Endogenous theta stimulation during meditation predicts reduced opioid dosing following treatment with Mindfulness-Oriented Recovery Enhancement.
Justin Hudak, Adam W. Hanley, William R. Marchand, Yoshio Nakamura, Brandon Yabko, Eric L Garland
Neuropsychopharmacology September 12, 2020 DOI: 10.1038/s41386-020-00831-4 (opens in new tab)
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Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 62 |
| Population | Veterans receiving long-term opioid therapy for chronic pain |
| Interventions | Mindfulness-Oriented Recovery Enhancement (MORE) supportive psychotherapy |
| Duration | 8 weeks |
| Topics | Meditation |
| Keywords | Humans Analgesics, opioid Electroencephalography Chronic pain |
| Citations | 46 |
| Key findings | Participants treated with MORE demonstrated significantly increased alpha and theta power (with larger theta power effect sizes) and increased frontal midline theta coherence relative to controls, and these neural changes were associated with altered self-referential processing. MORE significantly reduced opioid dose over time, and this dose reduction was partially statistically mediated by changes in frontal theta power. |
Abstract
Veterans experience chronic pain at greater rates than the rest of society and are more likely to receive long-term opioid therapy (LTOT), which, at high doses, is theorized to induce maladaptive neuroplastic changes that attenuate self-regulatory capacity and exacerbate opioid dose escalation. Mindfulness meditation has been shown to modulate frontal midline theta (FMT) and alpha oscillations that are linked with marked alterations in self-referential processing. These adaptive neural oscillatory changes may promote reduced opioid use and remediate the neural dysfunction occasioned by LTOT. In this study, we used electroencephalography (EEG) to assess the effects of a mindfulness-based, cognitive training intervention for opioid misuse, Mindfulness-Oriented Recovery Enhancement (MORE), on alpha and theta power and FMT coherence during meditation. We then examined whether these neural effects were associated with reduced opioid dosing and changes in self-referential processing. Before and after 8 weeks of MORE or a supportive psychotherapy control, veterans receiving LTOT (N = 62) practiced mindfulness meditation while EEG was recorded. Participants treated with MORE demonstrated significantly increased alpha and theta power (with larger theta power effect sizes) as well as increased FMT coherence relative to those in the control condition-neural changes that were associated with altered self-referential processing. Crucially, MORE significantly reduced opioid dose over time, and this dose reduction was partially statistically mediated by changes in frontal theta power. Study results suggest that mindfulness meditation practice may produce endogenous theta stimulation in the prefrontal cortex, thereby enhancing inhibitory control over opioid dose escalation behaviors.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 20
- Mindfulness-induced endogenous theta stimulation occasions self-transcendence and inhibits addictive behavior. Science Advances October 14, 2022
- Modulating self-referential processing through meditation and psychedelics: is scientific investigation of self-transcendence clinically relevant? World Psychiatry June 1, 2024
- The potential of 5‐methoxy‐N,N‐dimethyltryptamine in the treatment of alcohol use disorder: A first look at therapeutic mechanisms of action Addiction Biology April 1, 2024
- Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions Neuroscience & Biobehavioral Reviews September 25, 2023
- Mindfulness-induced self-transcendence promotes universal love with consequent effects on opioid misuse. Behaviour Research and Therapy April 1, 2024
and 15 more in the library
Cites 26
- Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness Frontiers in Human Neuroscience 2012
- A systematic review of the neurophysiology of mindfulness on EEG oscillations Neuroscience & Biobehavioral Reviews 2015
- Me, myself, bye: regional alterations in glutamate and the experience of ego dissolution with psilocybin. Neuropsychopharmacology November 1, 2020
- Review of the Neural Oscillations Underlying Meditation Frontiers in Neuroscience March 26, 2018
- Neural correlates of nondual awareness in meditation. Annals of the New York Academy of Sciences 2014
and 21 more in the library