Change in brain oscillations as a mechanism of mindfulness-meditation, cognitive therapy, and mindfulness-based cognitive therapy for chronic low back pain

Author: Melissa A Day1,2, Natasha Matthews1, Jason B Mattingley1,3, Dawn M Ehde1, Aaron P Turner2,4, Rhonda M Williams2,4, Mark P Jensen2
1 School of Psychology,University of Queensland, Brisbane, QLD, Australia.
2 Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
3 Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia.
4 VA Puget Sound Health Care System, Seattle, WA.
Conference/Journal: Pain Med
Date published: 2021 Feb 9
Other: Special Notes: doi: 10.1093/pm/pnab049. , Word Count: 268

Psychological treatments for chronic low back pain (CLBP) are effective. However, limited research has investigated their neurophysiological mechanisms. This study examined electroencephalography- (EEG-) assessed brain oscillation changes as potential mechanisms of cognitive therapy (CT), mindfulness-meditation (MM), and mindfulness-based cognitive therapy (MBCT) for CLBP. The a priori bandwidths of interest were changes in theta, alpha and beta power, measured at pre- and post-treatment.

A secondary analysis of a clinical trial.

University of Queensland Psychology Clinic.

Adults (N = 57) with CLBP who completed pre- and post-treatment EEG and pain outcome assessments.

EEG data were examined for five regions of interest (ROIs); the primary outcome was pain intensity.

A significant reduction in theta (p=.015) and alpha (p=.006) power in the left frontal ROI across all treatments was found, although change in theta and alpha power in this region was not differentially associated with outcome across treatments. There were significant reductions in beta power in all five ROIs across all treatments (ps≤.013). Beta power reduction in the central ROI showed a significant association with reduced pain intensity in MBCT only (p=.028). Changes in other regions were not statistically significant.

These findings provide support for the capacity of psychological CLBP treatments to induce changes in brain activity. The reduced beta power in all five ROIs indicated that all three treatments engendered a state of lowered cortical arousal. The growing body of research in this area could potentially inform novel directions towards remedying central nervous system abnormalities associated with CLBP.

Keywords: Electroencephalography (EEG); chronic low back pain; cognitive therapy; mechanism; mindfulness meditation; neural oscillations.

PMID: 33561289 DOI: 10.1093/pm/pnab049