Brief mindfulness training can mitigate the influence of prior expectations on pain perception

Abstract

Background: Recent neuroimaging evidence suggests that mindfulness practice may mitigate the biasing influence of prior cognitive and emotional expectations on pain perception. The current study tested this hypothesis using a pain-cueing paradigm, which has reliably been shown to elicit conditioned hypoalgesic and hyperalgesic effects. Specifically, we aimed to investigate whether the instructed use of a mindfulness compared to a suppression strategy differentially modulates the magnitudes of conditioned hypoalgesia and hyperalgesia. Methods: Sixty-two healthy non-meditators were assigned to listen to either brief mindfulness or suppression instructions, in between the conditioning and testing phases of a pain-cueing task. Participants provided ratings of anticipatory anxiety, pain intensity and pain unpleasantness throughout the task. They also completed trait and state self-report measures of mindfulness and pain catastrophizing. Results: Results indicated that the paradigm was successful in inducing conditioned hyperalgesic and hypoalgesic effects. Importantly, while we found evidence of cue-induced hyperalgesia in both groups, only the suppression group reported cueinduced hypoalgesia. No group differences in pain ratings were found for unconditioned (novel-cued) stimuli. Conclusions: These findings provide partial support for recently proposed predictive processing models, which posit that mindfulness may lead to a prioritization of current sensory information over previous expectations. We explore potential explanations for the asymmetrical group differences in conditioned hypoalgesia versus conditioned hyperalgesia, and discuss our results in light of recent neuroimaging insights into the neuropsychological mechanisms of mindfulness and expectancydriven pain modulation. Significance: The current study provides novel insights into the working mechanisms of mindfulness-driven pain modulation. Our data suggest that brief mindfulness training may reduce the influence of prior beliefs and expectations on pain perception. This finding adds to growing evidence suggesting that mindfulness may alleviate pain via neuropsychological mechanisms opposite to those typically observed in conditioning/placebo procedures and other cognitive manipulations. These unique mechanisms underline the potential of mindfulness as an alternative to traditional cognitive pain regulatory strategies.

Evaluation of Mindfulness Training Combined with Aerobic Exercise on Neurological Function and Quality of Life in Patients with Peripheral Neuropathy Type 2 Diabetes Mellitus

“…is concept of mindfulness training is very much in line with the idea of aerobic exercise, and mindfulness meditation combined with aerobic exercise practice is more effective than aerobic exercise practice alone in improving clinical symptoms and neurological function in patients with DPN. Patients must be instructed to adjust their breathing while practicing Aerobic exercise [21,22]. In addition, it is also important to instruct the patient to feel the pressure and relaxation of the alternate contraction and relaxation of the muscles of the legs, to experience the sensation of the feet touching the ground, and to encourage the patient to pay attention to his Contrast Media & Molecular Imaging heart and learn to accept and relax.…”

Dynamic processes of mindfulness-based alterations in pain perception

“…Although researchers (Dimidjian and Linehan, 2003;Shapiro et al, 2006) have not yet reached a consensus on the definition of mindfulness, one thing for sure is that "ability to return to the present moment" (attention) and the "curious, open, and receptive attitude" (mindful attitude) are the two core components of mindfulness (Duan, 2014). The analgesic effect of mindfulness can be achieved by changing pain anticipation (Brown and Jones, 2010;Gard et al, 2012;Vencatachellum et al, 2021;Sezer et al, 2022), pain catastrophizing (Jensen et al, 2014;Garland and Howard, 2018;Vencatachellum et al, 2021), pain unpleasantness (Brown and Jones, 2010;Perlman et al, 2010;Zeidan et al, 2011Zeidan et al, , 2015Gard et al, 2012;Lutz et al, 2013), and pain intensity (Grant and Rainville, 2009;Zeidan et al, 2011Zeidan et al, , 2015. Mindfulness might exert its impact by decreasing the interference of experience-based top-down cognitive and affective processing with ongoing pain processing, which could lead to a reduction in pain intensity.…”

“…Pain perception is, therefore, a complex process that is comprised of various components including not only the sensory system, but also cognitive, and affective-motivational dimensions (Apkarian et al, 2011). A variety of cognitive processes have been shown to influence pain perception and bias nociceptive processing, both on the behavioral (Perlman et al, 2010;Wetherell et al, 2011;Ehde et al, 2014;Diotaiuti et al, 2021;Vencatachellum et al, 2021) as well as the neural level in the human brain (Rainville et al, 1997;Wager et al, 2004;Vanhaudenhuyse et al, 2009;Gard et al, 2012;Jensen et al, 2012;Zeidan et al, 2015;Mioduszewski et al, 2020). One of those processes is clearly attention.…”