findings suggest that expectancy and belief may play a stronger role in attenuating acute pain in novices following brief mindfulness interventions than the actual mindfulness-specific processes or instructions delivered.
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32
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Medina S, O’Daly OG, Howard MA, Feliu-Soler A, Luciano JV. Differential Brain Perfusion Changes Following Two Mind–Body Interventions for Fibromyalgia Patients: an Arterial Spin Labelling fMRI Study. Mindfulness (N Y) 2022; 13:449-461. [PMID: 35222735 PMCID: PMC8831296 DOI: 10.1007/s12671-021-01806-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2021] [Indexed: 12/20/2022]
Abstract
Objectives Further mechanistic insight on mind–body techniques for fibromyalgia (FMS) is needed. Arterial spin labelling (ASL) imaging can capture changes in regional cerebral blood flow (rCBF) that relate to spontaneous pain. Methods We recruited FMS patients undergoing either mindfulness-based stress reduction training (MBSR, n = 14) or a psychoeducational programme (FibroQoL, n = 18), and a control FMS group with no add-on treatment (n = 14). We acquired whole-brain rCBF maps and self-report measures at baseline and following treatment and explored interaction effects in brain perfusion between the treatment group and session with a focus on the amygdala, the insula and the anterior cingulate cortex (ACC). Results We identified a significant interaction effect in the amygdala, which corresponded with rCBF decreases following FibroQoL specifically. At baseline, rCBF in the amygdala for the FibroQoL group correlated with pain catastrophizing and anxiety scores, but not after treatment, suggesting a decoupling between activity in the amygdala and negative emotional symptoms of FMS as a consequence of treatment. Baseline rCBF correlated positively with pain symptoms in the ACC and the anterior insula across all patients; moreover, the correlation between rCBF changes post intervention in the insula and pain improvement was negative for both treatments and significantly different from the control group. We suggest that there is disruption of the typical relationship between clinical pain and activity as a product of these two nonpharmacological therapies. Conclusions We have demonstrated that different mind-to-body treatments correspond to differential changes in clinical symptoms and brain activity patterns, which encourages future research investigating predictors of treatment response. Trial Registration NCT02561416. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-021-01806-2.
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Affiliation(s)
- Sonia Medina
- Department of Neuroimaging, King’s College London, London, UK
| | - Owen G. O’Daly
- Department of Neuroimaging, King’s College London, London, UK
| | | | - Albert Feliu-Soler
- Department of Clinical & Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
| | - Juan V. Luciano
- Department of Clinical & Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
- Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
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33
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Ashar YK, Gordon A, Schubiner H, Uipi C, Knight K, Anderson Z, Carlisle J, Polisky L, Geuter S, Flood TF, Kragel PA, Dimidjian S, Lumley MA, Wager TD. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry 2022; 79:13-23. [PMID: 34586357 PMCID: PMC8482298 DOI: 10.1001/jamapsychiatry.2021.2669] [Citation(s) in RCA: 143] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Chronic back pain (CBP) is a leading cause of disability, and treatment is often ineffective. Approximately 85% of cases are primary CBP, for which peripheral etiology cannot be identified, and maintenance factors include fear, avoidance, and beliefs that pain indicates injury. OBJECTIVE To test whether a psychological treatment (pain reprocessing therapy [PRT]) aiming to shift patients' beliefs about the causes and threat value of pain provides substantial and durable pain relief from primary CBP and to investigate treatment mechanisms. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial with longitudinal functional magnetic resonance imaging (fMRI) and 1-year follow-up assessment was conducted in a university research setting from November 2017 to August 2018, with 1-year follow-up completed by November 2019. Clinical and fMRI data were analyzed from January 2019 to August 2020. The study compared PRT with an open-label placebo treatment and with usual care in a community sample. INTERVENTIONS Participants randomized to PRT participated in 1 telehealth session with a physician and 8 psychological treatment sessions over 4 weeks. Treatment aimed to help patients reconceptualize their pain as due to nondangerous brain activity rather than peripheral tissue injury, using a combination of cognitive, somatic, and exposure-based techniques. Participants randomized to placebo received an open-label subcutaneous saline injection in the back; participants randomized to usual care continued their routine, ongoing care. MAIN OUTCOMES AND MEASURES One-week mean back pain intensity score (0 to 10) at posttreatment, pain beliefs, and fMRI measures of evoked pain and resting connectivity. RESULTS At baseline, 151 adults (54% female; mean [SD] age, 41.1 [15.6] years) reported mean (SD) pain of low to moderate severity (mean [SD] pain intensity, 4.10 [1.26] of 10; mean [SD] disability, 23.34 [10.12] of 100) and mean (SD) pain duration of 10.0 (8.9) years. Large group differences in pain were observed at posttreatment, with a mean (SD) pain score of 1.18 (1.24) in the PRT group, 2.84 (1.64) in the placebo group, and 3.13 (1.45) in the usual care group. Hedges g was -1.14 for PRT vs placebo and -1.74 for PRT vs usual care (P < .001). Of 151 total participants, 33 of 50 participants (66%) randomized to PRT were pain-free or nearly pain-free at posttreatment (reporting a pain intensity score of 0 or 1 of 10), compared with 10 of 51 participants (20%) randomized to placebo and 5 of 50 participants (10%) randomized to usual care. Treatment effects were maintained at 1-year follow-up, with a mean (SD) pain score of 1.51 (1.59) in the PRT group, 2.79 (1.78) in the placebo group, and 3.00 (1.77) in the usual care group. Hedges g was -0.70 for PRT vs placebo (P = .001) and -1.05 for PRT vs usual care (P < .001) at 1-year follow-up. Longitudinal fMRI showed (1) reduced responses to evoked back pain in the anterior midcingulate and the anterior prefrontal cortex for PRT vs placebo; (2) reduced responses in the anterior insula for PRT vs usual care; (3) increased resting connectivity from the anterior prefrontal cortex and the anterior insula to the primary somatosensory cortex for PRT vs both control groups; and (4) increased connectivity from the anterior midcingulate to the precuneus for PRT vs usual care. CONCLUSIONS AND RELEVANCE Psychological treatment centered on changing patients' beliefs about the causes and threat value of pain may provide substantial and durable pain relief for people with CBP. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03294148.
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Affiliation(s)
- Yoni K. Ashar
- Department of Psychiatry, Weill Cornell Medical College, New York City, New York,Department of Psychology and Neuroscience, University of Colorado, Boulder,Institute of Cognitive Science, University of Colorado, Boulder
| | - Alan Gordon
- Pain Psychology Center, Los Angeles, California
| | - Howard Schubiner
- Ascension Providence Hospital, Southfield, Michigan,Michigan State University College of Human Medicine, East Lansing
| | | | - Karen Knight
- Panorama Orthopedics and Spine Center, Golden, Colorado
| | - Zachary Anderson
- Department of Psychology and Neuroscience, University of Colorado, Boulder,Institute of Cognitive Science, University of Colorado, Boulder,Department of Psychology, Northwestern University, Evanston, Illinois
| | - Judith Carlisle
- Department of Psychology and Neuroscience, University of Colorado, Boulder,Institute of Cognitive Science, University of Colorado, Boulder,Department of Philosophy, Washington University in Saint Louis, Saint Louis, Missouri
| | - Laurie Polisky
- Department of Psychology and Neuroscience, University of Colorado, Boulder,Institute of Cognitive Science, University of Colorado, Boulder
| | - Stephan Geuter
- Department of Psychology and Neuroscience, University of Colorado, Boulder,Institute of Cognitive Science, University of Colorado, Boulder,Johns Hopkins University Department of Biostatistics, Baltimore, Maryland
| | - Thomas F. Flood
- Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Philip A. Kragel
- Department of Psychology and Neuroscience, University of Colorado, Boulder,Institute of Cognitive Science, University of Colorado, Boulder,Department of Psychology, Emory University, Atlanta, Georgia
| | - Sona Dimidjian
- Department of Psychology and Neuroscience, University of Colorado, Boulder,Renée Crown Wellness Institute, University of Colorado, Boulder
| | - Mark A. Lumley
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Tor D. Wager
- Department of Psychology and Neuroscience, University of Colorado, Boulder,Institute of Cognitive Science, University of Colorado, Boulder,Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire
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Feng B, Hu X, Lu WW, Wang Y, Ip WY. Are mindfulness treatments effective for pain in cancer patients? A systematic review and meta-analysis. Eur J Pain 2022; 26:61-76. [PMID: 34369040 DOI: 10.1002/ejp.1849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/22/2021] [Accepted: 07/31/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Mindfulness-based interventions (MBIs) have been recently applied in pain management and cancer care. However, inconsistencies exist concerning the effectiveness of MBIs on pain control among cancer patients. Therefore, this study aimed to examine the efficacy of MBIs on pain in cancer patients via a systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS Databases (MEDLINE, PubMed, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov) were searched using key terms related to pain, cancer and mindfulness. The primary outcome was pain intensity. Standardized mean difference (SMD) of each outcome with 95% confidence interval (95% CI) was calculated. The quality of evidence was assessed by GRADE assessment. RESULTS Ten RCTs with 843 participants were included. Significant pooled effects of MBIs on pain intensity were found at both short-term (SMD = -0.19, 95% CI [-0.33 to -0.04]) and long-term (SMD = -0.20, 95% CI [-0.35 to -0.05]) follow-up, whereas no significance was observed for pain interference. In subgroup analyses, significant intervention effects were only seen in clinic-based MBIs compared to remote MBIs, and pooled effects of MBIs in attenuating pain were discovered relative to passive rather than active comparators. GRADE ratings showed moderate certainty of evidence in MBIs for pain intensity but low for pain interference. CONCLUSIONS The efficacy of MBIs in reducing pain intensity among cancer patients was revealed in this meta-analysis, albeit with a small effect size. Future research is warranted to optimize mindfulness treatment for pain control in cancer patients with high methodological quality and a large sample size. SIGNIFICANCE The effect of MBIs on pain in cancer patients was demonstrated in our analysis, albeit with small effect sizes. High-quality RCTs are needed to verify the efficacy of MBIs on cancer patients or survivors with pain complaints. Future trials should take into account the specific pain outcome measures (pain intensity or pain interference), the approach of intervention provision (clinic-based or remote MBI, group or individual practice), the duration and frequency of interventions and the comparators (passive or active control arms).
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Affiliation(s)
- Beibei Feng
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Orthopaedics & Traumatology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Xiaoqian Hu
- School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - William W Lu
- Department of Orthopaedics & Traumatology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yuling Wang
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wing-Yuk Ip
- Department of Orthopaedics & Traumatology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Guo X, Wang M, Wang X, Guo M, Xue T, Wang Z, Li H, Xu T, He B, Cui D, Tong S. Progressive Increase of High-Frequency EEG Oscillations during Meditation is Associated with its Trait Effects on Heart Rate and Proteomics: A Study on the Tibetan Buddhist. Cereb Cortex 2021; 32:3865-3877. [PMID: 34974617 DOI: 10.1093/cercor/bhab453] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 11/12/2022] Open
Abstract
Meditation has been a spiritual and healing practice in the East for thousands of years. However, the neurophysiologic mechanisms underlying its traditional form remain unclear. In this study, we recruited a large sample of monks (n = 73) who practice Tibetan Buddhist meditation and compared with meditation-naive local controls (n = 30). Their electroencephalography (EEG) and electrocardiogram signals were simultaneously recorded and blood samples were collected to investigate the integrative effects of Tibetan Buddhist on brain, heart, and proteomics. We found that the EEG activities in monks shifted to a higher frequency from resting to meditation. Meditation starts with decrease of the (pre)frontal delta activity and increase of the (pre)frontal high beta and gamma activity; while at the deep meditative state, the posterior high-frequency activity was also increased, and could be specified as a biomarker for the deep meditation. The state increase of posterior high-frequency EEG activity was significantly correlated with the trait effects on heart rate and nueropilin-1 in monks, with the source of brain-heart correlation mainly locating in the attention and emotion networks. Our study revealed that the effects of Tibetan Buddhist meditation on brain, heart, and proteomics were highly correlated, demonstrating meditation as an integrative body-mind training.
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Affiliation(s)
- Xiaoli Guo
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Meiyun Wang
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Xu Wang
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Menglin Guo
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Ting Xue
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Zhuo Wang
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Han Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Tianjiao Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin He
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, USA.,Center for Neuroscience Institute, Carnegie Mellon University, Pittsburgh, USA
| | - Donghong Cui
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Shanbao Tong
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
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Cook SH, Wood EP, Mirin N, Bandel M, Delorme M, Gad L, Jayakar O, Mustafa Z, Tatar R, Javdani S, Godfrey E. Optimizing a mindfulness-based intervention to alleviate stress from discrimination among young sexual and gender minorities of color: A study protocol. JMIR Res Protoc 2021; 11:e35593. [PMID: 34928237 PMCID: PMC8800091 DOI: 10.2196/35593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 01/07/2023] Open
Abstract
Background Young sexual and gender minorities (SGMs) of color may face unique experiences of discrimination based on their intersectional positions (eg, discrimination based on both racial or ethnic identity and sexual identity). Emerging evidence suggests that mindfulness practices may reduce stress from discrimination and improve overall well-being among young SGM. Moreover, the omnipresence of smartphone access among racial or ethnic and sexual minority communities provides a method through which to administer mindfulness-based interventions among young SGMs of color. Objective This paper outlines the protocol of the Optimizing a Daily Mindfulness Intervention to Reduce Stress from Discrimination among Young Sexual and Gender Minorities of Color (REDUCE) study, a pilot optimization trial of a smartphone-based mindfulness intervention that was developed in conjunction with the Healthy Minds Program (HMP) with the aim of reducing stress from discrimination among young SGMs. Methods In total, 80 young (ages 18-29 years) SGMs of color will be enrolled in the study. The HMP is a self-guided meditation practice, and participants will be randomized to either a control condition or an intervention that uses a neuroscience-based approach to mindfulness. We will use the multiphase optimization strategy to assess which combination of mindfulness interventions is the most effective at reducing stress from discrimination among young SGMs of color. A combination of mindfulness-based meditation intervention components will be examined, comprising mindfulness-based practices of awareness, connection, and purpose. Awareness refers to the practice of self-awareness, which reduces the mind’s ability to be distracted and instead be present in the moment. Connection refers to the practice of connection with oneself and others and emphasizes on empathy and compassion with oneself and others. Purpose encourages goal-making in accordance with one’s values and management of behavior in accordance with these goals. In addition, we will assess the feasibility and acceptability of the HMP application among young SGMs of color. Results The REDUCE study was approved by the Institutional Review Board of New York University, and recruitment and enrollment began in the winter of 2021. We expect to complete enrollment by the summer of 2022. The results will be disseminated via social media, journal articles, abstracts, or presentations, as well as to participants, who will be given the opportunity to provide feedback to the researchers. Conclusions This optimization trial is designed to test the efficacy, feasibility, and acceptability of implementing an application-based, mindfulness-based intervention to reduce stress from discrimination and improve well-being among young SGMs of color. Evidence from this study will assist in the creation of a sustainable, culturally relevant mobile app–based mindfulness intervention to reduce stress from discrimination among young SGMs of color. Trial Registration Clinicaltrials.gov NCT05131360; https://clinicaltrials.gov/ct2/show/NCT05131360 International Registered Report Identifier (IRRID) DERR1-10.2196/35593
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Abstract
ABSTRACT Interventions to promote athlete health and performance have traditionally been focused on the physical elements of injury and training. More recently, however, increasing attention has been placed on the mental aspects of athlete health, with emerging evidence suggesting that injury risk and athletic performance are significantly affected by athlete well-being. Mindfulness meditation has been shown to have significant benefits for a number of physical and mental health outcomes in various clinical populations, and recent research has explored how mindfulness may enhance athletic performance, improve athlete mental health, reduce injury risk, and perhaps even facilitate recovery from injury. As awareness of mindfulness as a noninvasive, low-risk, and accessible intervention increases in the Western society, use among athletes has increased as well. Health care providers should be aware of this evidence in order to guide athletes regarding the use of mindfulness as an intervention to potentially improve athlete health and performance.
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Affiliation(s)
- Scott A Anderson
- Department of Kinesiology, Watson Human Performance Laboratory, Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI
| | | | - Drew Watson
- Department of Orthopedics & Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Cheng X, Chen J, Zhang X, Zhang Y, Wu Q, Ma Q, Sun J, Zou W, Lin T, Zhong L, Deng W, Sun X, Cui L, Cheng X, Chen Y, Cai Y, Zheng C, Cheng D, Yang C, Ye B, Zhang X, Wei X, Cao L. Alterations in resting-state global brain connectivity in bipolar I disorder patients with prior suicide attempt. Bipolar Disord 2021; 23:474-486. [PMID: 32981096 DOI: 10.1111/bdi.13012] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/16/2020] [Accepted: 09/19/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bipolar I disorder (BD-I) is associated with a high risk of suicide attempt; however, the neural circuit dysfunction that confers suicidal vulnerability in individuals with this disorder remains largely unknown. Resting-state functional magnetic resonance imaging (rs-fMRI) allows non-invasive mapping of brain functional connectivity. The current study used an unbiased voxel-based graph theory analysis of rs-fMRI to investigate the intrinsic brain networks of BD-I patients with and without suicide attempt. METHODS A total of 30 BD-I patients with suicide attempt (attempter group), 82 patients without suicide attempt (non-attempter group), and 67 healthy controls underwent rs-fMRI scan, and then global brain connectivity (GBC) was computed as the sum of connections of each voxel with all other gray matter voxels in the brain. RESULTS Compared with the non-attempter group, we found regional differences in GBC values in emotion-encoding circuits, including the left superior temporal gyrus, bilateral insula/rolandic operculum, and right precuneus (PCu)/cuneus in the bipolar disorder (BD) attempter group, and these disrupted hub-like regions displayed fair to good power in distinguishing attempters from non-attempters among BD-I patients. GBC values of the right PCu/cuneus were positively correlated with illness duration and education in the attempter group. CONCLUSIONS Our results indicate that abnormal connectivity patterns in emotion-encoding circuits are associated with the increasing risk of vulnerability to suicide attempt in BD patients, and global dysconnectivity across these emotion-encoding circuits might serve as potential biomarkers for classification of suicide attempt in BD patients.
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Affiliation(s)
- Xiaofang Cheng
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, PR China.,The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Jianshan Chen
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Xiaofei Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Yihe Zhang
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, PR China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, PR China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, PR China
| | - Qiuxia Wu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Qing Ma
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, PR China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, PR China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, PR China
| | - Jiaqi Sun
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Wenjin Zou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Taifeng Lin
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Liangda Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Wenhao Deng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Xiaoyi Sun
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, PR China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, PR China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, PR China
| | - Liqian Cui
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | | | - Yingmei Chen
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Yinglian Cai
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Chaodun Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Daomeng Cheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Chanjuan Yang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Biyu Ye
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Xiangyang Zhang
- Department of Radiology, Institute of Psychology, Chinese Academy of Sciences, Beijing, PR China
| | - Xinhua Wei
- Jinan University, Guangzhou, Guangdong, PR China.,Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, PR China
| | - Liping Cao
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
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Case L, Adler-Neal AL, Wells RE, Zeidan F. The Role of Expectations and Endogenous Opioids in Mindfulness-Based Relief of Experimentally Induced Acute Pain. Psychosom Med 2021; 83:549-556. [PMID: 33480666 PMCID: PMC8415135 DOI: 10.1097/psy.0000000000000908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Expectations contribute to cognitive pain modulation through opioidergically mediated descending inhibition. Mindfulness meditation reduces pain independent of endogenous opioids, engaging unique corticothalamocortical mechanisms. However, it remains unknown whether expectations for pain relief predict mindfulness-induced analgesia and if these expectations are modified by endogenous opioids. METHODS In this secondary analysis of previously published work, 78 pain-free participants (mean age, 27 ± 7 years; 50% women) were randomized to a four-session mindfulness meditation or book listening regimen. Expectations for intervention-induced pain relief were assessed before and after each intervention. Pain ratings were examined after meditation or rest (control group) during noxious heat (49°C) and intravenous administration of saline placebo or the opioid antagonist naloxone (0.15 mg/kg bolus + 0.1 mg kg-1 h-1 infusion. RESULTS Mindfulness significantly lowered pain during saline and naloxone infusion. Higher expected pain relief from mindfulness predicted lower pain intensity (r(40) = -0.41, p = .009). The relationship between meditation-related expectations and pain intensity reductions was exhibited during naloxone (r(20) = -0.76, p < .001) but not saline (r(20) = -0.22, p = .36). Expectations for book listening-based analgesia did not significantly predict pain changes during saline (r(20) = -0.37, p = .11) or naloxone (r(18) = 0.26, p = .30) in the control group. CONCLUSIONS These novel findings demonstrate a significant role for expectations in mindfulness-based pain relief. However, this role was minimal during saline and stronger during opioid blockade, despite similar pain reductions. This supports growing evidence that mindfulness engages multiple mechanisms to reduce pain, suggesting that mindfulness might be an effective pain-reducing technique even for individuals with low expectations for pain relief.
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Affiliation(s)
- Laura Case
- Department of Anesthesiology, University of California at San Diego
| | | | | | - Fadel Zeidan
- Department of Anesthesiology, University of California at San Diego
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
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Cognitive Defusion Is a Core Cognitive Mechanism for the Sensory-Affective Uncoupling of Pain During Mindfulness Meditation. Psychosom Med 2021; 83:566-578. [PMID: 33790200 DOI: 10.1097/psy.0000000000000938] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Mindfulness meditation can downregulate the experience of pain. However, its specific underlying regulatory mechanisms are still largely unknown. Here, we aimed to investigate the role of cognitive defusion-a form of psychological distancing from internal experiences-in mindfulness-based pain regulation. METHODS We implemented a thermal heat paradigm that was designed to amplify the cognitive-affective aspects of pain in 43 novice meditators (2-day formal training; 51.2% women; 53.2 ± 7.0 years old) and 27 expert meditators (>10,000-hour practice; 44.4% women; 51.9 ± 8.4 years old). We collected pain intensity and unpleasantness reports and trait measures of pain catastrophizing assessed by the Pain Catastrophizing Scale (PCS), cognitive defusion assessed by the Drexel Defusion Scale (DDS), and cognitive fusion assessed by the Cognitive Fusion Questionnaire, as well as of several other constructs commonly reported in the literature. RESULTS Experts reported lower PCS (6.9 ± 5.2 versus 17.2 ± 8.5, p < .001) but higher DDS (39.4 ± 6.4 versus 28.9 ± 6.6, p < .001) than novices. Across participants, the PCS and DDS were negatively correlated and shared unique variance that survived adjusting for other mindfulness-related and cognitive-emotional constructs (β = -0.64, p < .001). Conversely, the relationships between PCS and other commonly reported constructs did not seem specific, as none of the relationships survived adjusting for DDS (adjusted β < 0.25, p > .05). Further supporting the relevance of DDS to pain, both the DDS and PCS specifically predicted pain unpleasantness as opposed to pain intensity. However, DDS seemed to be a more specific predictor of unpleasantness than PCS, as the relationship between DDS and unpleasantness survived adjusting for PCS (adjusted β = -0.33, p = .016), but not vice versa (adjusted β = 0.20, p = .162). We also found that the Cognitive Fusion Questionnaire showed a similar pattern of associations with PCS and pain self-reports to what was found for the DDS, although these associations were less consistent. CONCLUSIONS Collectively, these findings highlight the central role of cognitive defusion in mindfulness-based pain regulation.
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De Benedittis G. Neural Mechanisms of Hypnosis and Meditation-Induced Analgesia: A Narrative Review. Int J Clin Exp Hypn 2021; 69:363-382. [PMID: 33960912 DOI: 10.1080/00207144.2021.1917294] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Meditation and hypnosis have both been found to attenuate pain; however, little is known about similarities and differences in the cognitive modulation of pain. Hypnotic and meditative states (e.g., mindfulness) reduce pain by sharing and overlapping multiple neuro-cognitive mechanisms, but they differ in many respects. While there are overlapping brain networks involved, the nature of these effects seems different. Both phenomena involve frontal modulation of pain-related areas. The role of the dorsolateral prefrontal cortex appears to depend, in hypnosis, on the type of suggestion given and, in meditation, on the level of practice. Whereas the anterior cingulate cortex seems to be a key node in both hypnosis and meditation, the dorsolateral prefrontal cortex appears to engage in hypnosis as a function of suggestion and, in meditation, as a function of proficiency.
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Vencatachellum S, van der Meulen M, Van Ryckeghem DML, Van Damme S, Vögele C. Brief mindfulness training can mitigate the influence of prior expectations on pain perception. Eur J Pain 2021; 25:2007-2019. [PMID: 34101937 DOI: 10.1002/ejp.1817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/29/2021] [Accepted: 06/04/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Recent neuroimaging evidence suggests that mindfulness practice may mitigate the biasing influence of prior cognitive and emotional expectations on pain perception. The current study tested this hypothesis using a pain-cueing paradigm, which has reliably been shown to elicit conditioned hypoalgesic and hyperalgesic effects. Specifically, we aimed to investigate whether the instructed use of a mindfulness compared to a suppression strategy differentially modulates the magnitudes of conditioned hypoalgesia and hyperalgesia. METHODS Sixty-two healthy non-meditators were assigned to listen to either brief mindfulness or suppression instructions, in between the conditioning and testing phases of a pain-cueing task. Participants provided ratings of anticipatory anxiety, pain intensity and pain unpleasantness throughout the task. They also completed trait and state self-report measures of mindfulness and pain catastrophizing. RESULTS Results indicated that the paradigm was successful in inducing conditioned hyperalgesic and hypoalgesic effects. Importantly, while we found evidence of cue-induced hyperalgesia in both groups, only the suppression group reported cue-induced hypoalgesia. No group differences in pain ratings were found for unconditioned (novel-cued) stimuli. CONCLUSIONS These findings provide partial support for recently proposed predictive processing models, which posit that mindfulness may lead to a prioritization of current sensory information over previous expectations. We explore potential explanations for the asymmetrical group differences in conditioned hypoalgesia versus conditioned hyperalgesia, and discuss our results in light of recent neuroimaging insights into the neuropsychological mechanisms of mindfulness and expectancy-driven pain modulation. SIGNIFICANCE The current study provides novel insights into the working mechanisms of mindfulness-driven pain modulation. Our data suggest that brief mindfulness training may reduce the influence of prior beliefs and expectations on pain perception. This finding adds to growing evidence suggesting that mindfulness may alleviate pain via neuropsychological mechanisms opposite to those typically observed in conditioning/placebo procedures and other cognitive manipulations. These unique mechanisms underline the potential of mindfulness as an alternative to traditional cognitive pain regulatory strategies.
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Affiliation(s)
- Shervin Vencatachellum
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Marian van der Meulen
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Dimitri M L Van Ryckeghem
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg.,Experimental Health Psychology and Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Stefaan Van Damme
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Claus Vögele
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Poletti S, Abdoun O, Zorn J, Lutz A. Pain regulation during mindfulness meditation: Phenomenological fingerprints in novices and experts practitioners. Eur J Pain 2021; 25:1583-1602. [PMID: 33797842 DOI: 10.1002/ejp.1774] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/19/2021] [Accepted: 03/27/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND The way people respond to pain is based on psychological mechanisms, beliefs and expectations. Mindfulness meditation (MM) has been shown to regulate pain and mental suffering through different mechanisms such as positive reappraisal, attentional and emotional regulation. Yet, subjective experience and meaning of pain in connection with MM are still largely unexplored. METHODS The present mixed-methods study combined an interpretative-phenomenological qualitative approach with an experimental thermal pain paradigm to explore and compare the meaning of experiencing pain in 32 novices who received short meditation training and 30 experts in meditation practice (more than 10, 000 hr in life). We collected the qualitative data during in-depth semi-structured interviews where we probed participants' response strategies. During the pain task, we collected self-reports of intensity and unpleasantness, while after the task we collected self-reports of avoidance, openness, vividness and blissfulness. RESULTS Five phenomenological clusters (PhC) emerged from the interviews, including three which described pain as an unpleasant sensation calling for: (1) experiential avoidance-suppression, (2) volitional agency-distanciation, or (3) a positive cognitive reappraisal and flexibility. Two additional clusters (4-5), containing mostly expert meditators, thematized pain sensation as an opportunity to gain metacognitive insights about mental processes, and to deconstruct one's suffering through these insights. PhC5 further integrates these insights with the recognition that suffering is part of the shared human experience and with the aspiration to relieve others from suffering. Each PhC was correlated to a unique profile of self-reports during the pain paradigm. CONCLUSION These findings need to be replicated in patients and practicing MM. They also warrant the integration of this mixed-method approach with brain imaging data to refine the experiential neuroscience of pain. SIGNIFICANCE We compared the meaning of experiencing and regulating pain in novices and expert meditators using qualitative interviews. We identified five phenomenological clusters describing relevant features implicated in pain response strategies and meditation. These clusters were organized along a pseudo-gradient, which captured meditation expertise and predicted self-reports related to a pain paradigm and psychometric scales associated with pain and its regulation. These findings advance our understanding of the metacognitive mechanisms and beliefs underlying mindfulness meditation and can inform pain treatment strategies.
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Affiliation(s)
- Stefano Poletti
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS, UMR5292, Lyon 1 University, Bron Cedex, Lyon, France
| | - Oussama Abdoun
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS, UMR5292, Lyon 1 University, Bron Cedex, Lyon, France
| | - Jelle Zorn
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS, UMR5292, Lyon 1 University, Bron Cedex, Lyon, France
| | - Antoine Lutz
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS, UMR5292, Lyon 1 University, Bron Cedex, Lyon, France
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Current Understanding of the Involvement of the Insular Cortex in Neuropathic Pain: A Narrative Review. Int J Mol Sci 2021; 22:ijms22052648. [PMID: 33808020 PMCID: PMC7961886 DOI: 10.3390/ijms22052648] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 12/22/2022] Open
Abstract
Neuropathic pain is difficult to cure and is often accompanied by emotional and psychological changes. Exploring the mechanisms underlying neuropathic pain will help to identify a better treatment for this condition. The insular cortex is an important information integration center. Numerous imaging studies have documented increased activity of the insular cortex in the presence of neuropathic pain; however, the specific role of this region remains controversial. Early studies suggested that the insular lobe is mainly involved in the processing of the emotional motivation dimension of pain. However, increasing evidence suggests that the role of the insular cortex is more complex and may even be related to the neural plasticity, cognitive evaluation, and psychosocial aspects of neuropathic pain. These effects contribute not only to the development of neuropathic pain, but also to its comorbidity with neuropsychiatric diseases. In this review, we summarize the changes that occur in the insular cortex in the presence of neuropathic pain and analgesia, as well as the molecular mechanisms that may underlie these conditions. We also discuss potential sex-based differences in these processes. Further exploration of the involvement of the insular lobe will contribute to the development of new pharmacotherapy and psychotherapy treatments for neuropathic pain.
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45
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Cortical Modulation of Nociception. Neuroscience 2021; 458:256-270. [PMID: 33465410 DOI: 10.1016/j.neuroscience.2021.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/28/2020] [Accepted: 01/03/2021] [Indexed: 02/06/2023]
Abstract
Nociception is the neuronal process of encoding noxious stimuli and could be modulated at peripheral, spinal, brainstem, and cortical levels. At cortical levels, several areas including the anterior cingulate cortex (ACC), prefrontal cortex (PFC), ventrolateral orbital cortex (VLO), insular cortex (IC), motor cortex (MC), and somatosensory cortices are involved in nociception modulation through two main mechanisms: (i) a descending modulatory effect at spinal level by direct corticospinal projections or mostly by activation of brainstem structures (i.e. periaqueductal grey matter (PAG), locus coeruleus (LC), the nucleus of raphe (RM) and rostroventral medulla (RVM)); and by (ii) cortico-cortical or cortico-subcortical interactions. This review summarizes evidence related to the participation of the aforementioned cortical areas in nociception modulation and different neurotransmitters or neuromodulators that have been studied in each area. Besides, we point out the importance of considering intracortical neuronal populations and receptors expression, as well as, nociception-induced cortical changes, both functional and connectional, to better understand this modulatory effect. Finally, we discuss the possible mechanisms that could potentiate the use of cortical stimulation as a promising procedure in pain alleviation.
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Ushio K, Nakanishi K, Mikami Y, Yoshino A, Takamura M, Hirata K, Akiyama Y, Kimura H, Okamoto Y, Adachi N. Altered Resting-State Connectivity with Pain-Related Expectation Regions in Female Patients with Severe Knee Osteoarthritis. J Pain Res 2020; 13:3227-3234. [PMID: 33299346 PMCID: PMC7719440 DOI: 10.2147/jpr.s268529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/16/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose Expectation affects pain experience in humans. Numerous studies have reported that pre-stimulus activity in the anterior insular cortex (aIC), together with prefrontal and limbic regions, integrated pain intensity and expectations. However, it is unclear whether the resting-state functional connectivity (rs-FC) between the aIC and other brain regions affects chronic pain. The purpose of this study was to examine the rs-FC between the aIC and the whole brain regions in female patients with severe knee osteoarthritis (OA). Patients and Methods Nineteen female patients with chronic severe knee OA and 15 matched controls underwent resting-state functional magnetic resonance imaging. We compared the rs-FC from the aIC seed region between the two groups. A disease-specific measurement of knee OA was performed. Results The aIC showed stronger rs-FC with the right orbitofrontal cortex (OFC), subcallosal area, and bilateral frontal pole compared with controls. The strength of rs-FC between the left aIC and the right OFC was positively correlated with the knee OA pain score (r = 0.49, p = 0.03). The strength of rs-FC between the right aIC and right OFC was positively correlated with the knee OA total score (r = 0.48, p = 0.036) and pain score (r = 0.46, p = 0.049). The OFC, subcallosal area, and frontal pole, together with the aIC, were activated during anticipation of pain stimulus. These areas have been reported as representative pain-related expectation regions. Conclusion This was the first study to show the stronger rs-FCs between the aIC and other pain-related expectation regions in female patients with severe knee OA. Female sex and preoperative pain intensity are risk factors of persistent postoperative pain after total knee arthroplasty. It is suggested that the functional relationship between pain-related expectation regions affects the formation of severe knee OA and persistent postoperative pain following total knee arthroplasty.
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Affiliation(s)
- Kai Ushio
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan.,Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuyoshi Nakanishi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Orthopedic Surgery, Nihon University School of Medicine, Nihon University, Tokyo, Japan
| | - Yukio Mikami
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan.,Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Atsuo Yoshino
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takamura
- Brain, Mind and KANSEI Sciences Research Center, Hiroshima University, Hiroshima, Japan
| | - Kazuhiko Hirata
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuji Akiyama
- Department of Clinical Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroaki Kimura
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan.,Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan.,Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Effect of Electroacupuncture on Pain Perception and Pain-Related Affection: Dissociation or Interaction Based on the Anterior Cingulate Cortex and S1. Neural Plast 2020; 2020:8865096. [PMID: 33123189 PMCID: PMC7582085 DOI: 10.1155/2020/8865096] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/01/2020] [Accepted: 09/23/2020] [Indexed: 01/02/2023] Open
Abstract
Electroacupuncture (EA) can effectively modulate pain perception and pain-related negative affect; however, we do not know whether the effect of EA on sensation and affect is parallel, or dissociated, interactional. In this study, we observed the effects of the anterior cingulate cortex (ACC) lesion and the primary somatosensory cortex (S1) activation on pain perception, pain-related affection, and neural oscillation in S1. ACC lesions did not affect pain perception but relieved pain-paired aversion. S1 activation increased pain perception and anxious behavior. EA can mitigate pain perception regardless of whether there is an ACC lesion. Chronic pain may increase the delta and theta band oscillatory activity in the S1 brain region and decrease the oscillatory activity in the alpha, beta, and gamma bands. EA intervention may inhibit the oscillatory activity of the alpha and beta bands. These results suggest that EA may mitigate chronic pain by relieving pain perception and reducing pain-related affection through different mechanisms. This evidence builds upon findings from previous studies of chronic pain and EA treatment.
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Jinich-Diamant A, Garland E, Baumgartner J, Gonzalez N, Riegner G, Birenbaum J, Case L, Zeidan F. Neurophysiological Mechanisms Supporting Mindfulness Meditation–Based Pain Relief: an Updated Review. Curr Pain Headache Rep 2020; 24:56. [DOI: 10.1007/s11916-020-00890-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Paoletti P, Ben-Soussan TD. Reflections on Inner and Outer Silence and Consciousness Without Contents According to the Sphere Model of Consciousness. Front Psychol 2020; 11:1807. [PMID: 32903475 PMCID: PMC7435012 DOI: 10.3389/fpsyg.2020.01807] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/30/2020] [Indexed: 01/06/2023] Open
Abstract
In the current hypothesis paper, we propose that focusing attention on silence can be used as a paradigm conceptually similar to sensory deprivation, to study consciousness without content. We briefly overview recent influential models of consciousness and consider how they assess the relationship between consciousness and contents. After discussing the strengths and weaknesses of current models, we suggest an extension based on the Sphere Model of Consciousness (SMC) and introduce new definitions for identification and self-awareness as states of consciousness. We further compare Paoletti's theoretical model for the development of self with other influential models, highlighting similarities and differences. We conclude with a discussion of how attentional focus on silence can be empirically tested.
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Affiliation(s)
| | - Tal Dotan Ben-Soussan
- Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation, Assisi, Italy
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50
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Wells RE, Collier J, Posey G, Morgan F, Auman T, Strittameter B, Magalhaes R, Adler-Neal A, McHaffie JG, Zeidan F. Attention to breath sensations does not engage endogenous opioids to reduce pain. Pain 2020; 161:1884-1893. [PMID: 32701847 PMCID: PMC7483215 DOI: 10.1097/j.pain.0000000000001865] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The endogenous opioidergic system is critically involved in the cognitive modulation of pain. Slow-breathing-based techniques are widely used nonpharmacological approaches to reduce pain. Yet, the active mechanisms of actions supporting these practices are poorly characterized. Growing evidence suggest that mindfulness-meditation, a slow-breathing technique practiced by nonreactively attending to breathing sensations, engages multiple unique neural mechanisms that bypass opioidergically mediated descending pathways to reduce pain. However, it is unknown whether endogenous opioids contribute to pain reductions produced by slow breathing. The present double-blind, placebo-controlled crossover study examined behavioral pain responses during mindfulness-meditation (n = 19), sham-mindfulness meditation (n = 20), and slow-paced breathing (n = 20) in response to noxious heat (49°C) and intravenous administration (0.15 mg/kg bolus + 0.1 mg/kg/hour maintenance infusion) of the opioid antagonist, naloxone, and placebo saline. Mindfulness significantly reduced pain unpleasantness ratings across both infusion sessions when compared to rest, but not pain intensity. Slow-paced breathing significantly reduced pain intensity and unpleasantness ratings during naloxone but not saline infusion. Pain reductions produced by mindfulness-meditation and slow-paced breathing were insensitive to naloxone when compared to saline administration. By contrast, sham-mindfulness meditation produced pain unpleasantness reductions during saline infusion but this effect was reversed by opioidergic antagonism. Sham-mindfulness did not lower pain intensity ratings. Self-reported "focusing on the breath" was identified as the operational feature particularly unique to the mindfulness-meditation and slow paced-breathing, but not sham-mindfulness meditation. Across all individuals, attending to the breath was associated with naloxone insensitive pain-relief. These findings provide evidence that slow breathing combined with attention to breath reduces pain independent of endogenous opioids.
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Affiliation(s)
| | - Jason Collier
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | - Grace Posey
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | - Fry Morgan
- Department of Psychiatry, Wake Forest School of Medicine
| | - Timothy Auman
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | | | - Rossana Magalhaes
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | | | - John G. McHaffie
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | - Fadel Zeidan
- Department of Anesthesiology, University of California San Diego
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