A Systematic Review of Pain-Related Neural Processes in Expert and Novice Meditator

Objectives: Mindfulness meditation (MM) is an attention and acceptance–based intervention effective for managing chronic pain. Current literature predominately focuses on the behavioral effects of short-term mindfulness-based programs for pain reduction. However, the long-term potential of MM and its effect on pain processing are less well understood. Furthermore, it is possible that short- and long-term effects of MM are underpinned by different neural processes. This systematic review was undertaken to better understand the short- and long-term effects of MM on brain processes related to pain by comparing pain-related neural process in novice and expert MM. Methods: A literature search was performed to identify relevant studies using MRI/fMRI and EEG/MEG. Results: A total of 14 studies were selected: 1 MEG and fMRI, 5 EEG, and 8 MRI/fMRI. Overall, findings across studies are consistent in reporting reduced pain ratings in both novice and expert meditators. However, different brain processes appeared to underlie this effect with experts showing greater activity in the somatosensory regions and novices showing reduced activity. The available evidence also indicates a greater dissociation between pain salience and pain unpleasantness in expert meditators along with greater changes in the respective brain regions, suggesting a dissociation between sensory and the cognitive-affective dimensions of pain. For novice meditators, however, the evidence is less conclusive. Conclusions: Given the ongoing nature of chronic pain, the long-term effects of mindfulness meditation should be explored to assess whether the effects of short-term programs remain post treatment.