The Role of Heart Rate Variability in Mindfulness-Based Pain Relief

Adler-Neal, Adrienne L.; Waugh, Christian E.; Garland, Eric L.; Shaltout, Hossam A.; Diz, Debra I.; Zeidan, Fadel

doi:10.1016/j.jpain.2019.07.003

Cited by 52 publications

(63 citation statements)

References 125 publications

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“…erefore, our findings may be more related to the role of HF-HRV in the regulation of pain-related arousal. Similarly, recent studies showed that increased HF-HRV was associated with decreased pain experience in a mindfulness meditation or simply a compassionate self-talk protocol [27,28]. Overall, we present interesting findings suggesting the particular significance of HF-HRV in moderating the relationship between self-compassion and pain experience.…”

Section: Discussionsupporting

confidence: 80%

Self-Compassion Demonstrating a Dual Relationship with Pain Dependent on High-Frequency Heart Rate Variability

Tian

Luo

Che

et al. 2020

Pain Research and Management

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One previous study indicated the significance of trait self-compassion in psychological well-being and adjustment in people with chronic pain. Higher-frequency heart rate variability (HF-HRV) was found to be closely associated with self-compassion and pain coping. The current study was therefore designed to investigate the relationship between self-compassion and experimental pain as well as the impact of HF-HRV. Sixty healthy participants provided self-reported self-compassion and underwent a cold pain protocol during which HF-HRV was evaluated. Results demonstrated a dual relationship between self-compassion and pain, dependent on the level of HF-HRV during pain exposure. Specifically, self-compassion was associated with lower pain in the condition of higher HF-HRV, while there was an inverse relationship between self-compassion and pain when HF-HRV was lower. Our data indicate the significance of HF-HRV in moderating the association between self-compassion and experimental pain.

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Section: Discussionsupporting

confidence: 80%

Self-Compassion Demonstrating a Dual Relationship with Pain Dependent on High-Frequency Heart Rate Variability

Tian

Luo

Che

et al. 2020

Pain Research and Management

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“…Furthermore, although the LF/HF ratio was not impacted, linear HRV measures predicted the placebo effect. Adler-Neal et al ( 2019 ) reported that the sham meditation program lowered pain and HF-HRV (only HF was analyzed). Finally, Jegindø et al ( 2013 ) reported that religious beliefs did not impact HRV components ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies showed that HRV predicted placebo responses on negative emotions and pain (Aslaksen and Flaten, 2008 ; De Pascalis and Scacchia, 2019 ). One study showed that sham meditation produced lower pain and HF-HRV (Adler-Neal et al, 2019 ). One study reported a lower LF/HF ratio following the placebo effect (Aslaksen and Flaten, 2008 ), but two studies showed the placebo effect failed to impact the LF/HF ratio (Chae et al, 2008 ; De Pascalis and Scacchia, 2019 ) ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…All six studies used power spectral analysis including time and frequency domains. Moreover, three studies analyzed the LF/HF ratio (Aslaksen and Flaten, 2008;Chae et al, 2008;De Pascalis and Scacchia, 2019); one study considered the coefficient component variance in LF and HF bands (Jegindø et al, 2013); and another study analyzed only HF-HRV (Adler-Neal et al, 2019). Pollo et al (2003) showed a decrease in LF-HRV in the placebo condition, as compared with the treatment conditions.…”

Section: Hrv and Placebo/nocebo Responsesmentioning

confidence: 99%

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Placebo Analgesia, Nocebo Hyperalgesia, and the Cardiovascular System: A Qualitative Systematic Review

Daniali

Flaten

2020

Front. Physiol.

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Background: Placebo/nocebo effects involve the autonomic nervous system, including cardiac activity, but studies have reported inconsistent findings on how cardiac activity is modulated following a placebo/nocebo effect. However, no systematic review has been conducted to provide a clear picture of cardiac placebo responses. Objective: The main goal of the present study is to review the effects of placebo analgesia and nocebo hyperalgesia on cardiac activity as measured by blood pressure, heart rate, and heart rate variability. Methods: Using several Boolean keyword combinations, the PubMed, EMBASE, PsycINFO, Cochrane Review Library, and ISI Web of Knowledge databases were searched until January 5, 2020, to find studies that analyzed blood pressure, heart rate, or heart rate variability indexes following a placebo analgesic/nocebo hyperalgesic effect. Results: Nineteen studies were found, with some reporting more than one index of cardiac activity; eight studies were on blood pressure, 14 studies on heart rate, and six on heart rate variability. No reliable association between placebo/nocebo effects and blood pressure or heart rate was found. However, placebo effects reduced, and nocebo effects increased low-frequency heart rate variability, and heart rate variability significantly predicted placebo effects in two studies. Conclusion: Placebo/nocebo effects can have reliable effects on heart rate variability, but not on heart rate and blood pressure.

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“…Moreover, the described method might be of clinical utility possibly predicting differential effects on different dimensions of pain, which could be associated with different mechanisms underlying successful pain treatment. In line with this interpretation, it was recently shown that mindfulness-based compared to sham-mindfulness meditation engages different mechanisms resulting in pain relief with respect to perceived pain unpleasantness, while a similar differentiation between underlying mechanism could not be found in relation to perceived pain intensity (Adler-Neal et al, 2019).…”

Section: Intensity Ratingsmentioning

confidence: 88%

What does “moderate pain” mean? Subgroups holding different conceptions of rating scales evaluate experimental pain differently

Becker

Fuchs

Schakib‐Ekbatan

et al. 2019

European Journal of Pain

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Background Pain ratings are almost ubiquitous in pain assessment, but their variability is high. Low correlations of continuous/numerical rating scales with categorical scales suggest that individuals associate different sensations with the same number on a scale, jeopardizing the interpretation of statistical results. We analysed individual conceptions of rating scales and whether these conceptions can be utilized in the analysis of ratings of experimental stimuli in pain‐free healthy individuals and people with reoccurring/persistent pain. Methods Using a free positioning task, healthy participants (N = 57) and people with reoccurring/persistent pain (N = 57) ad libitum positioned pain descriptors on lines representing intensity and un‐/pleasantness scales. Furthermore, participants rated experimental thermal stimuli on visual analogue scales with the same end anchors. A latent class regression approach was used to detect subgroups with different response patterns in the free positioning task, indicating different conceptions of pain labels, and tested whether these subgroups differed in their ratings of experimental stimuli. Results Subgroups representing different conceptions of pain labels could be described for the intensity and the un‐/pleasantness scale with in part opposing response patterns in the free positioning task. Response patterns did not differ between people with and without pain, but in people with pain subgroups showed differential ratings of high intensity experimental stimuli. Conclusions Individuals' conceptions of pain labels differ. These conceptions can be quantified and utilized to improve the analysis of ratings of experimental stimuli. Identifying subgroups with different conceptions of pain descriptions could be used to improve predictions of responses to pain in clinical contexts. Significance The present results provide a novel approach to incorporate individual conceptualizations of pain descriptors, which can induce large distortions in the analysis of pain ratings, in pain assessment. The approach can be used to achieve better pain estimates, representing individual conceptions of pain and achieving a better comparability between individuals but also between pain‐free persons and patients with chronic pain. Particularly, in clinical settings this could improve quantification of perceived pain and the patient‐clinician communication.

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The Role of Heart Rate Variability in Mindfulness-Based Pain Relief

Cited by 52 publications

References 125 publications

Self-Compassion Demonstrating a Dual Relationship with Pain Dependent on High-Frequency Heart Rate Variability

Self-Compassion Demonstrating a Dual Relationship with Pain Dependent on High-Frequency Heart Rate Variability

Placebo Analgesia, Nocebo Hyperalgesia, and the Cardiovascular System: A Qualitative Systematic Review

What does “moderate pain” mean? Subgroups holding different conceptions of rating scales evaluate experimental pain differently

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