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Is Mindfulness Associated With Lower Pain Reactivity and Connectivity of the Default Mode Network? A Replication and Extension Study in Healthy and Episodic Migraine Participants

Published:August 04, 2022DOI:https://doi.org/10.1016/j.jpain.2022.07.011

      Highlights

      • Mindfulness does not relate to experimental pain in healthy adults.
      • Mindfulness does not relate to headache characteristics in migraine patients.
      • Mindfulness does not associate with default mode network (DMN) connectivity in healthy adults.
      • Mindfulness does not associate with DMN connectivity in migraine.
      • Non-judging of experience may relate to pain, catastrophizing and DMN connectivity in migraine.

      Abstract

      Formal training in mindfulness-based practices promotes reduced experimental and clinical pain, which may be driven by reduced emotional pain reactivity and undergirded by alterations in the default mode network, implicated in mind-wandering and self-referential processing. Recent results published in this journal suggest that mindfulness, defined here as the day-to-day tendency to maintain a non-reactive mental state in the absence of training, associates with lower pain reactivity, greater heat-pain thresholds, and resting-state default mode network functional connectivity in healthy adults in a similar manner to trained mindfulness. The extent to which these findings extend to chronic pain samples and replicate in healthy samples is unknown. Using data from healthy adults (n = 36) and episodic migraine patients (n = 98) and replicating previously published methods, we observed no significant association between mindfulness and heat-pain threshold, pain intensity or unpleasantness, or pain catastrophizing in healthy controls, or between mindfulness and headache frequency, severity, impactor pain catastrophizing in patients. There was no association between default mode network connectivity and mindfulness in either sample when probed via seed-based functional connectivity analyses. In post-hoc whole brain exploratory analyses, a meta-analytically derived default mode network node (ie, posterior cingulate cortex) showed connectivity with regions unassociated with pain processing as a function of mindfulness, such that healthy adults higher in mindfulness showed greater functional connectivity between the posterior cingulate cortex-and cerebellum. Collectively, these findings suggest that the relationship between mindfulness and default mode network functional connectivity may be nuanced or non-robust, and encourage further investigation of how mindfulness relates to pain.

      Perspective

      This study found few significant associations between dispositional mindfulness and pain, pain reactivity and default mode connectivity in healthy adults and migraine patients. The relationship between mindfulness and default mode network connectivity may be nuanced or non-robust.

      Key words

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      References

        • Baer RA
        • Smith GT
        • Allen KB
        Assessment of mindfulness by self-report: The Kentucky inventory of mindfulness skills.
        Assessment. 2004; 11 (Available from:): 191-206
        • Baer RA
        • Smith GT
        • Hopkins J
        • Krietemeyer J
        • Toney L
        Using self-report assessment methods to explore facets of mindfulness.
        Assessment. 2006; 13: 27-45
        • Baer RA
        • Smith GT
        • Lykins E
        • Button D
        • Krietemeyer J
        • Sauer S
        • Walsh E
        • Duggan D
        • Williams JMG
        Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples.
        Assessment. 2008; 15: 329-342
        • Behzadi Y
        • Restom K
        • Liau J
        • Liu TT
        A component based noise correction method (CompCor) for BOLD and perfusion based fMRI.
        Neuroimage. 2007; 37: 90-101
        • Brewer JA
        • Worhunsky PD
        • Gray JR
        • Tang YY
        • Weber J
        • Kober H
        Meditation experience is associated with differences in default mode network activity and connectivity.
        Proc Natl Acad Sci. 2011; 108: 20254-20259
        • Burrowes SAB
        • Goloubeva O
        • Stafford K
        • McArdle PF
        • Goyal M
        • Peterlin BL
        • Haythornthwaite JA
        • Seminowicz DA
        Enhanced mindfulness-based stress reduction in episodic migraine - Effects on sleep quality, anxiety, stress, and depression: A secondary analysis of a randomized clinical trial.
        Pain. 2022; 163: 436-444
        • Cassidy EL
        • Atherton RJ
        • Robertson N
        • Walsh DA
        • Gillett R
        Mindfulness, functioning and catastrophizing after multidisciplinary pain management for chronic low back pain.
        Pain. 2012; 153: 644-650
        • Ciere Y
        • Snippe E
        • Padberg M
        • Jacobs B
        • Visser A
        • Sanderman R
        • Fleer J
        The role of state and trait positive affect and mindfulness in affective reactivity to pain in chronic migraine.
        Heal Psychol. 2019; 38: 94-102
        • Conti Y
        • Vatine JJ
        • Levy S
        • Levin Meltz Y
        • Hamdan S
        • Elkana O
        Pain catastrophizing mediates the association between mindfulness and psychological distress in chronic pain syndrome.
        Pain Pract. 2020; 20: 714-723
        • Dickenson J
        • Berkman ET
        • Arch J
        • Lieberman MD
        Neural correlates of focused attention during a brief mindfulness induction.
        Soc Cogn Affect Neurosci. 2013; 8: 40-47
        • Dorado K
        • Schreiber KL
        • Koulouris A
        • Edwards RR
        • Napadow V
        • Lazaridou A
        Interactive effects of pain catastrophizing and mindfulness on pain intensity in women with fibromyalgia.
        Heal Psychol Open. 2018; 52055102918807406
        • Farb NAS
        • Segal ZV.
        • Mayberg H
        • Bean J
        • McKeon D
        • Fatima Z
        • Anderson AK
        Attending to the present: mindfulness meditation reveals distinct neural modes of self-reference.
        Soc Cogn Affect Neurosci. 2007; 2: 313-322
        • Gard T
        • Hölzel BK
        • Sack AT
        • Hempel H
        • Lazar SW
        • Vaitl D
        • Ott U
        Pain attenuation through mindfulness is associated with decreased cognitive control and increased sensory processing in the brain.
        Cereb Cortex. 2012; 22: 2692-2702
        • Garrison KA
        • Zeffiro TA
        • Scheinost D
        • Constable RT
        • Brewer JA
        Meditation leads to reduced default mode network activity beyond an active task.
        Cogn Affect Behav Neurosci. 2015; 15: 712-720
        • Grant JA
        • Courtemanche J
        • Rainville P
        A non-elaborative mental stance and decoupling of executive and pain-related cortices predicts low pain sensitivity in Zen meditators.
        Pain. 2011; 152: 150-156
        • Harrison R
        • Zeidan F
        • Kitsaras G
        • Ozcelik D
        • Salomons TV
        Trait mindfulness is associated with lower pain reactivity and connectivity of the default mode network.
        J Pain. 2019; 20: 645-654
        • Holroyd KA
        • Drew JB
        • Cottrell CK
        • Romanek KM
        • Heh V
        Impaired functioning and quality of life in severe migraine: The role of catastrophizing and associated symptoms.
        Cephalalgia. 2007; 27: 1156-1165
        • Hölzel BK
        • Ott U
        • Hempel H
        • Hackl A
        • Wolf K
        • Stark R
        • Vaitl D
        Differential engagement of anterior cingulate and adjacent medial frontal cortex in adept meditators and non-meditators.
        Neurosci Lett. 2007; 421: 16-21
        • Hubbard CS
        • Khan SA
        • Keaser ML
        • Seminowicz DA
        • Mathur VA
        • Goyal M
        Altered brain structure and function correlate with disease severity and pain catastrophizing in migraine patients.
        eNeuro. 2014; 1
        • Kim H
        A dual-subsystem model of the brain's default network: Self-referential processing, memory retrieval processes, and autobiographical memory retrieval.
        Neuroimage. 2012; 61: 966-977
        • Kosinski M
        • Bayliss MS
        • Bjorner JB
        • Ware JE
        • Garber WH
        • Batenhorst A
        • Cady R
        • Dahlöf CGH
        • Dowson A
        • Tepper S
        A six-item short-form survey for measuring headache impact: The HIT-6TM.
        Qual Life Res. 2003; 12: 963-974
        • Krimmel SR
        • Keaser ML
        • Speis D
        • Haythornthwaite JA
        • Seminowicz DA
        Migraine disability, pain catastrophizing, and headache severity are associated with evoked pain and targeted by mind-body therapy.
        medRxiv. 2021; (07.05.21259849, 2021)
        • Kucyi A
        • Davis KD
        Dynamic functional connectivity of the default mode network tracks daydreaming.
        Neuroimage. 2014; 100: 471-480
        • Lee AC
        • Harvey WF
        • Price LL
        • Morgan LPK
        • Morgan NL
        • Wang C
        Mindfulness is associated with psychological health and moderates pain in knee osteoarthritis.
        Osteoarthr Cartil W.B. Saunders. 2017; 25: 824-831
        • Leonardi WM
        • Steiner TJ
        • Scher AT
        • Lipton RB
        • Leonardi M
        • Steiner TJ
        • Scher AT
        • Lipton RB
        The global burden of migraine: Measuring disability in headache disorders with WHO's Classification of Functioning, Disability and Health (ICF).
        J Headache Pain. 2005; 6: 429-440
        • Ludwig DS
        • Kabat-Zinn J
        Mindfulness in medicine.
        JAMA. 2008; 300: 1350-1352
        • Lutz A
        • McFarlin DR
        • Perlman DM
        • Salomons TV.
        • Davidson RJ
        Altered anterior insula activation during anticipation and experience of painful stimuli in expert meditators.
        Neuroimage. 2013; 64: 538-546
        • Maldjian JA
        • Laurienti PJ
        • Burdette JH
        Precentral gyrus discrepancy in electronic versions of the Talairach atlas.
        Neuroimage. 2004; 21: 450-455
        • Maldjian JA
        • Laurienti PJ
        • Kraft RA
        • Burdette JH
        An Automated Method for Neuroanatomic and Cytoarchitectonic Atlas-Based Interrogation of fMRI Data Sets.
        Neuroimage. 2003; 19: 1233-1239
        • McCracken LM
        • Gauntlett-Gilbert J
        • Vowles KE
        The role of mindfulness in a contextual cognitive-behavioral analysis of chronic pain-related suffering and disability.
        Pain. 2007; 131: 63-69
        • Mischkowski D
        • Stavish CM
        • Palacios-Barrios EE
        • Banker LA
        • Dildine TC
        • Atlas LY
        Dispositional mindfulness and acute heat pain: Comparing stimulus-evoked pain with summary pain assessment.
        Psychosom Med. 2021; 83: 539-548
        • Mun CJ
        • Okun MA
        • Karoly P
        Trait mindfulness and catastrophizing as mediators of the association between pain severity and pain-related impairment.
        Pers Individ Dif Pergamon. 2014; 66: 68-73
        • Murphy K
        • Fox MD
        Towards a consensus regarding global signal regression for resting state functional connectivity MRI.
        Neuroimage. 2017; 154: 169-173
        • Muschelli J
        • Nebel MB
        • Caffo BS
        • Barber AD
        • Pekar JJ
        • Mostofsky SH
        Reduction of motion-related artifacts in resting state fMRI using aCompCor.
        Neuroimage. 2014; 96: 22-35
        • Navarrete J
        • González-Moret R
        • Cortés X
        • Lisón JF
        • Soria JM
        • Baños RM
        • Cebolla A
        Dispositional mindfulness and inflammatory bowel disease: Mindful awareness mediates the relation between severity and quality of life, stress, and fatigue.
        Mindfulness. 2021; 12: 1524-1533
        • Parkinson TD
        • Kornelsen J
        • Smith SD
        Trait mindfulness and functional connectivity in cognitive and attentional resting state networks.
        Front Hum Neurosci. 2019; 13: 112
        • Petter M
        • Chambers CT
        • McGrath PJ
        • Dick BD
        The role of trait mindfulness in the pain experience of adolescents.
        J Pain. 2013; 14: 1709-1718
        • Power JD
        • Barnes KA
        • Snyder AZ
        • Schlaggar BL
        • Petersen SE
        Spurious but systematic correlations in functional connectivity MRI networks arise from subject motion.
        Neuroimage. 2012; 59: 2142-2154
        • Power JD
        • Mitra A
        • Laumann TO
        • Snyder AZ
        • Schlaggar BL
        • Petersen SE
        Methods to detect, characterize, and remove motion artifact in resting state fMRI.
        Neuroimage. 2014; 84: 320-341
        • Power JD
        • Plitt M
        • Laumann TO
        • Martin A
        Sources and implications of whole-brain fMRI signals in humans.
        Neuroimage. 2017; 146: 609-662
        • Power JD
        • Schlaggar BL
        • Petersen SE
        Recent progress and outstanding issues in motion correction in resting state fMRI.
        Neuroimage. 2022; 105: 536-551
        • Schütze R
        • Rees C
        • Preece M
        • Schütze M
        Low mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain.
        Pain. 2010; 148: 120-127
        • Seminowicz DA
        • Burrowes SAB
        • Kearson A
        • Zhang J
        • Krimmel SR
        • Samawi L
        • Furman AJ
        • Keaser ML
        • Gould NF
        • Magyari T
        • White L
        • Goloubeva O
        • Goyal M
        • Peterlin BL
        • Haythornthwaite JA
        Enhanced mindfulness-based stress reduction in episodic migraine: A randomized clinical trial with magnetic resonance imaging outcomes.
        Pain. 2020; 161: 1837-1846
        • Senders A
        • Borgatti A
        • Hanes D
        • Shinto L
        Association between pain and mindfulness in multiple sclerosis: A cross-sectional survey.
        Int J MS Care. 2018; 20: 28-34
        • Sullivan MJL
        • Bishop SR
        • Pivik J
        The pain catastrophizing scale: Development and validation.
        Psychol Assess. 1995; 7: 524-532
        • Waldron SM
        • Gauntlett-Gilbert J
        • Marks E
        • Loades ME
        • Jacobs K
        Dispositional mindfulness and its relationship with distress and functioning in adolescents with chronic pain and low-level pain.
        J Pediatr Psychol. 2018; 43: 1038-1046
        • Worsley KJ
        • Marrett S
        • Neelin P
        • Vandal AC
        • Friston KJ
        • Evans AC
        A unified statistical approach for determining significant signals in images of cerebral activation.
        Hum Brain Mapp. 1996; 4: 58-73
        • Yang M
        • Rendas-Baum R
        • Varon SF
        • Kosinski M
        Validation of the Headache Impact Test (HIT-6TM) across episodic and chronic migraine.
        Cephalalgia. 2011; 31: 357-367
        • Yarkoni T
        • Poldrack R
        • Nichols T
        • Van Essen D
        • Wager T
        NeuroSynth: a new platform for large-scale automated synthesis of human functional neuroimaging data.
        in: Front Neuroinformatics Conerence Abstr 4th INCF Congr Neuroinformatics Frontiers Media SA. 2011
        • Zeidan F
        • Emerson NM
        • Farris SR
        • Ray JN
        • Jung Y
        • McHaffie JG
        • Coghill RC
        Mindfulness meditation-based pain relief employs different neural mechanisms than placebo and sham mindfulness meditation-induced analgesia.
        J Neurosci. 2015; 35: 15307-15325
        • Zeidan F
        • Gordon NS
        • Merchant J
        • Goolkasian P
        The effects of brief mindfulness meditation training on experimentally induced pain.
        J Pain. 2010; 11: 199-209
        • Zeidan F
        • Grant JA
        • Brown CA
        • McHaffie JG
        • Coghill RC
        Mindfulness meditation-related pain relief: Evidence for unique brain mechanisms in the regulation of pain.
        Neurosci Lett. 2012; 520: 165-173
        • Zeidan F
        • Salomons T
        • Farris SR
        • Emerson NM
        • Adler-Neal A
        • Jung Y
        • Coghill RC
        Neural mechanisms supporting the relationship between dispositional mindfulness and pain.
        Pain. 2018; 159: 2477-2485