Brain imaging reveals how mindfulness program boosts pain regulation

Research at the University of Wisconsin-Madison’s Center for Healthy Minds has isolated the changes in pain-related brain activity that follow mindfulness training — pointing a way toward more targeted and precise pain treatment.

The study, published today (July 27) in The American Journal of Psychiatry, identified pathways in the brain specific to pain regulation on which activity is altered by the center’s eight-week Mindfulness Based Stress Reduction course.

These changes were not seen in participants who took a similar course without the mindfulness instruction — important new evidence that the brain changes are due to the mindfulness training itself, according to Joseph Wielgosz, who led the work while he was a graduate student at UW-Madison and is now a postdoctoral researcher at Stanford University. The study is the first to demonstrate pain-related brain changes from a standardized mindfulness course that is widely offered in clinical settings.

Around one-third of Americans experience pain-related problems, but common treatments — like medications and invasive procedures — don’t work for everyone and, according to Wielgosz, have contributed to an epidemic of addiction to prescription and illicit drugs.

Popular with patients and promising in its clinical outcomes, mindfulness training courses like MBSR have taken a central place in the drive for a more effective approach to pain management. By practicing nonjudgmental, “present-centered” awareness of mind and body, participants can learn to respond to pain with less distress and more psychological flexibility — which can ultimately lead to reductions in pain itself.

To measure neural pain response, study participants had their brains scanned while receiving a carefully controlled heat-based stimulus on their forearm. The researchers recorded two brain-wide signatures of pain-related activity, developed by collaborator Tor Wager, a professor of neuroscience at Dartmouth College. This innovative technique dramatically improves the ability to detect pain-related signals in the brain’s complex activity. Changes in signatures can also be more easily interpreted in psychological terms.

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