Table 1.
Effects of meditation in patients with chronic pain
| Brain area or bandwidth | Effect | Hypothesized function and/or behavioural correlate |
|---|---|---|
| Primary and secondary somatosensory cortices | Decreased pain-related activation (post-meditation) | Decreased pain processing, associated with lower self-reported pain intensity* |
| Insula | Increased activation | Increased control over sensory processing among experienced meditators‡ |
| Bilateral insula | Increased activation (during meditation) Decreased pain-related activation (post-meditation) |
Increased interoceptive awareness§ Decreased pain processing, associated with lower self-reported pain intensity* |
| Posterior and anterior insula | Increased grey matter | Thickness inversely correlated with pain sensitivity‡ |
| Dorsal anterior insula | Increased activation | Faster neural habituation and downregulation of pain anticipation‡ |
| PFC | Reduced activation Increased grey matter |
Decreased executive and evaluative processing; that is, decreased negative judgements and memories about pain‡ Thickness inversely correlated with pain sensitivity‡ |
| Dorsomedial PFC | Increased activation | Heightened attention§ |
| Dorsolateral PFC and MCC | Reduced functional connectivity | Decoupling of cognitive-evaluative and sensory-discriminative functions‡ |
| MCC | Increased grey matter | Thickness inversely correlated with pain sensitivity‡ |
| Anterior MCC | Increased activation | Faster neural habituation and downregulation of pain anticipation |
| Parietal cortex | Increased grey matter*‡ | Thickness inversely correlated with pain sensitivity‡ |
| Anterior cingulate cortex | Increased activation | Increased interoceptive awareness2 |
| Increased pain processing among experienced meditators‡ | ||
| Hippocampus | Reduced activation | Decreased evaluative processing; that is, decreased negative judgements and memories about pain‡ |
| Increased grey matter*‡ | Thickness inversely correlated with pain sensitivity‡ | |
| Thalamus | Increased activation | Increased pain processing among experienced meditators‡ |
| Amygdala | Reduced activation | Decreased anticipation of pain negative emotional processing; that is, decreased negative emotions in response to pain‡ |
| Brainstem | Increased grey matter | Thickness inversely correlated with pain sensitivity‡ |
| Alpha activity (8–13 Hz) | Increased power in this relatively slow (inhibitory) oscillation | Alpha activity associated with reduced anxiety and greater feelings of calm and positive affect|| |
| Theta activity (4–8 Hz) | Increased power in this very slow (inhibitory) oscillation | Theta activity associated with heightened attention, reduced anxiety and sympathetic autonomic nervous system activity, and enhanced memory functions‡§ |
Among healthy individuals (following brief training in mindfulness meditation) during experimental pain stimulation.
Among experienced meditators during painful stimulation.
During meditation among healthy individuals.
State and trait effects, not dependent on meditation expertise.
Abbreviations: MCC, midcingulate cortex; PFC, prefrontal cortex.