The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer.

The advent of neuroimaging methodologies, such as functional magnetic resonance imaging (fMRI), has significantly advanced our understanding of the neurophysiological processes supporting a wide spectrum of mind-body approaches to treat pain. A promising self-regulatory practice, mindfulness meditation, reliably alleviates experimentally induced and clinical pain. Yet, the neural mechanisms supporting mindfulness-based pain relief remain poorly characterized. The present review delineates evidence from a spectrum of fMRI studies showing that the neural mechanisms supporting mindfulness-induced pain attenuation differ across varying levels of meditative experience. After brief mindfulness-based mental training (ie, less than 10 hours of practice), mindfulness-based pain relief is associated with higher order (orbitofrontal cortex and rostral anterior cingulate cortex) regulation of low-level nociceptive neural targets (thalamus and primary somatosensory cortex), suggesting an engagement of unique, reappraisal mechanisms. By contrast, mindfulness-based pain relief after extensive training (greater than 1000 hours of practice) is associated with deactivation of prefrontal and greater activation of somatosensory cortical regions, demonstrating an ability to reduce appraisals of arising sensory events. We also describe recent findings showing that higher levels of dispositional mindfulness, in meditation-naïve individuals, are associated with lower pain and greater deactivation of the posterior cingulate cortex, a neural mechanism implicated in self-referential processes. A brief fMRI primer is presented describing appropriate steps and considerations to conduct studies combining mindfulness, pain, and fMRI. We postulate that the identification of the active analgesic neural substrates involved in mindfulness can be used to inform the development and optimization of behavioral therapies to specifically target pain, an important consideration for the ongoing opioid and chronic pain epidemic

The meditative mind: a comprehensive meta-analysis of MRI studies

Over the past decade mind and body practices, such as yoga and meditation, have raised interest in different scientific fields; in particular, the physiological mechanisms underlying the beneficial effects observed in meditators have been investigated. Neuroimaging studies have studied the effects of meditation on brain structure and function and findings have helped clarify the biological underpinnings of the positive effects of meditation practice and the possible integration of this technique in standard therapy. The large amount of data collected thus far allows drawing some conclusions about the neural effects of meditation practice. In the present study we used activation likelihood estimation (ALE) analysis to make a coordinate-based meta-analysis of neuroimaging data on the effects of meditation on brain structure and function. Results indicate that meditation leads to activation in brain areas involved in processing self-relevant information, self-regulation, focused problem-solving, adaptive behavior, and interoception. Results also show that meditation practice induces functional and structural brain modifications in expert meditators, especially in areas involved in self-referential processes such as self-awareness and self-regulation. These results demonstrate that a biological substrate underlies the positive pervasive effect of meditation practice and suggest that meditation techniques could be adopted in clinical populations and to prevent disease

Issues and perspectives in meditation research: in search for a definition

Despite the growing interest in the neurobiological correlates of meditation, most research has omitted to take into account the underlying philosophical aspects of meditation and its wider implications. This, in turn, is reflected in issues surrounding definition, study design, and outcomes. Here, I highlight the often ignored but important aspect of definition in the existing scholarship on neuroscience and meditation practice. For a satisfactory account of a neuroscience of meditation, we must aim to retrieve an operational definition that is inclusive of a traditional ontological description as well as the modern neurocognitive account of the phenomena. Moving beyond examining the effects of meditation practice, to take a potential step forward in the direction to establish how meditation works, it becomes crucial to appraise the philosophical positions that underlie the phenomenology of meditation in the originating traditions. This endeavor may challenge our intuitions and concepts in either directions, but issues pertaining to definition, design, and validity of response measures are extremely important for the evolution of the field and will provide a much-needed context and framework for meditation based interventions

Correlation between Pineal Activation and Religious Meditation Observed by Functional Magnetic Resonance Imaging

The human brain possesses plenty of functions but little is known about its scientific relationship with mind and spirit. Conferences^1,2^ focused on the connection between science and religion were held very recently in which neuroscientists, Buddhist scholars and Dalai Lama discussed attention, mental imagery, emotion, mind, brain functions and meditation, suggesting religious meditation offers an effective means to investigate the mystery of mind and spirit. In the past decade, scientists struggled to obtain brain mappings for various meditation styles using different brain imaging techniques and stimulating results have been observed^3-17^. In this letter we report that, together with other brain regions, pineal body exhibit significant activation during meditation process, supporting the long lasting speculation that pineal plays an important role in the intrinsic awareness which might concern spirit or soul. Pineal is known as an endocrine organ which produces substrates including melatonin and has been ascribed numerous even mysterious functions but its activation during meditation has never been observed by brain imaging technique. In seventeenth century, based on anatomic observation, Descartes ventured to suggest that pineal serves as the principal seat of the soul^18-20^. Inspired by its geometric center in the brain, physiologists, psychologists, philosophers and religionists have been speculating for centuries about pineal's function relevant to spirit and soul. In this study, we chose Chinese Original Quiet Sitting, one style of meditation, to explore this long lasting speculation by functional magnetic resonance imaging technique. Our results demonstrate a correlation between pineal activation and religious meditation which might have profound implications in physiological understanding of the intrinsic awareness

Focused Attention vs. Open Monitoring: An Event-Related Potential Study of Emotion Regulation by Two Distinct Forms of Mindfulness Meditation

This study investigated the effects of two novel forms of 8-week mindfulness meditation training, focused attention (FA) and open monitoring (OM), relative to an established training, mindfulness-based cognitive therapy (MBCT), on early emotional reactivity to negative emotional images as assessed by electroencephalography (EEG). Data on the late-positive potential (LPP) were analyzed to address whether the three mindfulness interventions attenuated the LPP from pre- to post-intervention, and if significant differences existed between groups in LPP at post-intervention. Rather than an attenuation, results indicated an average increase in LPP amplitude from pre- to post-intervention. No significant differences were found in the LPP between the training conditions at post-intervention. These results provide preliminary evidence that mindfulness training in novice practitioners may heighten initial emotional reactivity. Further, well-designed research is needed to examine a wider range of neural responses to better understand emotion regulation process effects of different forms of mindfulness training

An Interpretation of the Continuous Adaptation of the Self/Environment Process

Insights into the nondual relationship of organism and environment and their processual nature have resulted in numerous efforts at understanding human behavior and motivation from a holistic and contextual perspective. Meadian social theory, cultural historical activity theory (CHAT), ecological psychology, and some interpretations of complexity theory persist in relating human activity to the wider and more scientifically valid view that a process metaphysics suggests. I would like to articulate a concept from ecological psychology – that of the affordance, and relate it to aspects of phenomenology and neuroscience such that interpretations of the self, cognition, and the brain are understood as similar to interpretations of molar behaviors exhibited in social processes. Experience with meditation as a method of joining normal reflective consciousness with ‘awareness’ is described and suggested as a useful tool in coming to better understand the nondual nature of the body

Mindfulness in mental health: a critical reflection

Mindfulness derives from Buddhist practice and is fundamentally concerned with the development of present moment awareness. It is arguably one of the fastest growing areas of mental health research with the last decade witnessing a tenfold increase in the number of published scientific papers concerning the applications of mindfulness in mental health contexts. Given the demonstrable growth of interest into the clinical utility of mindfulness, this paper provides a: (i) timely and evidence-based appraisal of current trends and issues in psychopathology-related mindfulness research, and (ii) discussion of whether the empirical evidence for mindfulness-based interventions actually merits their growing popularity and utilization amongst mental health stakeholders. It is concluded that mindfulness-based interventions have the potential to play an important role in psychiatric treatment settings as well as in applied psychological settings more generally. However, due to the rapidity at which mindfulness has been taken out of its traditional Buddhist setting, and what is possibly evidence of media and/or scientific hype concerning the effectiveness of mindfulness, it is recommended that future research seeks to: (i) consolidate and replicate research findings, (ii) assess the maintenance of outcomes over longer time periods, (iii) investigate potential adverse effects, and (iv) fully control for potential performance bias in mindfulness-based intervention studies. It is further recommended that future research seeks to investigate the Buddhist position that sustainable improvements to mental and spiritual health typically require consistent daily mindfulness practice over a period of many years (i.e., they do not arise after attending eight two-hour classes with some self-practice in between)