chronic pain in resting-state fMRI

同理⼼心與社會認知從神經學的⾓角度看痛的語⾔言

Year Onefrom: http://mcadenver.blogspot.tw/2013/07/the-doctor-rates-your-pain-with-brett.html

http://mcadenver.blogspot.tw/2013/07/the-doctor-rates-your-pain-with-brett.html

Please recall your personal experience about “PAIN”

How did you feel？

!

What did you want to react？

!

What did you think about？

• In summary, what do you think “PAIN” is？

from: http://joelmarino.wordpress.com/category/uncategorized/

http://joelmarino.wordpress.com/category/uncategorized/

Painsurvive

Linton, 2004need attention

Eccleston & Crombez, 1999

culture and social value Linton, 2005

subjective experience Linton & Shaw, 2011

http://qinzi.baike.com/article-1091625.htmlhttp://www.movieweb.com/movie/pain-is-beautiful

http://www.theschooloflife.com/ http://joneska7.wordpress.com/

chronic pain

Attention!Learning & Memory

Depression!Anxiety

cognition

emotion

Slower RT!

Impaired Perceptual-motor Coordination

behavior

Sah et al., 2003

Veldhuijzen et al., 2006

Luerding et al., 2008Alanoglu et al., 2005; Antepohl et al., 2003; Biessels et al., 2007

Maihofner and DeCol, 2007

task negative network

related to mental disorder

introspection, or self-referential thought

Broyd et al., 2009

Kennedy et al., 2006; Greicius et al., 2007; Williamson, 2007

Default Mode Network (DMN)

• Deactivation in DMN in resting-state fMRI

• Less DMN deactivation in cognitive task

• Disrupted the DMN Baliki et al., 2008

Seminowicz and Davis, 2007

Tagliazucchi et al., 2010

• Analgesic and acupuncture regulate DMN activation Letzen et al., 2013; Li et al. 2013

DMN with Pain

Mindfulness Based Stress Reduction (MBSR)

The awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment to moment (Kabat-Zinn, 2003) !!The non-judgmental observation of the ongoing stream of internal and external stimuli as they arise (Baer, 2003)

awareness present experience acceptance

newbuddhist.com

What is mindfulness?

created by Jon Kabat-Zinn in 1979

combined western medical research and eastern meditation culture

used on chronic pain patients in 1982

Mindfulness Based Stress Reduction

• Improvement in self-reports

!

• Before MBSR: Different pattern of the DMN (compared with control)

!

• After MBSR: Similar pattern of DMN (compared with control)

Objectives

33 participants: 21 females, 12 males 1 drop out, 4 excluded from fMRI

age：22~61 years old

from: www.waimauku.school.nz/WebSpace/49/

http://www.waimauku.school.nz/WebSpace/49/

Surveys and Questionnaires

MindfulnessPainKentucky Inventory of Mindfulness Skills (KIMS)Dallas Pain Ques;onnaire (DPQ)

Short Form of McGill Ques;onnaire (SFMPQ)

daily activities work-‐leisure activities anxiety-‐depression social interest

sensory affective Present Pain Intensity

observing describing acting with awareness accept without judgment

Dallas Pain Ques;onnaire (DPQ)

daily activities !

!

work-‐leisure activities !

!

anxiety-‐depression !

!

social interest


Pain

sensory !

!

affective !

!

Present Pain Intensity

Short Form of McGill Ques;onnaire (SFMPQ)


Pain

Kentucky Inventory of Mindfulness Skills (KIMS)

observing !

!

describing !

!

acting with awareness !

!

accept without judgment


Mindfulness

resting state fMRI• close their eyes and think about nothing, but to remain awaked

• lasts 10 min

• Resting data are collected using a gradient-echo planar pulse (EPI) sequence [repetition time (TR) = 3 s, echo time (TE) = 30 ms, 35 slices oriented AC-PC, flip angle = 90 degrees, matrix size = 64 × 64, voxel size = 3.75 × 3.75 × 3.75, slice gap = 0 mm, field of view (FOV) = 24 × 24 cm].

MBSR• 8-weeks program and one day practicing

• the methods:

• Body scan meditation

• Sitting meditation

• Gental Hatha Yoga

• Walking meditation

• Others

pictures from: http://www.justbeinghere.org/p/blog-page_8351.html

July 8/8 8/17 9/26 9/27

!!

recruited participants

program started

1st !

SFMPQ

program finished

2nd fMRI

1st !

DPQ & KIMS

1st fMRI

2nd !

DPQ, SFMPQ, KIMS

After MBSR………

DPQ

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improvement in self-report (except anxiety/depression)

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participants

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empathy and languagehttp://www.kidsnews.com.ar/lengua/hablemos-en-globish/

&!

Advices Questions

Health & Medicine

chronic pain in resting-state fMRI