A Virtual Reality Meditative Intervention Modulates Pain and the Pain Neuromatrix in Patients with Opioid Use Disorder.
Mohammed M Faraj, Nina M Lipanski, Austin Morales, Elimelech Goldberg, Martin H Bluth, Hilary A Marusak, Mark K Greenwald
Pain Medicine November 26, 2021 DOI: 10.1093/pm/pnab162 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective, non-blinded, single-arm Peer reviewed |
|---|---|
| Sample size | 15 |
| Population | Patients undergoing methadone maintenance treatment for opioid use disorder |
| Duration | 12-week intervention, sessions twice weekly; pre- and post-intervention fMRI; cortisol and CRP measured at baseline and weeks 4, 8, and 12 |
| Topics | Meditation Addiction |
| Keywords | Cortisol Craving Methadone Pain neuromatrix Postcentral gyrus FMRI |
| Key points | A virtual reality-based meditative intervention decreased pain, craving, anxiety, and depression after sessions, reduced saliva cortisol, and altered pain-related brain activation and connectivity. |
Abstract
Standard of care for opioid use disorder (OUD) includes medication and counseling. However, there is an unmet need for complementary approaches to treat OUD patients coping with pain; furthermore, few studies have probed neurobiological features of pain or its management during OUD treatment. This preliminary study examines neurobiological and behavioral effects of a virtual reality-based meditative intervention in patients undergoing methadone maintenance treatment (MMT). Prospective, non-blinded, single-arm, 12-week intervention with standardized assessments. Academic research laboratory affiliated with an on-site MMT clinic. Fifteen (11 female) MMT patients completed a virtual reality, therapist-guided meditative intervention that included breathing and relaxation exercisessessions were scheduled twice weekly. Assessments included functional magnetic resonance imaging (fMRI) of pain neuromatrix activation and connectivity (pre- and post-intervention), saliva cortisol and C-reactive protein (CRP) at baseline and weeks 4, 8 and 12; and self-reported pain and affective symptoms before and after each intervention session. After each intervention session (relative to pre-session), ratings of pain, opioid craving, anxiety and depression (but not anger) decreased. Saliva cortisol (but not CRP) levels decreased from pre- to post-session. From pre- to post-intervention fMRI assessments, pain task-related left postcentral gyrus (PCG) activation decreased. At baseline, PCG showed positive connectivity with other regions of the pain neuromatrix, but this pattern changed post-intervention. These preliminary findings demonstrate feasibility, therapeutic promise, and brain basis of a meditative intervention for OUD patients undergoing MMT.
Comparable studies
Other non-randomized and open-label trials on addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction Psychiatrically healthy nicotine-dependent smokers | 2014 | Open-label pilot study | n = 15 |
| Psilocybin-Occasioned Mystical Experiences in the Treatment of Tobacco Addiction Smokers | 2015 | Open-label pilot study | n = 15 |
| Ketamine Psychedelic Therapy (KPT): A Review of the Results of Ten Years of Research Alcoholic patients | 1997 | Controlled clinical trial | n = 211 |
| First study of safety and tolerability of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in patients with alcohol use disorder. Patients with alcohol use disorder (AUD) following community alcohol detoxification | 2021 | Open-label safety and tolerability proof-of-concept study | n = 14 |
| The Psychedelic Debriefing in Alcohol Dependence Treatment: Illustrating Key Change Phenomena through Qualitative Content Analysis of Clinical Sessions Participants in a psilocybin-assisted treatment study for alcohol dependence | 2018 | Open-label pilot (proof-of-concept) study with qualitative content analysis | n = 17 |
Citations in the library
Cited by 3
- Psychological and physiological health outcomes of virtual reality-based mindfulness interventions: A systematic review and evidence mapping of empirical studies. Digital health 2024
- Virtual Reality Combined with Mind-Body Therapies for the Management of Pain: A Scoping Review. International Journal of Clinical and Experimental Hypnosis 2024
- Effects of meditation compared to music listening on biomarkers in breast cancer survivors with cognitive complaints: secondary outcomes of a pilot randomized control trial. Explore November 10, 2021
Cites 10
- Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity Frontiers in Human Neuroscience October 9, 2018
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
- Meditation reduces pain-related neural activity in the anterior cingulate cortex, insula, secondary somatosensory cortex, and thalamus Frontiers in Psychology December 16, 2014
- Attention to breath sensations does not engage endogenous opioids to reduce pain. Pain March 9, 2020
- Binary Model of the Dynamics of Active versus Passive Mindfulness in Managing Depression OBM Integrative and Complementary Medicine December 23, 2018
and 5 more in the library