The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer.
Fadel Zeidan, Jennifer N Baumgartner, Robert C. Coghill
PAIN Reports July 1, 2019 DOI: 10.1097/pr9.0000000000000759 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Intervention | Mindfulness meditation |
| Topics | Meditation |
| Keywords | FMRI Pain Placebo |
| Key findings | The neural mechanisms supporting mindfulness-based pain relief appear to differ by meditative experience: brief practice (under 10 hours) is associated with higher-order prefrontal regulation of low-level nociceptive targets, while extensive practice (over 1000 hours) is associated with prefrontal deactivation and greater somatosensory activation. Higher dispositional mindfulness in meditation-naïve individuals is associated with lower pain and greater posterior cingulate cortex deactivation. The authors propose these substrates could inform behavioral pain therapies. |
Abstract
The advent of neuroimaging methodologies, such as functional magnetic resonance imaging (fMRI), has significantly advanced our understanding of the neurophysiological processes supporting a wide spectrum of mind-body approaches to treat pain. A promising self-regulatory practice, mindfulness meditation, reliably alleviates experimentally induced and clinical pain. Yet, the neural mechanisms supporting mindfulness-based pain relief remain poorly characterized. The present review delineates evidence from a spectrum of fMRI studies showing that the neural mechanisms supporting mindfulness-induced pain attenuation differ across varying levels of meditative experience. After brief mindfulness-based mental training (ie, less than 10 hours of practice), mindfulness-based pain relief is associated with higher order (orbitofrontal cortex and rostral anterior cingulate cortex) regulation of low-level nociceptive neural targets (thalamus and primary somatosensory cortex), suggesting an engagement of unique, reappraisal mechanisms. By contrast, mindfulness-based pain relief after extensive training (greater than 1000 hours of practice) is associated with deactivation of prefrontal and greater activation of somatosensory cortical regions, demonstrating an ability to reduce appraisals of arising sensory events. We also describe recent findings showing that higher levels of dispositional mindfulness, in meditation-naïve individuals, are associated with lower pain and greater deactivation of the posterior cingulate cortex, a neural mechanism implicated in self-referential processes. A brief fMRI primer is presented describing appropriate steps and considerations to conduct studies combining mindfulness, pain, and fMRI. We postulate that the identification of the active analgesic neural substrates involved in mindfulness can be used to inform the development and optimization of behavioral therapies to specifically target pain, an important consideration for the ongoing opioid and chronic pain epidemic.
Comparable studies
Other narrative reviews on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical populations | 2003 | Review | |
| Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects | 2007 | Review | |
| Mindfulness Interventions | 2016 | Review | |
| Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation | 2017 | Review | |
| Mindfulness and acceptance: expanding the cognitive-behavioral tradition | 2005 | Review |
Citations in the library
Cited by 39
- A neurophenomenological approach to non-ordinary states of consciousness: hypnosis, meditation, and psychedelics Trends in Cognitive Sciences December 22, 2022
- Mindfulness in migraine: A narrative review Expert Review of Neurotherapeutics January 14, 2020
- Mindfulness meditation is related to sensory‐affective uncoupling of pain in trained novice and expert practitioners European Journal of Pain April 20, 2020
- Cognitive Defusion Is a Core Cognitive Mechanism for the Sensory-Affective Uncoupling of Pain During Mindfulness Meditation Psychosomatic Medicine March 31, 2021
- Interpretability of Spatiotemporal Dynamics of the Brain Processes Followed by Mindfulness Intervention in a Brain-Inspired Spiking Neural Network Architecture Sensors December 21, 2020
and 34 more in the library
Cites 46
- Mechanisms of mindfulness Journal of Clinical Psychology December 29, 2005
- How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective Perspectives on Psychological Science October 14, 2011
- Mindfulness Interventions Annual Review of Psychology September 30, 2016
- A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction Annals of Behavioral Medicine February 1, 2007
- Patterns of Brain Activity Supporting Autobiographical Memory, Prospection, and Theory of Mind, and Their Relationship to the Default Mode Network Journal of Cognitive Neuroscience July 6, 2009
and 41 more in the library