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Neural mechanisms supporting the relationship between dispositional mindfulness and pain

Zeidan, Fadela,*; Salomons, Timb; Farris, Suzan R.a; Emerson, Nichole M.a; Adler-Neal, Adriennea; Jung, Youngkyooc; Coghill, Robert C.a,d

doi: 10.1097/j.pain.0000000000001344
Research Paper

Interindividual 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 nonreactively 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 whether 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-naive and healthy volunteers completed the Freiburg Mindfulness Inventory and were administered innocuous (35°C) and noxious stimulation (49°C) during perfusion-based functional magnetic resonance imaging. Higher Freiburg Mindfulness Inventory ratings were associated with lower pain intensity (P = 0.005) and pain unpleasantness ratings (P = 0.005). 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 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 posterior cingulate cortex should be considered as important mechanistic targets for pain therapies.

Trait mindfulness, the innate capacity to nonreactively attend to the present moment, was associated with lower pain and brain mechanisms supporting self-referential processes.

aDepartment of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, United States

bDepartment of Psychology, School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom

cDepartment of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States

dDepartment of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Corresponding author. Address: Department of Neurobiology and Anatomy, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC 27157, Unites States. Tel.: 336-716-4284; fax: 336-716-4534. E-mail address: fzeidan@wakehealth.edu (F. Zeidan).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received March 13, 2018

Received in revised form July 03, 2018

Accepted July 09, 2018

© 2018 International Association for the Study of Pain
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