Chronic pain is a serious public health problem that causes significant economic loss and suffering. Conventional treatments are often ineffective, leaving patients with substantial pain and impaired quality-of-life. Mindfulness Based Stress Reduction (MBSR) is a protocolized CAM therapy based on Buddhist meditation practices: practitioners cultivate non-judgmental attention to the breath and sensory feelings as a way of focusing on and being mindful of the present moment. MBSR is a promising therapy for chronic pain, implemented in many major medical centers worldwide. While understanding of specific mechanisms underlying MBSR for chronic pain is poor, in healthy individuals, at least one study has found that MBSR elicits changes over the central sulcus in the neocortex, the cortical entry point where bodily feelings are processed. These same cortical areas are abnormal in chronic pain patients: in Brodmann Area (BA) 3b,the representation of the painful part is abnormally large and fragmented. The research application tests the specific hypothesis that MBSR elicits therapeutic cortical plasticity in BA 3b by carrying out a RCT in 60 chronic pain patients, using functional magnetic resonance imaging (fMRI) to compare MBSR's efficacy in normalizing cortical maps with that of attention and wait-list control. In addition to the research application, the training program includes formal education in 1) fMRI neuroimaging methods, 2) basic neuroscience, 3) biostatistical methods related to fMRI. This training prepares me to meet my long-term objective of becoming an independent neuroscientist. Through formal didactic instruction and strong mentoring from experienced investigators who are leaders in the field, I will develop the requisite tools to shed light on cortical mechanisms underlying chronic pain and MBSR. This application meets the NCCAM strategic plan's call for studies investigating neural mechanisms underlying mind-body therapies. In its development of a specific replicable experimental model for examining cortical body maps, it has broad implications for our understanding of CAM therapies. Specifically, in its rigorous study of a neural substrate underlying human embodied experience, this research application has great potential significance for understandings of a mechanism underlying mind-body CAM therapies for chronic pain.

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
1K01AT003459-01
Application #
7081991
Study Section
Special Emphasis Panel (ZAT1-LD (05))
Program Officer
Stoney, Catherine
Project Start
2006-05-01
Project End
2011-04-30
Budget Start
2006-05-01
Budget End
2007-04-30
Support Year
1
Fiscal Year
2006
Total Cost
$129,951
Indirect Cost
Name
Harvard University
Department
Other Health Professions
Type
Schools of Medicine
DUNS #
047006379
City
Boston
State
MA
Country
United States
Zip Code
02115
Sacchet, Matthew D; LaPlante, Roan A; Wan, Qian et al. (2015) Attention drives synchronization of alpha and beta rhythms between right inferior frontal and primary sensory neocortex. J Neurosci 35:2074-82
Wells, Rebecca Erwin; Yeh, Gloria Y; Kerr, Catherine E et al. (2013) Meditation's impact on default mode network and hippocampus in mild cognitive impairment: a pilot study. Neurosci Lett 556:15-9
Wells, Rebecca Erwin; Kerr, Catherine E; Wolkin, Jennifer et al. (2013) Meditation for adults with mild cognitive impairment: a pilot randomized trial. J Am Geriatr Soc 61:642-5
Kerr, Catherine E; Sacchet, Matthew D; Lazar, Sara W et al. (2013) Mindfulness starts with the body: somatosensory attention and top-down modulation of cortical alpha rhythms in mindfulness meditation. Front Hum Neurosci 7:12
Daubenmier, Jennifer; Sze, Jocelyn; Kerr, Catherine E et al. (2013) Follow your breath: respiratory interoceptive accuracy in experienced meditators. Psychophysiology 50:777-89
Mehling, Wolf E; Price, Cynthia; Daubenmier, Jennifer J et al. (2012) The Multidimensional Assessment of Interoceptive Awareness (MAIA). PLoS One 7:e48230
Wan, Qian; Kerr, Catherine; Pritchett, Dominique et al. (2011) Dynamics of dynamics within a single data acquisition session: variation in neocortical alpha oscillations in human MEG. PLoS One 6:e24941
Kerr, Catherine E; Jones, Stephanie R; Wan, Qian et al. (2011) Effects of mindfulness meditation training on anticipatory alpha modulation in primary somatosensory cortex. Brain Res Bull 85:96-103
Kerr, Catherine E; Josyula, Krishnapriya; Littenberg, Ronnie (2011) Developing an observing attitude: an analysis of meditation diaries in an MBSR clinical trial. Clin Psychol Psychother 18:80-93
Mehling, Wolf E; Wrubel, Judith; Daubenmier, Jennifer J et al. (2011) Body Awareness: a phenomenological inquiry into the common ground of mind-body therapies. Philos Ethics Humanit Med 6:6

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