chronic pain in resting-state fmri
DESCRIPTION
This document is mainly about how chronic pain influent people's behavioral, emotional and cognitive abilities. This is also our first year results of our project.TRANSCRIPT
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
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/
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/
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
Surveys and Questionnaires
Pain
sensory !
!
affective !
!
Present Pain Intensity
Short Form of McGill Ques;onnaire (SFMPQ)
Surveys and Questionnaires
Pain
Kentucky Inventory of Mindfulness Skills (KIMS)
observing !
!
describing !
!
acting with awareness !
!
accept without judgment
Surveys and Questionnaires
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)
!
participants
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empathy and languagehttp://www.kidsnews.com.ar/lengua/hablemos-en-globish/
&!
Advices Questions