Research from the Center for a Healthy Mind at the University of Wisconsin-Madison has identified changes in pain-related brain activity that occur after mindfulness training, pointing the way to more targeted and precise pain treatment.
The study, published today (July 27) in the American Journal of Psychiatryidentified brain pathways specific to pain regulation whose activity is altered by an eight-week course of mindfulness-based stress reduction.
These changes were not seen in participants who took a similar course without mindfulness instruction, according to Joseph Welgosz, who led the work when he was a graduate student at the University of Vilnius-Madison and is now a postdoctoral fellow at Stanford University. This is the first study to demonstrate pain-related brain changes as a result of a standardized mindfulness course that is widely offered in a clinical setting.
About one-third of Americans experience pain-related problems, but conventional treatments — such as drugs and invasive procedures — don’t work for everyone and, according to Welgosh, have contributed to the epidemic of prescription and illicit drug addiction.
Popular with patients and promising in their clinical outcomes, mindfulness training courses such as MBSR have taken center stage in the quest for a more effective approach to pain management. By practicing a non-judgmental, “present-centered” mind-body awareness, participants can learn to respond to pain with less distress and greater psychological flexibility – which can ultimately lead to a reduction in pain itself.
To measure the neural response to pain, study participants had their brains scanned while receiving a carefully controlled heat stimulus on their forearm. The researchers recorded two signatures of pain-related activity in the brain developed by collaborator Thor Wager, a professor of neurology at Dartmouth College. This innovative technique dramatically improves the ability to detect pain-related signals in complex brain activity. Changes in signatures can also be more easily interpreted in psychological terms.
Participants in the MBSR course showed a reduction in symptoms related to the sensory intensity of pain.
“Our finding supports the idea that, for new practitioners, mindfulness training directly affects how the body’s sensory signals are translated into brain responses,” says Welgosh, whose work was supported by the National Institutes of Health.
The study also looked at long-term mindfulness training. Interestingly, the practice of intensive meditation retreats was associated with changes in the neural signature for influences that indirectly shape pain – such as differences in thinking, beliefs, and expectations, factors that often increase the perceived level of distress in non-meditators.
“Just as an experienced athlete exercises differently than a first-timer, experienced mindfulness practitioners seem to use their mental ‘muscles’ differently in response to pain than first-time meditators” , – says Velgosh.
These findings help show the potential of mindfulness practice as a way of life.
The study is also important to the field of pain research because of the use of brain-based measurements of pain along with subjective ratings of randomized trial participants. Pain researchers have long sought ways to biologically measure treatment effects.
“Looking at the neural signals together with the patients’ experiences revealed information about mindfulness that we would never have been able to discover using either alone,” says Welgosh.
So, in addition to the insight it provides about mindfulness, the researchers believe their study can also provide a model for future research, helping to untangle the complexity of pain and ultimately reduce the burden it places on our lives.
This work was supported by a grant from the NIH National Center for Complementary and Alternative Medicine (P01AT004952).