University of Massachusetts Medical School Faculty Publications

Title

Neural activations during self-related processing in patients with chronic pain and effects of a brief self-compassion training - A pilot study

UMMS Affiliation

Department of Family Medicine and Community Health; Center for Integrated Primary Care

Publication Date

2020-07-30

Document Type

Article

Disciplines

Cognition and Perception | Health Services Administration | Health Services Research | Neuroscience and Neurobiology | Pain Management | Psychiatry and Psychology

Abstract

Chronic pain negatively affects psychological functioning including self-perception. Self-compassion may improve self-related functioning in patients with chronic pain but understanding of the neural mechanisms is limited. In this study, twenty patients with chronic low back pain read negative self-related situations and were instructed to be either self-reassuring or self-critical while undergoing fMRI. Patients rated their feelings of self-reassurance and self-criticism during each condition, and brain responses were contrasted with neutral instructions. Trait self-compassion measures (SCS) were also acquired. Brain activations during self-criticism and self-reassurance were localized to prefrontal, self- and emotion-processing areas, such as medial prefrontal cortex, dorsolateral prefrontal cortex (dlPFC), dorsal anterior cingulate cortex and posterior cingulate cortex. Self-reassurance resulted in more widespread and stronger activations relative to self-criticism. Patients then completed a brief self-compassion training (8 contact hours, 2 weeks home practice). Exploratory pre-post comparisons in thirteen patients found that feelings of self-criticism were significantly reduced and brain activations were greater in the anterior insula and prefrontal cortical regions such as dlPFC. Pre-post increases in dlPFC activation correlated with increased self-compassion (SCS), suggesting that early self-compassion skills might primarily target self-criticism via dlPFC upregulation. Future controlled studies on self-compassion training in chronic pain populations should extend these results.

Keywords

corticial midline regions, dorsolateral prefrontal cortex, emotion regulation, fMRI, insula, pain, prefrontal cortex, self-compassion, self-criticism, self-related processes

DOI of Published Version

10.1016/j.pscychresns.2020.111155

Source

Lutz J, Berry MP, Napadow V, Germer C, Pollak S, Gardiner P, Edwards RR, Desbordes G, Schuman-Olivier Z. Neural activations during self-related processing in patients with chronic pain and effects of a brief self-compassion training - A pilot study. Psychiatry Res Neuroimaging. 2020 Oct 30;304:111155. doi: 10.1016/j.pscychresns.2020.111155. Epub 2020 Jul 30. PMID: 32799058. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Psychiatry research. Neuroimaging

PubMed ID

32799058

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