Thread by @FadelZeidan

Our latest work published in @PAINthejournal: Attention to Breath Sensations Reduces Pain Independent of Endogenous Opioids.

We dissected components of mindfulness meditation by randomizing folks to a #mindfulness #meditation, sham-mindfulness, + slow-paced breathing group 1/n

This was a double-blinded, randomized crossover designed study where subjects received IV naloxone or placebo-saline during noxious heat (49°C) to determine which aspect of mindfulness (if any) engages endogenous opioids to reduce pain. 2/n

We discovered that mindfulness and slow-paced breathing significantly reduced pain independent of endogenous opioids.

However: Sham-mindfulness meditation reduced pain during saline infusion but analgesia was reversed when we blocked endogenous #opioids 3/n

These data were quite perplexing because all techniques significantly lowered breathing rates, but only sham-mindfulness meditation based pain relief was reversed by naloxone. 4/n

We coded our qualitative data + found that those reporting "focusing on the breath" predicted naloxone-insensitive pain reductions and was the operational feature for this effect. 5/n

We stated "Self-directed attention to breath sensations bridges #interoception of bodily awareness and executive control of motoric processes regulating respiration with exteroceptive awareness of the individual’s internal and external sensory environment." 6/n

Take home message:
1. This is the first study to show that slow paced breathing reduces pain independent of endogenous opioids.
2. Slow paced breathing is super easy to perform, especially for those with cognitive deficits. 7/n

3. We believe that attention to the breath activates a novel corticothalamo-cortical #pain modulatory pathway.
4. This is our 3rd study now showing that mindfulness-induced pain relief is not mediated by endogenous opioids 8/n

5. Sham-meditation is opioidergically mediated and serves a power control condition to mindfulness meditation.

This work is not possible without funding from the @NIH_NCCIH and our collaborators including @RebeccaWellsMD

You can find the preprint here: mindrxiv.org/u237t/

The results in a snapshot

Red = naloxone infusion
Blue = saline infusion
y axis = percent change in pain
a axis = groups