Attention to breath sensations does not engage endogenous opioids to reduce pain

2020 ◽  
Author(s):  
Fadel Zeidan ◽  
Adrienne Adler-Neal ◽  
Rebecca E. Wells ◽  
Jason Collier ◽  
Grace Posey ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Mindfulness Meditation ◽  
Endogenous Opioids ◽  
Saline Infusion ◽  
Opioid Antagonist ◽  
Operational Feature ◽  
Paced Breathing ◽  
Lower Pain ◽  
Slow Breathing ◽  
Pain Unpleasantness

The endogenous opioidergic system is critically involved in the cognitive modulation of pain. Slow-breathing based techniques are widely utilized non-pharmacological approaches to reduce pain, although the active mechanisms of actions supporting these practices are poorly characterized. Growing evidence suggest that mindfulness-meditation, a slow-breathing technique practiced by non-reactively attending to breathing sensations, engages multiple unique neural mechanisms that bypass opioidergically mediated descending pathways to reduce pain. Yet, it is unknown if endogenous opioids contribute to pain-reductions produced by slow-breathing. The present double-blind, placebo-controlled crossover study examined behavioral pain responses during mindfulness-meditation (n=19), sham-mindfulness meditation (n=20), and slow-paced breathing (n=20) in response to noxious heat (49°C) and intravenous administration (0.15 mg/kg bolus + 0.1 mg/kg/h maintenance infusion) of the opioid antagonist, naloxone and placebo-saline. Mindfulness significantly reduced pain unpleasantness ratings across both infusion sessions when compared to rest, but not pain intensity. Slow-paced breathing significantly lower pain intensity and unpleasantness ratings during naloxone but not saline. Pain reductions produced by mindfulness-meditation and slow-paced breathing were insensitive to naloxone when compared to saline infusion. In contrast, sham-mindfulness meditation produced pain unpleasantness reductions during saline infusion but this effect was reversed by opioidergic antagonism. Sham-mindfulness did not lower pain intensity ratings. Self-reported “focusing on the breath” was identified as the operational feature particularly unique to the mindfulness-meditation and slow paced-breathing, but not sham-mindfulness meditation. Across all individuals, attending to the breath was associated with naloxone insensitive pain-relief. These findings provide evidence that slow-breathing combined with attention to breath reduces pain independent of endogenous opioids.

scholarly journals Opioid Antagonist Enhances Meditation Analgesia in Experienced Meditators

2017 ◽  
Author(s):  
Lisa May ◽  
Peter Kosek ◽  
Fadel Zeidan ◽  
Elliot Berkman
Keyword(s):  
Pain Intensity ◽  
Endogenous Opioids ◽  
Opioid Antagonist ◽  
Meditation Practice ◽  
Endogenous Opioid ◽  
Cohen’S D ◽  
Pain Ratings ◽  
Cohen's D ◽  
Pain Unpleasantness

Objective: Studies have consistently shown that long-term meditation practice is associated with reduced pain, but the neural mechanisms by which long-term meditation practice reduces pain remain unclear. This study tested endogenous opioid involvement in meditation analgesia associated with long-term meditation practice.Methods: Electrical pain was induced with randomized, double-blind, cross-over administration of the opioid antagonist Naloxone (0.15mg/kg bolus dose, then 0.2mg/kg/hr infusion dose) with 32 healthy, experienced meditation practitioners and a standardized open monitoring meditation.Results: Under saline, pain ratings were significantly lower during meditation (pain intensity: 6.41 ± 1.32; pain unpleasantness: 3.98 ± 2.17) than at baseline (pain intensity: 6.86 ±1.04, t(31) = 2.476, p = 0.019, Cohen’s d = 0.46; pain unpleasantness: 4.96 ±1.75, t(31) = 3.746, p = 0.001, Cohen’s d = 0.68), confirming the presence of meditation analgesia. Comparing saline and Naloxone revealed significantly lower pain intensity (t(31) = 3.12, p = 0.004, d = 0.56), and pain unpleasantness (t(31) = 3.47, p = 0.002, d = 0.62), during meditation under Naloxone (pain intensity: 5.53 ± 1.54; pain unpleasantness: 2.95 ± 1.88) than under saline (pain intensity: 6.41 ± 1.32; pain unpleasantness: 3.98 ± 2.17). Naloxone not only failed to eliminate meditation analgesia, it made meditation analgesia stronger.Conclusions: Long-term meditation practice does not rely on endogenous opioids to reduce pain. Naloxone’s blockade of opioid receptors enhanced meditation analgesia; pain ratings during meditation were significantly lower under Naloxone than under saline. Possible biological mechanisms by which Naloxone-induced opioid receptor blockade enhances meditation analgesia are discussed.

scholarly journals Transient reductions in postoperative pain and anxiety using virtual reality in children

2020 ◽  
Author(s):  
Vanessa A. Olbrecht ◽  
Keith T O'Conor ◽  
Sara E Williams ◽  
Chloe O Boehmer ◽  
Gilbert W Marchant ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Anxiety Sensitivity ◽  
Pain Catastrophizing ◽  
Medical Center ◽  
Controlled Study ◽  
Acute Postoperative Pain ◽  
Lower Pain ◽  
Pain Unpleasantness

Objective: Virtual reality (VR) is a promising method to manage pain. Distraction-based VR (VR-D) is thought to reduce pain by redirecting attention. While VR-D can reduce pain associated with acutely painful procedures, it is unclear if VR-D can reduce pain after surgery. We assessed the ability of a single VR-D session to decrease acute postoperative pain and anxiety and explored if pain catastrophizing and anxiety sensitivity influenced the ability of VR-D to reduce these outcomes in children following surgery. Design: Single-center, prospective, pilot study Setting: Cincinnati Childrens Hospital Medical Center (CCHMC) Subjects: 50 children/adolescents (age 7-21 years) with postoperative pain followed by the Acute Pain Service Methods: Patients received a single VR-D session following surgery. Prior to the VR-D session, patients completed pain catastrophizing (PCS-C) and anxiety sensitivity (CASI) questionnaires. Primary outcome consisted of changes in pain intensity following VR-D (immediately, 15, and 30 minutes). Secondary outcomes included changes in pain unpleasantness and anxiety. Results: VR-D decreased pain intensity immediately and 15-minutes after VR-D. Reductions in pain unpleasantness were observed up to 30 minutes following VR-D. Anxiety was also reduced immediately and at 15-minutes following VR-D. While patients with higher pain catastrophizing had higher baseline pain intensity and unpleasantness, they did not show larger pain reductions following VR-D compared to those with lower pain catastrophizing. Conclusions: VR-D is beneficial in transiently reducing pain intensity, unpleasantness, and anxiety in children with acute postoperative pain. This study informs design of larger, controlled study assessing VR-D for acute postoperative pain and anxiety.

Cardiovascular effects of opioid antagonist naloxone in rostral ventrolateral medulla of rabbits

1990 ◽  
Vol 258 (2) ◽  
pp. R325-R331 ◽  
Author(s):  
D. A. Morilak ◽  
G. Drolet ◽  
J. Chalmers
Keyword(s):  
Pressor Response ◽  
Cardiovascular Effects ◽  
Rostral Ventrolateral Medulla ◽  
Endogenous Opioids ◽  
Opioid Antagonist ◽  
Ventrolateral Medulla ◽  
Inhibitory Influence ◽  
Beneficial Effects ◽  
Arterial Blood ◽  
Depressor Effect

We have examined the influence of endogenous opioids on the basal and reflex control of arterial blood pressure in the pressor region of the rostral ventrolateral medulla (RVLM) of chloralose-anesthetized rabbits. We tested basal effects both in intact animals and after hypotensive hemorrhage. Bilateral administration of the opiod antagonist naloxone (20 nmol, 100 nl) directly into the RVLM induced a gradual and prolonged increase in mean arterial pressure (MAP) (+17 +/- 2 mmHg). This was preceded by a brief and mild depressor effect (-9 +/- 3 mmHg), which was attributable to a transient reduction in excitability immediately after naloxone injection. When naloxone was administered into the RVLM after hemorrhage (20 ml/kg), it improved recovery of MAP relative to saline controls, again producing a gradual, prolonged pressor response (+29 +/- 5 mmHg). The effect of naloxone on a baroreflex in intact animals was only transient, with a brief, nonsignificant attenuation of the reflex depressor response to aortic nerve stimulation. We conclude that endogenous opioids exert a tonic inhibitory influence on RVLM pressor neurons and that this input remains active after hemorrhage. The RVLM may thus be one site for the beneficial effects of naloxone in preventing circulatory decompensation after hemorrhage. In contrast, opioid neurons are not an essential component of baroreflex-mediated sympathoinhibition in the RVLM.

Transdiagnostic Cognitive Processes in Chronic Pain and Comorbid PTSD and Depression in Veterans

2021 ◽  
Author(s):  
Melissa A Day ◽  
Rhonda M Williams ◽  
Aaron P Turner ◽  
Dawn M Ehde ◽  
Mark P Jensen
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Pain Intensity ◽  
Cognitive Processes ◽  
Cognitive Process ◽  
Stress Disorder ◽  
Secondary Analysis ◽  
Lower Pain ◽  
Depression Scales ◽  
Ptsd Group

Abstract Background Chronic pain in Veterans is a major problem compounded by comorbid posttraumatic stress disorder (PTSD) and depression. Adopting a transdiagnostic framework to understanding “shared territory” among these diagnoses has the potential to inform our understanding of the underlying cognitive processes and mechanisms that transverse diagnostic boundaries. Purpose To examine the associations between pain-related cognitive processes (diversion, distancing, absorption, and openness), pain intensity, PTSD and depressive symptoms, and the extent to which Veterans with chronic pain with and without comorbid PTSD and depression engage in different/similar pain-related cognitive processes. Methods Secondary analysis of pretreatment data with a subsample (n = 147) of Veterans with chronic pain from a larger clinical trial. Pretreatment PCL-5 and PROMIS Depression scales were used to categorize participants into three groups: (a) Pain-only; (b) Pain-PTSD; and (c) Pain-PTSD-DEP. Results Compared to the Pain-only group, the Pain-PTSD and Pain-PTSD-DEP groups reported significantly greater pain intensity, PTSD and depressive symptoms, and ruminative pain absorption. The Pain-PTSD-DEP group had significantly lower pain diversion and pain openness scores. When diversion and openness were used within the Pain-PTSD-DEP group, however, they were both associated with lower pain intensity and openness was additionally associated with lower PTSD scores. However, in the Pain-PTSD group, pain openness was associated with higher depression scores. Conclusions Across increasing complexity of comorbidity profiles (i.e., one vs. two comorbid conditions), ruminative absorption with pain emerged as a cognitive process that transverses diagnoses and contributes to worse outcomes. Nonjudgmental acceptance may not be universally beneficial, potentially depending upon the nature of comorbidity profiles.

Pain Acceptance Among Retired National Football League Athletes: Implications for Clinical Intervention

2021 ◽  
pp. 1-14
Author(s):  
Zachary L. Mannes ◽  
Erin G. Ferguson ◽  
Nicole Ennis ◽  
Deborah S. Hasin ◽  
Linda B. Cottler
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Pain Intensity ◽  
National Football League ◽  
Clinical Intervention ◽  
Covariate Adjustment ◽  
Pain Acceptance ◽  
Career Information ◽  
Lower Pain ◽  
Daily Pain

Over 80% of National Football League (NFL) retirees experience daily pain. Pain acceptance is an important psychological construct implicated in the intensity of chronic pain, though these findings have not been extended to NFL retirees. Therefore, the current study examined the association between pain acceptance and pain intensity among former NFL athletes. NFL retirees (N = 90) recruited from 2018 to 2019 completed questionnaires that assessed pain, substance use, and NFL career information. Multiple linear regression examined the association between current pain acceptance and pain intensity while adjusting for other risk factors of pain. NFL retirees reported average scores of 33.31 (SD = 10.00), and 2.18 (SD = 2.40) on measures of pain acceptance and pain intensity, respectively. After covariate adjustment, greater pain acceptance (β = −0.538, p < .001) was associated with lower pain intensity. These findings can further inform the behavioral and mental health care of retired NFL athletes.

scholarly journals The importance of oxytocin mechanisms in the control of mouse parturition

Reproduction ◽  
2002 ◽  
pp. 543-552 ◽  
Author(s):  
AJ Douglas ◽  
G Leng ◽  
JA Russell
Keyword(s):  
Red Light ◽  
Endogenous Opioids ◽  
Beta Agonist ◽  
Early Gene ◽  
Opioid Antagonist ◽  
Dependent Manner ◽  
Birth Process ◽  
Opioid Agonist ◽  
Adrenergic Antagonist ◽  
Oxytocin Neurones

The role of oxytocin in parturition in mice was investigated. Pup birth profiles, blood samples and brains were collected from parturient mice observed under red light conditions in a reversed light:dark photoperiod. Peripheral administration of an oxytocin antagonist in a dose-dependent manner delayed the birth of subsequent pups, indicating that oxytocin is required for a normal pup birth profile. Oxytocin neurones were activated during birth as shown by both increased immediate early gene ( Fos) expression in oxytocin neurones in the supraoptic nucleus and increased plasma oxytocin concentrations during birth. In addition, the nucleus of the tractus solitarius and the olfactory bulbs, sites that process inputs to oxytocin neurones, become activated during parturition. Exposure to stress during parturition halted subsequent deliveries; at this stage plasma oxytocin concentrations were not higher than those of virgin mice, and birth was restored by administration of oxytocin. Administration of beta-adrenergic antagonist (propranolol) also restored stress-delayed birth, whereas administration of ritrodrine (beta-agonist) delayed birth in non-stressed mice, indicating that adrenergic mechanisms contribute to stress-delayed births in mice. Administration of morphine (mu-opioid agonist) delayed births transiently, but naloxone (opioid antagonist) did not prevent stress-delayed birth, indicating that endogenous opioids do not appear to contribute to neuroendocrine or uterine mechanisms that promote birth in mice. Therefore, despite evidence in oxytocin knockout mice that oxytocin is not essential for parturition in this species, the results of the present study indicate that oxytocin neurone activity and secretion contribute to the birth process in normal mice.

scholarly journals The Confounding Effect of Assessor Ethnicity on Subjective Pain Reporting in Women

2017 ◽  
Vol 11 (1) ◽  
pp. 1-11
Author(s):  
Jacob Miguel Vigil ◽  
Patrick Coulombe ◽  
Lauren Nikki Rowell ◽  
Chance Strenth ◽  
Eric Kruger ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Severe Pain ◽  
Pain Sensitivity ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Random Effects Models ◽  
Subjective Pain ◽  
Lower Pain ◽  
Pain Reporting ◽  
Hispanic White

The current study examines how subjective pain reporting is influenced by the concordant and discordant nature of the ethnic identities of pain expressers (participants) and pain assessors (experimenters). Three discomfort conditions that varied in stimuli intensity (Study 1: mild pain; Study 2: severe pain), and distraction components (Study 3) were used to assess whether pain intensity and tolerance reporting differ with the ethnic identification of the participant and the experimenter. Specifically, 87 Hispanic and 74 Non-Hispanic White (NHW) women (18–51 yrs., Mage = 20.0, SD = 4.3) underwent a cold pressor pain task (CPT) after engaging in minimal procedural interactions with one of the 22 research experimenters (47% Hispanic, 42% females). The procedural interactions with the experimenters included only consenting and instructions, with no interaction between experimenter and participant during the actual CPT. Random-effects models showed that between the 0% and 18% of the variance in pain sensitivity (intensity and tolerance scores) was attributable to characteristics of the experimenters. Controlling for self-esteem, baseline pain levels, and the gender of the experimenter, Hispanic subjects showed higher pain sensitivity (as marked by lower pain tolerance and higher pain intensity scores) following interactions with an NHW rather than a Hispanic experimenter in response to the most severe pain intensity stimuli. These results question the validity of common findings of ethnic differences in pain sensitivity from studies that have not accounted for the ethnic identity of the pain assessor (and the general communicative nature of pain reporting).

Regulation of the photoperiod-induced cycle in the peripheral blood concentrations of β-endorphin and prolactin in the ram: role of dopamine and endogenous opioids

1990 ◽  
Vol 127 (3) ◽  
pp. 461-469 ◽  
Author(s):  
E. Ssewannyana ◽  
G. A. Lincoln
Keyword(s):  
Plasma Concentrations ◽  
Prolactin Secretion ◽  
Endogenous Opioids ◽  
Fold Change ◽  
Opioid Antagonist ◽  
Light Cycle ◽  
Blood Concentrations ◽  
The Mean ◽  
Short Days

ABSTRACT In a group of adult Soay rams housed indoors under an artificial light cycle of alternating 16-week periods of long and short days, there was a conspicuous longterm cycle in the peripheral plasma concentrations of β-endorphin and prolactin. The levels of β-endorphin were highest under short days and lowest under long days (15-fold change), and inversely related to the changes in the plasma levels of prolactin (120-fold change). The role of dopamine in the control of β-endorphin and prolactin was investigated in a series of experiments, conducted under both long and short days, in which rams were treated with dopamine receptor agonists (dopamine and bromocriptine) and antagonists (pimozide and sulpiride). Naloxone (opioid antagonist) was also administered to assess the additional involvement of endogenous opioids. Dopamine injected i.v. (6·6 mg/kg every 10 min) did not significantly affect the mean plasma concentrations of β-endorphin and prolactin under either long or short days. Pimozide (0·08 mg/kg i.m. every 2 h) caused a large increase in the mean plasma concentrations of β-endorphin and prolactin under long days but not short days. Naloxone (1·6 mg/kg, i.v.), administered alone or in combination with dopamine or pimozide, had no effect on the mean plasma concentrations of β-endorphin and prolactin, except under short days when, combined with pimozide, it induced an increase in the plasma concentrations of the two polypeptides. Bromocriptine (0·06 mg/kg, s.c.) caused a significant decrease in the plasma concentrations of both β-endorphin and prolactin; this effect was most marked at the times of increased secretion (under short days for β-endorphin and under long days for prolactin). Sulpiride (0·59 mg/kg, s.c.) produced the converse effect and caused an increase in the plasma concentrations of β-endorphin and prolactin with the amplitude and duration of the effect varying with the stage of the photoperiod-induced cycle. From these results in the Soay ram, we conclude that dopamine inhibits β-endorphin and prolactin secretion by way of D2 receptors under both long and short days. Endogenous opioids interact with dopamine, augmenting this inhibition under short days. Differences in the acute responses in the secretion of β-endorphin and prolactin, and the inverse relationship between β-endorphin and prolactin during the cycle, indicate that different regulatory systems involving dopamine influence the two pituitary polypeptides. Journal of Endocrinology (1990) 127, 461–469

Endogenous opioids are differentially involved in appetitive and consummatory aspects of sexual behavior of male rats

1994 ◽  
Vol 266 (2) ◽  
pp. R606-R613 ◽  
Author(s):  
W. R. Van Furth ◽  
I. G. Wolterink-Donselaar ◽  
J. M. van Ree
Keyword(s):  
Sexual Behavior ◽  
Neural Control ◽  
Test Chamber ◽  
Endogenous Opioids ◽  
Male Rats ◽  
Opioid Antagonist ◽  
Sexual Performance ◽  
Repeated Testing ◽  
Ejaculation Latency ◽  
Male Wistar Rats

The sexual activity of 40 male Wistar rats was tested weekly in a bilevel test chamber to evaluate the involvement of endogenous opioids in the appetitive and consummatory aspects of sexual behavior. It has been suggested that the increase of the anticipatory level-changing behavior over repeated testing, displayed before the introduction of a receptive female, is sexually motivated. Two doses of the opioid antagonist naloxone, 1 and 10 mg/kg, prevented the increase of the anticipatory level-changing over four repeated tests of sexually experienced rats without prior experience in the bilevel test chamber and decreased the number of level changes of rats displaying a high number of level changes. Analysis of the pattern of inhibition suggested that the lower dose of naloxone may reduce sexual reward and that, in addition, the higher dose may block the expression of motivation. In contrast, naloxone treatment facilitated the efficiency of the sexual performance, with less mounts and intromissions preceding ejaculation and a shorter ejaculation latency, implying an inhibitory role of endogenous opioids in the neural control of some aspects of sexual performance (e.g., ejaculatory threshold). These results suggest that endogenous opioids may increase sexual appetite and diminish sexual performance.

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