A Systematic Review of Pain-Related Neural Processes in Expert and Novice Meditator
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REVIEW
A Systematic Review of Pain-Related Neural Processes in Expert and Novice Meditator Michael Y. Wang 1
&
Neil W. Bailey 1 & Jake E. Payne 1 & Paul B. Fitzgerald 1 & Bernadette M. Fitzgibbon 1
Accepted: 11 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objectives Mindfulness meditation (MM) is an attention and acceptance–based intervention effective for managing chronic pain. Current literature predominately focuses on the behavioral effects of short-term mindfulness-based programs for pain reduction. However, the long-term potential of MM and its effect on pain processing are less well understood. Furthermore, it is possible that short- and long-term effects of MM are underpinned by different neural processes. This systematic review was undertaken to better understand the short- and long-term effects of MM on brain processes related to pain by comparing pain-related neural process in novice and expert MM. Methods A literature search was performed to identify relevant studies using MRI/fMRI and EEG/MEG. Results A total of 14 studies were selected: 1 MEG and fMRI, 5 EEG, and 8 MRI/fMRI. Overall, findings across studies are consistent in reporting reduced pain ratings in both novice and expert meditators. However, different brain processes appeared to underlie this effect with experts showing greater activity in the somatosensory regions and novices showing reduced activity. The available evidence also indicates a greater dissociation between pain salience and pain unpleasantness in expert meditators along with greater changes in the respective brain regions, suggesting a dissociation between sensory and the cognitive-affective dimensions of pain. For novice meditators, however, the evidence is less conclusive. Conclusions Given the ongoing nature of chronic pain, the long-term effects of mindfulness meditation should be explored to assess whether the effects of short-term programs remain post treatment. Keywords Mindfulness meditation . Pain . fMRI . EEG . Brain
When pain persists beyond the typical tissue healing period of 3 months, it is classified as chronic pain (Treede et al. 2015). In the majority of cases, the experience of ongoing pain has a significant impact on quality of life and general well-being (Cimmino et al. 2011; Holmes et al. 2013; Skinner et al. 2004). Pain perception, like all sensory-related experiences, is a multidimensional process, influenced by a combination of biological, cognitive, affective, and social factors (Linton and Shaw 2011; Raja et al. 2020). Management options, however, have traditionally focused on treating the sensory experience of pain through invasive options such as surgery and prescriptive medication. Although some relief can be achieved, surgical procedures are limited to a select sample * Michael Y. Wang [email protected] 1
Epworth Centre for Innovation in Mental Health, Epworth Clinic, 888 Toorak Road, Camberwell, Victoria 3004, Australia
of patients (Farrell et al. 2018), while pharmaceutical interventio
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