Neural mechanisms supporting the relationship between dispositional mindfulness and pain

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.

Neuraxial Cytokines in Pain States

“…Consistent with this assertion are the findings that intracerebroventricular (ICV) injection of TNF, IL-1β, and IL-6 induced hyperalgesia (205)(206)(207) and that blocking these cytokines in the brain reduced the behaviorally defined expression of a pain state (208). Of note, mechanistically, it is not clear whether this pain state reflects the role of an enhanced supraspinal response to the ascending pain stimulus or an activation of descending facilitatory/loss of descending inhibitory system (209).…”

The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer

“…Some individuals are simply more “mindful” than others, as evinced by higher scores on standardized measures of dispositional/trait mindfulness without any formal training in meditation. 24,52,128,142…”

“…81,90,100 Two recent studies combined psychophysics, noxious heat stimulation, and distinct functional neuroimaging techniques to identify the neural mechanisms supporting the postulated relationship between trait mindfulness and pain sensitivity 142 and pain threshold. 52 Zeidan et al 142 used perfusion-based arterial spin labeling (ASL) fMRI to determine the significant relationship between higher dispositional mindfulness (as measured by the Freiburg Mindfulness Inventory) and lower pain ratings in response to noxious heat (49°C). 142 As hypothesized, higher trait mindfulness was associated with greater deactivation of the posterior, midline nodes of the so-called default mode network.…”

“…52 Zeidan et al 142 used perfusion-based arterial spin labeling (ASL) fMRI to determine the significant relationship between higher dispositional mindfulness (as measured by the Freiburg Mindfulness Inventory) and lower pain ratings in response to noxious heat (49°C). 142 As hypothesized, higher trait mindfulness was associated with greater deactivation of the posterior, midline nodes of the so-called default mode network. The default mode network is defined by oscillating activity within a group of distinct brain regions (medial prefrontal cortex, posterior cingulate cortex [PCC]/precuneus, inferior, and lateral temporal cortices) and is associated with facilitating self-referential processes.…”

Synergistic Effects of Vitamin D and Mindfulness Training in Pain Severity, Pain-Related Disability and Neuropathy-Specific Quality of Life Dimensions in Painful Diabetic Neuropathy: A Randomized Clinical Trial with Placebo-controlled

“…Also, with mindful abilities patients learn to reduction of catastrophizing of pain and accepting some grades of pain as a part of their life.so were be able to nd recreation and interpersonal activities despite presence of pain. So, with these improvements, their pain-related disability reduced and so on improved their QOL (13,27,30). On the other hand, in animal models Overall, several genes such as Oxt, Penk, Pomc Payne, Pth, and Tgfb1-encoding for peptides are top candidates to describe the remedial advantage of vitamin D supplementation on neuropathic pain (31).…”