African American/Black participants with chronic pain and depression who took part in Integrative Medical Group Visits (IMGV) showed reduced pain severity from baseline to 9 weeks, a change not seen in White participants. However, White participants experienced reduced pain severity from 9 to 21 weeks, while African American/Black participants showed no significant change during that later period. At baseline, African American/Black participants had higher pain severity and differed in age, work status, and comorbidities. The findings suggest race-based differences in response to mindfulness-based integrative treatments, highlighting the need for further investigation into how such heterogeneity relates to health disparities.
Mindfulness training for primary care patients with anxiety or depression increased activity in the dorsal medial prefrontal cortex when anticipating pain, and this brain change was strongly linked to initiating health behavior changes. Greater increases in this brain response correlated with higher levels of action plan initiation, suggesting that mindfulness strengthens emotion regulation and goal-directed behavior in the face of discomfort.
Machine learning applied to data from a clinical trial of mindfulness for chronic low back pain identified distinct phenotypes that predict who will respond to the intervention. Among 132 participants in the mindfulness arm, 49 were responders and 83 were non-responders. The top three responder phenotypes correctly identified 26 of the 49 responders with 92-100% precision, and the top three non-responder phenotypes identified 36 of the 83 non-responders with 100% precision. These results may help clinicians and patients decide whether mindfulness is likely to be beneficial, improving treatment efficiency and outcomes.