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Pinpointing the unique impact of mindfulness meditation on pain

Posted 12.15.2015 | by AMRA

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Pain is a common and often complex medical complaint. Previous studies demonstrate the possible pain-reducing effects of mindfulness-based interventions, but little is known about how these interventions actually work. Is mindful awareness their “active ingredient,” or is it slowed breathing, or even just the expectancy of a benefit?

Zeidan et al. [The Journal of Neuroscience] compared the changes in pain sensitivity resulting from a genuine mindfulness intervention with the changes resulting from a sham mindfulness intervention and two other control conditions. Participants rated their subjective pain in response to an unpleasant heat stimulus while undergoing functional Magnetic Resonance Imaging (fMRI). They also completed the Freiburg Mindfulness Inventory prior to initial training and at the end of their final fMRI session.

A racially diverse cohort of 75 healthy, meditation-naive young adult men and women were randomly assigned to either mindfulness meditation, a sham mindfulness meditation, placebo conditioning, or listening to an audio book. Genuine mindfulness meditation training consisted of four 20-minute sessions involving a breath-focused sitting meditation along with didactic instruction in non-judgmental attention. Sham meditation training involved four 20-minute sessions of alleged “mindfulness meditation” that consisted of merely sitting upright and taking a deep breath every few minutes without any didactic instruction.

Placebo conditioning involved four 20-minute conditioning sessions in which an alleged “analgesic cream” (in actuality, only petrolatum jelly) was applied to the skin and participants were exposed to a series of heat stimuli that were covertly and progressively lowered in temperature over the course of the sessions. Control participants listen to four 20-minute audio recordings from a book.

In a separate final assessment session after training completion, all the participants underwent fMRI scanning while […]

December 15th, 2015|News|

Meditation Reduces Pain Elaboration

Posted from archive: 01.02.2014 | by AMRA

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Grant [Annals of the New York Academy of Sciences] reviewed recent experimental studies of the effects of focused attention (FA) and open monitoring (OM) meditation on pain perception. FA meditations require sustained attention on a focal stimulus (e.g., the breath or a mantra), whereas OM meditations involve sustained attention on the monitoring process itself (e.g., dzogchen or choiceless awareness). Experimental support for FA’s analgesic effect is somewhat weak and inconsistent. However, there is mounting support for OM’s ability to attenuate pain.

Studies from three independent laboratories demonstrated that OM meditators show increased neural activity in their pain processing centers (e.g., the somatosensory cortex, anterior cingulate cortex, and insula) and decreased activity in brain regions associated with elaborative mental processes (e.g., the various prefrontal cortical regions) when confronted with a painful stimulus. One study of Zen practitioners also showed that experienced meditators had decreased functional connectivity between these brain regions, and the less the functional connectivity, the lower their pain sensitivity.

An analysis of pain ratings and neural activity indicated that OM-mediated analgesia is due neither to distraction nor to opioid system activation, but to decreased elaborative cognitive activity. The author argued that sustained present-moment attention to sensory processes precludes the formation of mental narratives, cognitive appraisals, and self-related processes that exacerbate pain. He also noted that increases in parasympathetic activity and decreases in limbic-mediated fear conditioning may also underlie OM’s analgesic effects.

Reference:

Grant, J. A. (2013). Meditative analgesia: The current state of the field. Annals of the New York Academy of Sciences, 1307:55-63. [PMID: 24673150]

[Link to abstract]

January 26th, 2014|News|

Stress But Not Pain Perception Reduced from Focused Attention

Posted from archive: 12.24.2013 | by AMRA

 

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Is mindfulness then more effective in reducing pain and stress than simple relaxation alone? Feuille and Pargament [Journal of Health Psychology] conducted a randomized controlled trial comparing standardized mindfulness (STM), spiritualized mindfulness (SPM), and simple relaxation in a cohort of 74 migraine sufferers. Participants underwent a brief, single-session training in STM, SPM, or simple relaxation, in which they received only 5 to 7 minutes of guided practice and then practiced their assigned technique at home for 20 minutes a day over two weeks. The STM and SPM conditions were identical, except for the inclusion of a spiritually oriented rationale in the SPM condition, which was untied to theism or the beliefs of any specific religion.

Both meditation groups employed focused attention to the breath without an open monitoring component. At the study’s 
conclusion, 
participants’ 
pain tolerance 
was evaluated 
by a cold 
pressor task 
assessing their 
ability to 
maintain their 
hand in icy cold 
water for as long 
as they could tolerate, and their pain, stress, and mindfulness (as measured by the Toronto Mindfulness Scale) were rated during the procedure. Both meditation groups reported significantly lower stress than the simple relaxation group, but none of the groups differed in their pain perception or tolerance. SPM participants had a greater sense of connection to the sacred and experienced higher levels of mindfulness, but the STM and simple relaxation participants failed to differ from each other on those measures.

Very brief meditation training did not alter pain perception and tolerance in this study, which is consistent with findings that focused attention is not as effective as open monitoring in reducing pain, but it may also […]

January 25th, 2014|News|