Brain Mechanisms Supporting Mindfulness-Based Pain Relief

支持基于正念的疼痛缓解的大脑机制

• 批准号: 8679883
• 负责人: Fadel Zeidan
• 金额: $ 9万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8679883
• 关键词: Absence of pain sensation; Academy; Address; Advisory Committees; Affect; Affective; American; Analgesics; Anterior; Area; Attenuated; Award; Awareness; Behavioral; Belief; Brain; Brain region; Characteristics; Clinical; Clinical Treatment; Cognitive; Control Groups; Data; Development; Economic Burden; Epidemic; Foundations; Goals; Health; Heating; Individual; Infusion procedures; Insula of Reil; Insurance Carriers; Intervention; Journals; Knowledge; Label; Mediating; Meditation; Mentors; Methodology; Naloxone; Narcotic Antagonists; Neurosciences; Opioid Receptor; Pain; Pain management; Pathway interactions; Patients; Phase; Placebos; Prefrontal Cortex; Prevalence; Procedures; Process; Property; Psychophysics; Research; Research Activity; Research Personnel; Resources; Saline; Sensory; Site; Societies; Somatosensory Cortex; Support System; System; Techniques; Testing; Time; Training; Training Activity; attenuation; base; career; career development; cingulate cortex; cognitive control; cost; cost effective; endogenous opioids; experience; insight; knowledge base; mindfulness; mindfulness meditation; neuroimaging; novel; palliative; programs; psychologic; public health relevance; relating to nervous system; skills; statistics

DESCRIPTION (provided by applicant): Pain is a multidimensional experience that involves sensory, cognitive and affective factors that make the treatment of clinical pain challenging and often a financial burden. Mindfulness meditation has been shown to alleviate pain in experimental and clinical settings, and at the same time is cost-effective. However, the pain- relieving mechanisms of mindfulness meditation remain poorly characterized. The central research aim of the proposed K99/R00 application is to identify the behavioral, neural, and pharmacologic mechanisms associated with mindfulness-based pain relief. To accomplish this aim, Dr. Zeidan will employ a wide-ranging approach to disentangle the potential analgesic properties of mindfulness meditation. For one, meditation's palliative effects may simply reflect demand characteristics associated with the belief that one is meditating. To address this issue, Dr. Zeidan has developed and employed a sham mindfulness meditation intervention to test the hypothesis that mindfulness meditation activates higher-order brain regions [rostral anterior cingulate cortex (ACC)] to reduce pain when compared to sham mindfulness meditation. In contrast, sham meditation is postulated to reduce pain by activating brain regions associated with placebo-analgesia (dorsolateral prefrontal cortex) when compared to mindfulness meditation. Interestingly, meditation-related pain relief engages brain regions (ACC, anterior insula) containing a high concentration of opioid receptors. However, it is still unknown if meditation-related pain relief is mediated by endogenous opioidergic systems. Administration of an opioid antagonist during meditation and noxious heat stimulation is hypothesized to significantly reduce the pain- relieving effects of meditation. In addition, the specific neuro-functional connections associated with reducing pain by meditation remain unknown. Dr. Zeidan will employ neuroimaging and functional connectivity analyses to test the hypothesis that meditation will activate neural systems involved in cognitive reappraisal processes (ACC) to reduce pain-related brain activity. The knowledge to be gained from these research activities will provide novel mechanistic insight into the efficacy and analgesic properties associated with mindfulness meditation, an important consideration for the treatment of clinical pain. The training goal of this K99/R00 application is to gain additional experience in neuroimaging and pharmacologic methodologies to allow Dr. Zeidan to successfully transition to an independent career focused on identifying the specific analgesic properties of mindfulness meditation. The training plan includes individual and team-mentoring strategies, additional coursework in neuroscience, pharmacologic techniques, statistics, scientifically validated meditation training, and career development. Dr. Zeidan is strongly supported by his mentor and career development advisory committee that is composed of leading experts in their respective fields. The proposed training and research activities of this K99/R00 award will provide Dr. Zeidan with the resources, knowledge base and skills to establish an independent line of programmatic research on the mechanisms of mindfulness and pain.

描述（由申请人提供）：疼痛是一种多维体验，涉及感觉、认知和情感因素，使临床疼痛的治疗具有挑战性，而且往往是一种经济负担。正念冥想已被证明可以在实验和临床环境中减轻疼痛，同时具有成本效益。然而，正念冥想的止痛机制仍然缺乏特征。拟议的K99/R 00应用程序的中心研究目标是确定与基于正念的疼痛缓解相关的行为，神经和药理学机制。为了实现这一目标，Zeidan博士将采用广泛的方法来解开正念冥想的潜在镇痛特性。首先，冥想的缓解作用可能只是反映了与冥想信念相关的需求特征。为了解决这个问题，Zeidan博士开发并采用了一种假正念冥想干预来测试这一假设，即与假正念冥想相比，正念冥想激活了高阶大脑区域[喙前扣带皮层（ACC）]以减少疼痛。相反，与正念冥想相比，假冥想被认为通过激活与安慰剂镇痛相关的大脑区域（背外侧前额叶皮层）来减少疼痛。有趣的是，冥想相关的疼痛缓解涉及含有高浓度阿片受体的大脑区域（ACC，前额叶）。然而，它仍然是未知的，如果冥想相关的疼痛缓解是由内源性阿片系统介导的。假设在冥想和有害热刺激期间给予阿片拮抗剂可显著降低冥想的疼痛缓解作用。此外，与通过冥想减轻疼痛相关的特定神经功能连接仍然未知。Zeidan博士将采用神经影像学和功能连接分析来验证一个假设，即冥想将激活参与认知重新评估过程（ACC）的神经系统，以减少与疼痛相关的大脑活动。从这些研究活动中获得的知识将为正念冥想的疗效和镇痛特性提供新的机制见解，这是临床疼痛治疗的重要考虑因素。这个K99/R 00应用程序的培训目标是获得神经成像和药理学方法的额外经验，使Zeidan博士能够成功过渡到一个独立的职业生涯，专注于确定正念冥想的特定镇痛特性。培训计划包括个人和团队指导策略，神经科学，药理学技术，统计学，科学验证的冥想训练和职业发展的额外课程。Zeidan博士得到了他的导师和职业发展咨询委员会的大力支持，该委员会由各自领域的顶尖专家组成。该K99/R 00奖项的拟议培训和研究活动将为Zeidan博士提供资源，知识基础和技能，以建立关于正念和疼痛机制的独立项目研究。