Delineating the Brain Mechanisms Supporting Modulation of Pain by Meditation

描述(申请人提供)：疼痛是一种多维体验，涉及感觉、认知和情感机制。这些因素之间的相互作用使临床疼痛的治疗具有挑战性，而且往往是经济负担。正念冥想已经被证明可以改善健康，幸福，同时也是划算的。此外，在实验和临床环境中，正念冥想被发现可以显著改善疼痛症状。不幸的是，这些好处在那些经过广泛冥想训练和练习的人身上得到了很大程度的体现。如果在短暂的训练后发现正念冥想可以减轻疼痛，那么冥想的效用可能会更有吸引力。与冥想相关的疼痛缓解所涉及的大脑机制在很大程度上是未知的，需要进一步研究。我们实验室的最新发现表明，冥想在四天(20米/天)的训练后，显著降低了40%的疼痛强度和57%的疼痛不适程度。利用一种新的核磁共振技术(动脉自旋标记)，我们发现与冥想相关的疼痛缓解与多种大脑机制有关，这些机制与躯体感觉大脑活动的减少和涉及认知控制、情绪调节和执行处理的大脑区域的增加有关。然而，目前尚不清楚冥想是否参与了有别于其他也涉及认知因素的疼痛调制过程的大脑机制。间接证据表明，冥想相关的疼痛调制与前岛叶皮质的激活有关，而安慰剂相关的疼痛 调制与该结构的激活减少有关。因此，这项联谊会中提出的研究将检验这样一个假设，即冥想诱导的疼痛调制涉及与安慰剂相关的疼痛调制过程中不同的大脑机制。这项奖学金将为申请者提供关于人类大脑疼痛机制调查的全面培训，并提供多种发展机会，以促进向独立调查员职业的过渡。

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.