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: 9396379
• 负责人: Fadel Zeidan
• 金额: $ 24.9万
• 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 2020-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9396379
• 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; 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; Pharmacology; 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; cognitive reappraisal; 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，涉及感官，认知和情感因素，使治疗临床疼痛的治疗具有挑战性，并且通常是经济负担。正念冥想已被证明可以减轻实验和临床环境中的疼痛，同时具有成本效益。但是，正念冥想的疼痛缓解机制的特征仍然很差。拟议的K99/R00应用的中心研究目的是确定与基于正念的疼痛缓解相关的行为，神经和药理机制。为了实现这一目标，Zeidan博士将采用广泛的方法来消除正念冥想的潜在镇痛特性。首先，冥想的姑息效应可能只是反映了与人们冥想的信念有关的需求特征。为了解决这个问题，Zeidan博士开发并采用了虚假的正念冥想干预措施来检验以下假设：正念冥想激活了高阶脑部区域[与虚假的正念冥想相比，正念冥想激活了高阶脑部区域[Rosttral前扣带回皮层（ACC）]以减轻疼痛。相比之下，与正念冥想相比，假设假冥想是通过激活与安慰剂 - 肌虫（背外侧前额叶皮层）相关的大脑区域来减轻疼痛的。有趣的是，与冥想相关的疼痛缓解使大脑区域（ACC，前岛）含有高浓度的阿片受体。但是，仍然尚不清楚冥想相关的疼痛缓解是由内源性阿片类系统介导的。假设在冥想期间给予阿片类药物拮抗剂和有害热刺激，以显着减少冥想的疼痛缓解作用。此外，与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通性分析来检验以下假设：冥想将激活涉及认知重新评估过程（ACC）的神经系统以减少与疼痛相关的脑活动。从这些研究活动中获得的知识将提供对与正念冥想相关的功效和镇痛特性的新型机械洞察力，这是治疗临床疼痛的重要考虑因素。该K99/R00应用程序的培训目标是获得神经影像学和药物方法论的额外经验，以使Zeidan博士成功地过渡到专注于确定正念冥想的特定镇痛特性的独立职业。培训计划包括个人和团队吸引力策略，神经科学领域的其他课程，药物技术，统计，经过科学验证的冥想培训和职业发展。 Zeidan博士得到了他的导师和职业发展咨询委员会的强烈支持，该委员会由各自领域的主要专家组成。该K99/R00奖的拟议培训和研究活动将为Zeidan博士提供有关正念和痛苦机制的独立程序研究的资源，知识库和技能。