Delineating the Brain Mechanisms Supporting Modulation of Pain by Meditation

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DESCRIPTION (provided by applicant): 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 shown to improve health, well being, and at the same time is cost-effective. Moreover, mindfulness meditation has been found to significantly improve pain symptoms in experimental and clinical settings. Unfortunately, these benefits have largely been demonstrated in those with extensive meditation training and practice. The utility of mindfulness meditation may prove more attractive if it is found to reduce pain after brief training. The brain mechanisms involved in meditation- related pain relief are largely unknown and require further investigation. Recent findings from our laboratory determined that meditation, after four days (20m/d) of training, dramatically 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 with multiple brain mechanisms related to reductions in somatosensory brain activity and increases in brain regions involved in cognitive control, emotion regulation, and executive processing. However, it remains unknown if meditation engages brain mechanisms that are distinct from other pain modulatory processes that also involve cognitive factors. Indirect evidence suggests that meditation-related pain modulation is associated with activation of the anterior insular cortex, while placebo-related pain modulation is associated with reduced activation of this structure. Thus, the research proposed in this fellowship will test the hypothesis that meditation induced modulation of pain engages brain mechanisms that are distinct from those involved during placebo-related pain modulation. This fellowship will provide the applicant with comprehensive training in the investigation of human brain mechanisms of pain and multiple development opportunities that will facilitate transition to a career as an independent investigator.