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Neural Mechanisms Supporting the Relationship between Dispositional Mindfulness and Pain

Zeidan, Fadel1; Salomons, Tim2; Farris, Suzan R.1; Emerson, Nichole M.; Neal, Adrienne Adler-1; Jung, Youngkyoo3; Coghill, Robert C.1,4

doi: 10.1097/j.pain.0000000000001344
Research Paper: PDF Only

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.

1Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston- Salem, NC, 27157,

2 School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights PO Box 217,United Kingdom,

3 Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, 27157,

4Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, 45229

Corresponding Author: Fadel Zeidan, Address: 1 Medical Center Boulevard, Winston-Salem NC, 27157 Telephone: 336-716-4284, Fax: 336-716-4534, Email: fzeidan@wakehealth.edu

© 2018 International Association for the Study of Pain