Brain imaging reveals how mindfulness program boosts pain regulation
腦部影像顯示正念課程如何促進疼痛調節
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.
威斯康辛大學麥迪遜分校的健康心理中心的研究，隔離出與疼痛相關的腦部活動的變化，這些變化是在接受正念訓練後發生的，這項研究為更有針對性和精確的疼痛治療指明了方向。
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.
這項研究今天 （2022年7 月 27 日）發表在《美國精神病學期刊》上，該研究確定了與疼痛調節相關的大腦途徑，而中心舉辦的正念減壓(MBSR)八周課程會改變這些途徑的活動。
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.
這些變化在參與相似課程但缺乏正念指導的受試者中並未觀察到。這是一個重要的新證據，表明這些大腦變化是由正念訓練本身引起的。這是由約瑟夫·維爾戈茲（Joseph Wielgosz）領導的研究，他在威斯康辛大學麥迪遜分校攻讀研究生時進行，現在是史丹佛大學的博士後研究員。這項研究是第一個展示在臨床上普遍實施的標準化正念課程與疼痛相關的大腦變化的研究。
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.
大約三分之一的美國人經歷過與疼痛相關的問題，但藥物治療和侵入性手術等常見治療方法並不適合所有人，而根據Joseph Wielgosz的說法，這些治療方法更導致了處方藥和非法藥物成癮的流行。
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.
正念培訓課程，如正念減壓(MBSR)，深受患者歡迎，其臨床效果也很有前景，對於推動更有效的疼痛管理方法更佔據了核心地位。通過練習"非評價"、“以當下為中心”的意識，參與者可以學會以較少的痛苦和更大的心理靈活性來應對疼痛—最終可以減輕疼痛本身。
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.
為了測量神經疼痛反應，研究參與者在他們的前臂放置一個精密控制的熱刺激物品，並接受腦部掃描。研究人員記錄了由合作者、達特茅斯學院神經科學教授托爾·瓦格（Tor Wager）開發的兩種與疼痛相關活動的腦部顯影特徵。這種創新的技術極大地提高了檢測大腦複雜活動中與疼痛相關信號的能力。顯影特徵的變化也更容易以心理學術語解釋。
Participants in the MBSR course showed reduction in a signature associated with the sensory intensity of pain.
正念減壓(MBSR)課程的參與者顯示出其與疼痛感覺強度相關的顯影特徵減少。
“Our finding supports the idea that for new practitioners, mindfulness training directly affects how sensory signals from the body are converted into a brain response,” says Wielgosz, whose work was supported by the National Institutes of Health.
維爾戈茲表示：“我們的研究結果支持這樣一個觀點：對於新手來說，正念訓練直接影響了身體感覺信號如何轉化為大腦反應。” 維爾戈茲的研究得到了美國國家衛生研究院的支持。
The innovative technique researchers used dramatically improves the ability to detect pain-related signals in the complex activity of the brain.
研究人員使用的創新技術顯著提高了在大腦複雜活動中檢測與疼痛相關信號的能力
The study also looked at longer-term mindfulness training. Intriguingly, practice on intensive meditation retreats was associated with changes in the neural signature for influences that shape pain indirectly — for example, differences in attention, beliefs and expectations, factors that often increase the perceived levels of distress in non-meditators.
這項研究還探討了較長期的正念培訓。有趣的是，在密集冥想靜修中的實踐與間接影響疼痛的神經特徵變化相關，例如，注意力、信仰和期望的差異，這些因素通常會增加非冥想者感知的痛苦程度。
“Just like an experienced athlete plays a sport differently than a first-timer, experienced mindfulness practitioners seem to use their mental ‘muscles’ differently in response to pain than first-time meditators,” Wielgosz says.
維爾戈茲表示：“就像經驗豐富的運動員在比賽中的表現不同於初次嘗試的人一樣，經驗豐富的正念練習者在面對疼痛時似乎以不同的方式使用他們的心理‘肌肉’。”
These findings help show the potential for mindfulness practice as a lifestyle behavior.
這些研究結果顯示出以實踐正念做為一種生活型態是極具潛力的。
The study is also significant for the field of pain research in its use of brain-based measures of pain alongside the subjective ratings of the participants in a randomized trial. Pain researchers have long sought ways to biologically measure the effect of treatment.
這項研究對疼痛研究領域也具有重要意義，因為它在一項隨機試驗中使用了基於腦部的疼痛測量方法，同時結合了受試者的主觀評價。疼痛研究者長期以來一直在尋求生物學上測量治療效果的方法。
“Looking at neural signatures together with patient experiences revealed insights about mindfulness that we could never have detected through either one alone,” Wielgosz says.
維爾戈茲表示：“將神經特徵與患者經驗一起觀察，揭示了有關正念的洞察，這是單獨使用其中一種方法無法檢測到的。”
Thus, in addition to the insights it provides about mindfulness, the researchers believe that their study can also provide a model for future research, helping to untangle the complexity of pain and ultimately reduce the burden it places on our lives.
因此，除了提供有關正念的見解外，研究人員認為他們的研究還可以為未來的研究提供一個模型，有助於理清疼痛的複雜性，最終減輕其對我們生活造成的負擔。
- Dr. Joe Wielgosz and Heather Harris
- 喬·維爾戈斯博士和希瑟·哈里斯
This work was supported by a grant from NIH’s National Center for Complementary and Alternative Medicine (P01AT004952).
這項工作得到了 NIH 國家補充和替代醫學中心 (P01AT004952) 的資助。