Pain Perception Can Be Modulated by Mindfulness Training: A Resting-State fMRI Study

Abstract

The multi-dimensional nature of pain renders difficult a holistic understanding of it. The conceptual framework of pain is said to be cognitive-evaluative, in addition to being sensory-discriminative and affective-motivational. To compare participants’ brain-behavior response before and after a 6-week mindfulness-based stress reduction training course on mindfulness in relation to pain modulation, three questionnaires (the Dallas Pain Questionnaire, Short Form McGill Pain Questionnaire-SFMPQ, and Kentucky Inventory of Mindfulness) as well as resting-state functional magnetic resonance imaging were administered to participants, divided into a pain-afflicted group (N = 18) and a control group (N = 16). Our results showed that the pain-afflicted group experienced significantly less pain after the mindfulness treatment than before, as measured by the SFMPQ. In conjunction, an increased connection from the anterior insular cortex (AIC) to the dorsal anterior midcingulate cortex (daMCC) was observed in the post-training pain-afflicted group and a significant correlation was found between AIC-daMCC connectivity and SFMPQ scores. The results suggest that mindfulness training can modulate the brain network dynamics underlying the subjective experience of pain.

Neurological Evidence of a Mind-Body Connection: Mindfulness and Pain Control

“…Attenuation of pain was associated with increased neuronal connectivity from the anterior insular cortex and dorsal anterior mid-cin-gulate cortex. These results suggest that mindfulness plays a role in the modulation of brain connections and networks that underlie the subjective experience of pain (28).…”

“…Mindfulness-based stress reduction is a structured, weekly meditation program that has standardized guidelines and involves a combination of mindfulness meditation, body awareness, and yoga (19). Su et al (28) examined functional MRI (fMRI) scans of the brains of persons who completed a 6-week mindfulness-based-stress-reduction course. fMRI was conducted at baseline and 6 weeks after completion of the course.…”

Association between alexithymia and impaired reward valuation in patients with fronto-insular damage.

“…If a patient presents with syndromes driven by pathological reward valuation (e.g., addiction or anhedonia), treatments promoting their ability to attend to and regulate conscious emotional states may enhance left frontoinsular recruitment and help to normalize motivated behavior. In this vein, enhanced frontoinsular recruitment is reliably observed following mindfulness interventions (Laneri et al, 2017; Sharp et al, 2018; Su et al, 2016; Tang et al, 2015), and enhanced frontoinsular recruitment may represent a viable mechanism through which mindfulness therapies help to curb pathological reward-guided behavior in individuals with substance use disorders (Bowen et al, 2014; Witkiewitz et al, 2019). Future studies at the intersection of affective and clinical neuroscience are needed to evaluate the role of frontoinsular circuits in facilitating the efficacy of mindfulness-based therapies and for developing alternative treatment approaches for nonresponders including targeted neuromodulation of left frontoinsular cortex (Downar, Blumberger, & Daskalakis, 2016).…”

Motivational Non-directive Resonance Breathing as a Treatment for Chronic Widespread Pain

“…Functional connectivity between the DMN and brain regions associated with emotion regulation (i.e., the insula and parahippocampus) in patients diagnosed with major depressive disorder (commonly co-morbid in those with CWP) has also been shown to decrease after 1 month of tVNS compared to sham stimulation. The change in depression severity significantly correlated with functional connectivity changes between the DMN and regions that are implicated in both pain modulation and emotion, such as the anterior insula and anterior cingulate cortex (Fang et al, 2016; Su et al, 2016). However, investigations of vagal pain modulation do not reliably report the preferential modulation of affect on pain unpleasantness even though behavioral and brain imaging studies show that tVNS improves affect and produces functional changes in brain regions where pain modulation and affect converge (Frangos et al, 2017).…”