Skip to main content

Advertisement

SpringerLink
Log in

Mindfulness-based stress reduction alters brain activity for breast cancer survivors with chronic neuropathic pain: preliminary evidence from resting-state fMRI

  • Original Research
  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

Breast cancer continues to be the most commonly diagnosed cancer among Canadian women, with as many as 25–60% of women suffering from chronic neuropathic pain (CNP) as a pervasive consequence of treatment. While pharmacological interventions have shown limited efficacy for the management of CNP to date, psychological interventions, such as mindfulness-based stress reduction (MBSR), may be a promising alterative for improving pain-related problems. The purpose of this study was to use brain imaging methods to investigate this potential.

Methods

Resting-state fMRI was used in female breast cancer survivors with CNP before and after an 8-week MBSR course (n = 13) and compared with a waitlist control group (n = 10).

Results

Focusing on the default mode network, the most significant results show greater posterior cingulate connectivity with medial prefrontal regions post-MBSR intervention. Moreover, this change in connectivity correlated with reduced pain severity for the MBSR group.

Conclusions

These results provide empirical evidence of a change in the brain following MBSR intervention associated with changes in the subjective experience of pain.

Implications for Cancer Survivors

This study gives hope for a non-invasive method of easing the struggle of CNP in women following breast cancer treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Brenner DR, Weir HK, Demers AA, Ellison LF, Louzado C, Shaw A, et al. Projected estimates of cancer in Canada in 2020. Can Med Assoc J. 2020;192(9):E199–205.

    Article  Google Scholar 

  2. Jung BF, Ahrendt GM, Oaklander AL, Dworkin RH. Neuropathic pain following breast cancer surgery: proposed classification and research update. Pain. 2003;104:1–13.

    Article  Google Scholar 

  3. Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology. 2008;70(18):1630–5.

    Article  CAS  Google Scholar 

  4. Bredal IS, Smeby NA, Ottesen S, Warncke T, Schlichting E. Chronic pain in breast cancer survivors: comparison of psychosocial, surgical, and medical characteristics between survivors with and without pain. J Pain Symptom Manag. 2014;48(5):852–62.

    Article  Google Scholar 

  5. Colloca L, Ludman T, Bouhassira D, Baron R, Dickenson AH, Yarnitsky D, et al. Neuropathic pain. Nature Reviews Disease Primers. 2017;3:17002.

    Article  Google Scholar 

  6. Bokhari F, Sawatzky JAV. Chronic neuropathic pain in women after breast cancer treatment. Pain Manag Nurs. 2009;10(4):197–205.

    Article  Google Scholar 

  7. Hilton L, Hempel S, Ewing BA, Apaydin E, Xenakis L, Newberry S, et al. Mindfulness meditation for chronic pain: systematic review and meta-analysis. Ann Behav Med. 2017;51(2):199–213.

    Article  Google Scholar 

  8. Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med. 1985;8(2):163–90.

    Article  CAS  Google Scholar 

  9. Khoo E-L, Small R, Cheng W, Hatchard T, Glynn B, Rice DB, et al. Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: a systematic review and network meta-analysis. Evidence-Based Mental Health. 2019;22(1):26–35.

    Article  Google Scholar 

  10. Pleman B, Park M, Han X, Price LL, Bannuru RR, Harvey WF, et al. Mindfulness is associated with psychological health and moderates the impact of fibromyalgia. Clin Rheumatol. 2019;38(6):1737–45.

    Article  Google Scholar 

  11. Poulin P, Romanow H, Rahbari N, Small R, Smyth CE, Hatchard T, et al. The relationship between mindfulness, pain intensity, pain catastrophizing, depression, and quality of life among cancer survivors living with chronic neuropathic pain. Support Care Cancer. 2016;24(10):4167–75.

    Article  Google Scholar 

  12. Rozworska KA, Poulin PA, Carson A, Tasca GA, Nathan HJ. Mediators and moderators of change in mindfulness-based stress reduction for painful diabetic peripheral neuropathy. J Behav Med. 2020;43(2):297–307.

    Article  Google Scholar 

  13. Lengacher CA, Reich RR, Paterson CL, Ramesar S, Park JY, Alinat C, et al. Examination of broad symptom improvement resulting from mindfulness-based stress reduction in breast cancer survivors: a randomized controlled trial. J Clin Oncol. 2016;34(24):2827–34.

    Article  Google Scholar 

  14. Matchim Y, Armer JM, Stewart BR. Effects of mindfulness-based stress reduction (MBSR) on health among breast cancer survivors. West J Nurs Res. 2011;33(8):996–1016.

    Article  Google Scholar 

  15. Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012;30(12):1335–42.

    Article  Google Scholar 

  16. Lerman R, Jarski R, Rea H, Gellish R, Vicini F. Improving symptoms and quality of life of female cancer survivors: a randomized controlled study. Ann Surg Oncol. 2012;19(2):373–8.

    Article  Google Scholar 

  17. Raichle ME. The brain’s default mode network. Annu Rev Neurosci. 2015;38:433–47.

    Article  CAS  Google Scholar 

  18. Khan RS, Ahmed K, Blakeway E, Skapinakis P, Nihoyannopoulos L, Macleod K, et al. Catastrophizing: a predictive factor for postoperative pain. Am J Surg. 2011;201(1):122–31.

    Article  Google Scholar 

  19. Toth C, Brady S, Hatfield M. The importance of catastrophizing for successful pharmacological treatment of peripheral neuropathic pain. J Pain Res. 2014;7:327–38.

    Article  Google Scholar 

  20. Baliki MN, Mansour AR, Baria AT, Apkarian AV. Functional reorganization of the default mode network across chronic pain conditions. PLoS ONE. 2014;9:e106133.

    Article  Google Scholar 

  21. Malfliet A, Coppieters I, Van Wilgen P, Kregel J, De Pauw R, Dolphens M, et al. Brain changes associated with cognitive and emotional factors in chronic pain: a systematic review. Eur J Pain. 2017;21:769–86.

    Article  CAS  Google Scholar 

  22. Baliki MN, Geha PY, Apkarian AV, Chialvo DR. Beyond feeling: chronic pain hurts the brain, disrupting the default-mode network dynamics. J Neurosci. 2008;28(6):1398–403.

    Article  CAS  Google Scholar 

  23. Harrison R, Zeidan F, Kitsaras G, Ozcelik D, Salomons TV. Trait mindfulness is associated with lower pain reactivity and connectivity of the default mode network. J Pain. 2019;20(6):645–54.

    Article  Google Scholar 

  24. Loggia ML, Kim J, Gollub RL, Vangel MG, Kirsch I, Kong J, et al. Default mode network connectivity encodes clinical pain: an arterial spin labeling study. Pain. 2013;154(1):24–33.

    Article  Google Scholar 

  25. Kucyi A, Moayedi M, Weissman-Fogel I, Goldberg MB, Freeman BV, Tenenbaum HC, et al. Enhanced medial prefrontal-default mode network functional connectivity in chronic pain and its association with pain rumination. J Neurosci. 2014;34(11):3969–75.

    Article  CAS  Google Scholar 

  26. Shergill Y, Rice D, Khoo EL, Jarvis G, Zhang T, Taljaard M, Monterio L, et al. Mindfulness-based stress reduction in breast cancer survivors with chronic neuropathic pain: a randomized controlled trial. [unpublished results –under review in Pain]. n.d.

  27. Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singap. 1994;23(2):129–38.

    CAS  PubMed  Google Scholar 

  28. Baer A, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13:27–45.

    Article  Google Scholar 

  29. Tan G, Jensen MP, Thornby JI, Shanti BF. Validation of the Brief Pain Inventory for chronic non-malignant pain. Pain. 2004;5(2):133–7.

    Article  Google Scholar 

  30. Baer RA, Smith GT, Lykins E, Button D, Krietemeyer J, Sauer S, et al. Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment. 2008;15(3):329–42.

    Article  Google Scholar 

  31. Faes MC, Reelick MF, Perry M, Olde Rikkert MG, Borm GF. Studies with group treatments required special power calculations, allocation methods, and statistical analyses. J Clin Epidemiol. 2012;65(2):138–46.

    Article  Google Scholar 

  32. Jiang B, Mu W, Wang J, Lu J, Jiang S, Li L, et al. MicroRNA-138 functions as a tumor suppressor in osteosarcoma by targeting differentiated embryonic chondrocyte gene 2. Journal of Experimental & Clinical Cancer Research: CR. 2016;35:69.

    Article  Google Scholar 

  33. Gusnard DA, Akbudak E, Shulman GL, Raichle ME. Medial prefrontal cortex and self-referential mental activity: relation to a default mode of brain function. Proc Natl Acad Sci U S A. 2001;98(7):4259–64.

    Article  CAS  Google Scholar 

  34. Cauda F, D’Agata F, Sacco K, Duca S, Cocito D, Paolasso I, et al. Altered resting state attentional networks in diabetic neuropathic pain. J Neurol Neurosurg Psychiatry. 2010;81(7):806–11.

    Article  CAS  Google Scholar 

  35. Li J, Huang X, Sang K, Bodner M, Ma K, Dong X-W. Modulation of prefrontal connectivity in postherpetic neuralgia patients with chronic pain: a resting-state functional magnetic resonance–imaging study. J Pain Res. 2018;11:2131–44.

    Article  Google Scholar 

  36. Mills EP, Di Pietro F, Alshelh Z, Peck CC, Murray GM, Russell Vickers E, et al. Brainstem pain-control circuitry connectivity in chronic neuropathic pain. Neurobiol Dis. 2018;38(2):465–73.

    CAS  Google Scholar 

Download references

Acknowledgments

The authors wish to thank the MRI technologists from the Ottawa Hospital for their assistance with data collection. We also thank the participants, MBSR group leaders, and the research staff involved in the primary study.

Funding

This work was supported by the Canadian Institutes of Health Research and the Canadian Breast Cancer Foundation.

Author information

Authors and Affiliations

  1. School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier Room 2079, Ottawa, Ontario, K1N 6N5, Canada

    A. M. Smith, A. Leeming, Z. Fang & O. Mioduszewski

  2. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada

    T. Hatchard, M. A. Schneider & A. Ferdossifard

  3. The Ottawa Health Research Institute, Ottawa, Canada

    Y. Shergill & E-L. Khoo

  4. Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Canada

    P. Poulin

Authors
  1. A. M. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Leeming
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Z. Fang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Hatchard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Mioduszewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. A. Schneider
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Ferdossifard
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Y. Shergill
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. E-L. Khoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. P. Poulin
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AS: conceptualization, supervision, resources, investigation, funding acquisition, writing, data curation, formal analysis, methodology, visualization, design. AL: writing—original draft. ZF: formal analysis, resources, visualization, writing—review and editing. TH: investigation, writing—review and editing. OM: investigation. MS: writing—review and editing. AF: writing—review and editing. PP: conceptualization, funding acquisition, writing—review and editing, supervision.

Corresponding author

Correspondence to A. M. Smith.

Ethics declarations

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Smith, A.M., Leeming, A., Fang, Z. et al. Mindfulness-based stress reduction alters brain activity for breast cancer survivors with chronic neuropathic pain: preliminary evidence from resting-state fMRI. J Cancer Surviv 15, 518–525 (2021). https://doi.org/10.1007/s11764-020-00945-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-020-00945-0

Keywords

Search

Navigation