Journal Article

Altered anterior insula activation during anticipation and experience of painful stimuli in expert meditators

Salomons, Tim V., Davidson, Richard J., McFarlin, Daniel R., Lutz, Antoine, Perlman, David M.

2013

Overview

Experientially opening oneself to pain rather than avoiding it is said to reduce the mind's tendency toward avoidance or anxiety which can further exacerbate the experience of pain. This is a central feature of mindfulness-based therapies. Little is known about the neural mechanisms of mindfulness on pain. During a meditation practice similar to mindfulness, functional magnetic resonance imaging was used in expert meditators (>10,000h of practice) to dissociate neural activation patterns associated with pain, its anticipation, and habituation. Compared to novices, expert meditators reported equal pain intensity, but less unpleasantness. This difference was associated with enhanced activity in the dorsal anterior insula (aI), and the anterior mid-cingulate (aMCC) the so-called ‘salience network’, for experts during pain. This enhanced activity during pain was associated with reduced baseline activity before pain in these regions and the amygdala for experts only. The reduced baseline activation in left aI correlated with lifetime meditation experience. This pattern of low baseline activity coupled with high response in aIns and aMCC was associated with enhanced neural habituation in amygdala and pain-related regions before painful stimulation and in the pain-related regions during painful stimulation. These findings suggest that cultivating experiential openness down-regulates anticipatory representation of aversive events, and increases the recruitment of attentional resources during pain, which is associated with faster neural habituation. ► We examined expert and novice meditators's BOLD reponse before, and during, pain. ► Expert meditators reported less unpleasantness than novices. ► This difference was associated with enhanced BOLD activity in the salience network. ► Experts had also less BOLD activity before pain in the salience network. ► Experts had faster habituation of BOLD response to pain in pain-related brain areas.

• Publisher: Elsevier Inc,Elsevier,Elsevier Limited
• Subject: Adaptation, Physiological - physiology / Anticipation, Psychological - physiology / Behavior / Biological and medical sciences / Brain / Cerebral Cortex - physiology / Emotion regulation / Female / Fundamental and applied biological sciences. Psychology / Grants / Humans / Inhibition (Psychology) / Insula cortex / Male / Medical imaging / Meditation / Meditation - methods / Meditation expertise / Middle Aged / Neuroimaging / Neuronal Plasticity - physiology / Open presence meditation / Pain / Pain Perception - physiology / Salience network / Studies / Vertebrates: nervous system and sense organs