Neural Mechanisms Supporting the Relationship between Dispositional Mindfulness and Pain.

Author: Zeidan F1, Salomons T2, Farris SR1, Emerson NM, Neal AA1, Jung Y3, Coghill RC1,4
1Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston- Salem, NC, 27157.
2School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights PO Box 217,United Kingdom.
3Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, 27157.
4Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 45229.
Conference/Journal: Pain.
Date published: 2018 Jul 12
Other: Special Notes: doi: 10.1097/j.pain.0000000000001344. [Epub ahead of print] , Word Count: 238

Inter-individual differences in pain sensitivity vary as a function of interactions between sensory, cognitive-affective and dispositional factors. Trait mindfulness, characterized as the innate capacity to non-reactively sustain attention to the present moment, is a psychological construct that is associated with lower clinical pain outcomes. Yet, the neural mechanisms supporting dispositional mindfulness are unknown. In an exploratory data analysis obtained during a study comparing mindfulness to placebo-analgesia, we sought to determine if dispositional mindfulness is associated with lower pain sensitivity. We also aimed to identify the brain mechanisms supporting the postulated inverse relationship between trait mindfulness and pain in response to noxious stimulation. We hypothesized that trait mindfulness would be associated with lower pain and greater deactivation of the default mode network. Seventy-six, meditation-naïve and healthy volunteers completed the Freiburg Mindfulness Inventory (FMI) and were administered innocuous (35°C) and noxious stimulation (49°C) during perfusion-based functional magnetic resonance imaging. Higher FMI ratings were associated with lower pain intensity (p =.005) and pain unpleasantness ratings (p =.005). Whole brain analyses revealed that higher dispositional mindfulness was associated with greater deactivation of a brain region extending from the precuneus to posterior cingulate cortex (PCC) during noxious heat. These novel findings demonstrate that mindful individuals feel less pain and evoke greater deactivation of brain regions supporting the engagement sensory, cognitive and affective appraisals. We propose that mindfulness and the PCC should be considered as important mechanistic targets for pain therapies.

PMID: 30015711 DOI: 10.1097/j.pain.0000000000001344