Neural mechanisms supporting the relationship between dispositional mindfulness and pain.

People who naturally have higher trait mindfulness—the ability to nonreactively pay attention to the present moment—report lower pain intensity and unpleasantness when exposed to noxious heat. In 76 healthy volunteers who had never meditated, higher scores on the Freiburg Mindfulness Inventory were linked to less pain. Brain scans showed that more mindful individuals had greater deactivation of a region from the precuneus to posterior cingulate cortex during pain, areas involved in sensory, cognitive, and emotional processing. These results suggest that dispositional mindfulness reduces pain through specific neural mechanisms, pointing to mindfulness and the posterior cingulate cortex as potential targets for pain therapies.

Study at a glance

Abstract

Interindividual differences in pain sensitivity vary as a function of interactions between sensory, cognitive-affective, and dispositional factors. Trait mindfulness, characterized as the innate capacity to nonreactively sustain attention to the present moment, is a psychological construct that is associated with lower clinical pain outcomes. Yet, the neural mechanisms supporting dispositional mindfulness are unknown. In an exploratory data analysis obtained during a study comparing mindfulness to placebo analgesia, we sought to determine whether dispositional mindfulness is associated with lower pain sensitivity. We also aimed to identify the brain mechanisms supporting the postulated inverse relationship between trait mindfulness and pain in response to noxious stimulation. We hypothesized that trait mindfulness would be associated with lower pain and greater deactivation of the default mode network. Seventy-six meditation-naive and healthy volunteers completed the Freiburg Mindfulness Inventory and were administered innocuous (35°C) and noxious stimulation (49°C) during perfusion-based functional magnetic resonance imaging. Higher Freiburg Mindfulness Inventory ratings were associated with lower pain intensity (P = 0.005) and pain unpleasantness ratings (P = 0.005). Whole brain analyses revealed that higher dispositional mindfulness was associated with greater deactivation of a brain region extending from the precuneus to posterior cingulate cortex during noxious heat. These novel findings demonstrate that mindful individuals feel less pain and evoke greater deactivation of brain regions supporting the engagement sensory, cognitive, and affective appraisals. We propose that mindfulness and the posterior cingulate cortex should be considered as important mechanistic targets for pain therapies.