Brain Mechanisms Supporting the Modulation of Pain by Meditation and Placebo

支持通过冥想和安慰剂调节疼痛的大脑机制

• 批准号: 8528483
• 负责人: Robert C Coghill
• 金额: $ 17.77万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8528483
• 关键词: Absence of pain sensation; Affect; Affective; American; Analgesics; Anterior; Anxiety; Area; Attention; Attenuated; Brain; Brain imaging; Brain region; Clinical; Clinical Treatment; Cognitive; Data; Development; Economic Burden; Evaluation; Event; Extinction (Psychology); Foundations; Functional Imaging; Individual; Insula of Reil; Investigation; Laboratories; Magnetic Resonance Imaging; Mediation; Meditation; Methodology; Narcotics; Pain; Pain intensity; Pathway interactions; Placebo Effect; Placebos; Process; Production; Sensory; Somatosensory Cortex; Spin Labels; Symptoms; Techniques; Testing; Thalamic structure; Training; cingulate cortex; cognitive control; conditioning; cost effective; emotion regulation; expectation; experience; frontal lobe; improved; insight; mindfulness; mindfulness meditation; relating to nervous system; response

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 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.

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。正念冥想已被发现在实验和临床环境中显著改善疼痛症状，但缺乏机制数据限制了这种成本效益高且不含麻醉剂的治疗方法的临床应用。我们实验室的最新发现表明，冥想只需经过四天(每天20分钟)的训练，就可以将疼痛强度降低40%，疼痛不愉快程度降低57%。采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初级躯体感觉皮质中与疼痛相关的大脑活动减少以及大脑区域如前岛、前扣带回皮质和眶前额叶皮质中的活动增加有关。后两个区域涉及认知控制、情绪调节和执行加工。这些发现表明，冥想在止痛过程中涉及到多种大脑机制。然而，其他认知因素，如期望、促进者注意力、减少焦虑和条件反射/消退过程的作用仍然知之甚少。这些因素与安慰剂效应密切相关。因此，这项拟议的研究试图确定与冥想相关的疼痛缓解是否涉及与安慰剂止痛不同的大脑机制。功能成像方法将被用来评估在中介诱导的疼痛缓解和条件安慰剂止痛期间的大脑激活。这项拟议的研究将为认知因素调节疼痛的神经底物提供重要的见解。