Mindfulness-based stress reduction alters brain activity for breast cancer survivors with chronic neuropathic pain: preliminary evidence from resting-state fMRI

Smith, Andra; Leeming, Allison; Fang, Zhuo; Hatchard, Taylor; Mioduszewski, Ola; Schneider, Maiko Abel; Ferdossifard, Ayda; Shergill, Yaad; Khoo, Eve‐Ling; Poulin, Patricia A.

doi:10.1007/s11764-020-00945-0

Cited by 20 publications

(23 citation statements)

References 33 publications

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“…Smith and colleagues 32 used resting state fMRI to investigate the impact of an 8-week MBSR program on functional connectivity (FC), pain severity, and pain intensity in breast cancer survivors with comorbid chronic neuropathic pain as compared with a WL control group. In the MBSR group, FC was increased between the posterior cingulate cortex (PCC) and the ACC/medial prefrontal cortex and decreased between the PCC and the bilateral precentral gyrus, right superior frontal gyrus and pons.…”

Section: Resultsmentioning

confidence: 99%

“… 40 Their results provide evidence that mindfulness strengthens prefrontal cognitive control mechanisms, with a concomitant downregulation of activity in regions relevant for affect processing, such as the amygdala and subcortical regions. 41 Conversely, the included studies report activation of both limbic and cortical brain regions in breast cancer patients treated with mindfulness, 25 , 30 - 33 which is typical in untrained meditators. 42 Thus, although limbic activation is consistent with other fMRI studies, it needs to be further explored as these structures are expected to be less active in relaxation paradigms.…”

Section: Discussionmentioning

confidence: 99%

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The Neural Signature of Psychological Interventions in Persons With Cancer: A Scoping Review

et al. 2022

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Objective: People diagnosed with cancer have to deal with the debilitating psychological implications of this disease. Although the clinical efficacy of psychological interventions is well documented, relatively little has been written on the neural correlates of these treatments in the context of oncology. The present work is the first to provide an overall perspective of the existing literature on this topic. It also considers the potential directions for future research. Methods: This scoping review was carried out across 5 databases (EMBASE, PsycINFO, OVID MEDLINE, CINAHL, COCHRANE CENTRAL), from conception dates until 3 December 2021. Results: From an initial set of 4172 records, 13 papers were selected for this review. They consisted of 9 randomized controlled studies (RCTs), 1 quasi-experiment, 2 single case studies, and 1 secondary quantitative analysis. The studies were also heterogeneous in terms of the patient and control populations, psychological interventions, and neuroimaging methodologies used. The findings from these few studies suggest that psychological interventions in oncology patients may modulate both cortical and subcortical brain activity, consistent with the brain areas involved in distress reactions in general and to cancer specifically. The implications of this scoping review in terms of future research are also discussed. Conclusions: The literature on the neural correlates of psychological interventions in cancer patients is very limited, and thus requires further exploration. The provision of psychological interventions offers cancer patients a more integrated approach to care, which may in turn help preserve both the physical and the psychological wellbeing of individuals with cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Neural Signature of Psychological Interventions in Persons With Cancer: A Scoping Review

et al. 2022

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“…The characteristics of the included studies were summarized in Table 1. Seven studies were conducted in the United States (Huberty et al., 2019; Johns et al., 2016; Kubo et al., 2019; Lengacher et al., 2016; Mosher et al., 2018, 2019; Porter et al., 2019), and the remaining were implemented in Denmark (Johannsen et al., 2016), Korea (Lee et al., 2017) and Canada (Smith et al, 2020). Six RCTs recruited patients with breast cancer, and one included patients with lung cancer.…”

Section: Resultsmentioning

confidence: 99%

“…There are several strengths in the study, which was conducted in a rigorous approach with a detailed search strategy. First, the primary outcome measure of this study is pain intensity, which is the most commonly adopted parameter to detect changes in pain before and after interventions (Kliger et al., 2015; Smith et al, 2020). Second, this meta‐analysis has included different genres of MBIs.…”

Section: Discussionmentioning

confidence: 99%

“…Mindfulness‐based interventions have been used for symptom management in cancer patients lately (Johannsen et al., 2016; Smith et al, 2020), and there exist some reviews to examine their effectiveness. Of those, several have adopted psychological parameters such as anxiety and depression or other symptoms than pain as the primary outcomes (Cillessen et al., 2019; Haller et al., 2017; Ng et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

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Are mindfulness treatments effective for pain in cancer patients? A systematic review and meta‐analysis

Feng

Wang

et al. 2021

European Journal of Pain

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Background and objective Mindfulness‐based interventions (MBIs) have been recently applied in pain management and cancer care. However, inconsistencies exist concerning the effectiveness of MBIs on pain control among cancer patients. Therefore, this study aimed to examine the efficacy of MBIs on pain in cancer patients via a systematic review and meta‐analysis of randomized controlled trials (RCTs). Methods Databases (MEDLINE, PubMed, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov) were searched using key terms related to pain, cancer and mindfulness. The primary outcome was pain intensity. Standardized mean difference (SMD) of each outcome with 95% confidence interval (95% CI) was calculated. The quality of evidence was assessed by GRADE assessment. Results Ten RCTs with 843 participants were included. Significant pooled effects of MBIs on pain intensity were found at both short‐term (SMD = −0.19, 95% CI [−0.33 to −0.04]) and long‐term (SMD = −0.20, 95% CI [−0.35 to −0.05]) follow‐up, whereas no significance was observed for pain interference. In subgroup analyses, significant intervention effects were only seen in clinic‐based MBIs compared to remote MBIs, and pooled effects of MBIs in attenuating pain were discovered relative to passive rather than active comparators. GRADE ratings showed moderate certainty of evidence in MBIs for pain intensity but low for pain interference. Conclusions The efficacy of MBIs in reducing pain intensity among cancer patients was revealed in this meta‐analysis, albeit with a small effect size. Future research is warranted to optimize mindfulness treatment for pain control in cancer patients with high methodological quality and a large sample size. Significance The effect of MBIs on pain in cancer patients was demonstrated in our analysis, albeit with small effect sizes. High‐quality RCTs are needed to verify the efficacy of MBIs on cancer patients or survivors with pain complaints. Future trials should take into account the specific pain outcome measures (pain intensity or pain interference), the approach of intervention provision (clinic‐based or remote MBI, group or individual practice), the duration and frequency of interventions and the comparators (passive or active control arms).

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Morphological and functional brain changes in chronic cancer‐related pain: A systematic review

Vyvere

Groote

Groef

et al. 2022

The Anatomical Record

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The purpose of this study was to perform a systematic review of the available literature on morphological and functional brain changes measured by modern neuroimaging techniques in patients suffering from chronic cancer‐related pain. A systematic search was conducted in PubMed, Embase, and Web of Science using different keyword combinations. In addition, a hand search was performed on the reference lists and several databases to retrieve supplementary primary studies. Eligible articles were assessed for methodological quality and risk of bias and reviewed by two independent researchers. The search yielded only four studies, three of which used MRI and one PET‐CT. None of the studies measured longitudinal morphological (i.e., gray or white matter) changes. All studies investigated functional brain changes and found differences in specific brain regions and networks between patients with chronic cancer‐related pain and pain‐free cancer patients or healthy volunteers. Some of these alterations were found in brain networks that also show changes in non‐cancer populations with chronic pain (e.g., the default mode network and salience network). However, specific findings were inconsistent, and there was substantial variation in imaging methodology, analysis, sample size, and study quality. There is a striking lack of research on morphological brain changes in patients with chronic cancer‐related pain. Moreover, only a few studies investigated functional brain changes. In the retrieved studies, there is some evidence that alterations occur in brain networks also involved in other chronic non‐cancer pain syndromes. However, the low sample sizes of the studies, finding inconsistencies, and methodological heterogeneity do not allow for robust conclusions.

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Mindfulness-based stress reduction alters brain activity for breast cancer survivors with chronic neuropathic pain: preliminary evidence from resting-state fMRI

Cited by 20 publications

References 33 publications

The Neural Signature of Psychological Interventions in Persons With Cancer: A Scoping Review

The Neural Signature of Psychological Interventions in Persons With Cancer: A Scoping Review

Are mindfulness treatments effective for pain in cancer patients? A systematic review and meta‐analysis

Morphological and functional brain changes in chronic cancer‐related pain: A systematic review

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