Pain is a multidimensional experience that involves sensory, cognitive and affective mechanisms. The constellation of interactions between these factors makes the treatment of clinical pain challenging and often a financial burden. Mindfulness meditation has been found to significantly improve pain symptoms in experimental and clinical settings, but lack of mechanistic data has limited clinical deployment of this cost- effective and narcotic-free treatment. Recent findings from our laboratory determined that meditation, after only four days (20 minutes/day) of training, reduced pain intensity by 40% and pain unpleasantness ratings by 57%. Employing an emerging MRI technique (arterial spin labeling), we found that meditation-related pain relief was associated reduced pain-related brain activity in the primary somatosensory cortex and increased activity in brain regions such as the anterior insula, anterior cingulate cortex, and orbitofrontal cortex. These latter regions are involved in cognitive control, emotion regulation, and executive processing. These findings demonstrate that meditation engages multiple brain mechanisms during pain relief. However, the contribution of other cognitive factors such as expectations, facilitator attention, anxiety reduction, and conditioning /extinction processes remains poorly understood. Such factors are critically involved in the placebo effect. Accordingly, the proposed study seeks to determine if meditation-related pain relief engages brain mechanisms that are distinct from those of placebo analgesia. Functional imaging methodologies will be employed to assess brain activation during mediation-induced pain relief and during conditioned placebo analgesia. The proposed investigation will provide significant insights into the neural substrates involved in the modulatin of pain by cognitive factors.

Public Health Relevance

Pain is a highly individual experience that produces incalculable suffering and produces a significant economic burden on millions of Americans. The proposed project will investigate the brain mechanisms that support meditation-related pain relief to provide a foundation for the development of better treatments for clinical pain.

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21AT007247-02
Application #
8528483
Study Section
Somatosensory and Chemosensory Systems Study Section (SCS)
Program Officer
Glowa, John R
Project Start
2012-09-01
Project End
2014-05-31
Budget Start
2013-06-01
Budget End
2014-05-31
Support Year
2
Fiscal Year
2013
Total Cost
$177,656
Indirect Cost
$57,618
Name
Wake Forest University Health Sciences
Department
Anatomy/Cell Biology
Type
Schools of Medicine
DUNS #
937727907
City
Winston-Salem
State
NC
Country
United States
Zip Code
27157