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（由申请人提供）：疼痛是一种涉及感觉，认知和情感机制的多维体验。这些因素之间的相互作用星座使得治疗临床疼痛具有挑战性，并且通常是经济负担。已发现正念冥想可显着改善实验和临床环境中的疼痛症状，但缺乏机械数据的临床部署有限，这种成本效益和无麻醉性治疗的临床部署。我们实验室的最新发现确定冥想仅在四天（20分钟/天）的训练后，疼痛强度降低了40％，疼痛不愉快的等级降低了57％。 采用新兴的MRI技术（动脉自旋标记），我们发现与冥想相关的疼痛缓解相关，可减少与疼痛相关的脑体感应疼痛相关的脑活动，并在脑部区域（例如前菌丝），前扣带回皮层和甲状腺皮质中增加脑部区域的活性。 这些后一个地区参与了认知控制，情绪调节和执行处理。这些发现表明，冥想在缓解疼痛期间与多种大脑机制相关。但是，其他认知因素的贡献，例如期望，促进者的关注，减少焦虑和调节 /灭绝过程，仍然了解得很了解。 这些因素与安慰剂效应至关重要。 因此，拟议的研究旨在确定与冥想相关的疼痛缓解是否与与安慰剂镇痛不同的大脑机制相关。将采用功能成像方法来评估调解诱导的疼痛缓解和条件安慰剂镇痛期间的脑激活。拟议的研究将为认知因素涉及的疼痛模量涉及的神经底物提供重要的见解。