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Reduced Emotional Reactivity in Breast Cancer Survivors with Chronic Neuropathic Pain Following Mindfulness-Based Stress Reduction (MBSR): an fMRI Pilot Investigation

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Abstract

Objectives

The present study aimed to investigate the impact of an 8-week mindfulness-based stress reduction (MBSR) program on emotional reactivity among a sample of breast cancer survivors with chronic neuropathic pain (CNP).

Methods

Twenty-one women were randomly assigned to a MBSR treatment group (n = 11) or a waitlist control group (n = 10) following medical review. Using functional magnetic resonance imaging (fMRI), participants were imaged before and after the MBSR program while completing the emotional Stroop task as a measure of emotional reactivity.

Results

The treatment group showed significantly less blood oxygen level–dependent (BOLD) activity post-MBSR across several brain regions involved in pain processing and visual attention. This included regions in the left somatosensory cortex, left precuneus, and left dorsolateral prefrontal cortex. Although emotional reactivity was the primary outcome, pain severity and interference from the Brief Pain Inventory were also assessed at both time points. Pain interference was significantly reduced following MBSR for the intervention group only.

Conclusions

These preliminary findings show that MBSR training has a marked impact on neural correlates of pain processing and attention, lending support to MBSR as a viable adjunctive treatment option for breast cancer survivors living with CNP. However, further research, with a larger sample size, is warranted.

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Acknowledgments

The authors would like to thank our funding sources, the Canadian Institute of Health Research and the Canadian Breast Cancer Foundation. The authors would also like to thank (1) the MRI technologists at the Ottawa Hospital; (2) MBSR group leaders Lynette Monteiro, Kimberly Sogge, Howard Nathan, Kathy Nathan, Brittany Glynn, Lakshmi Sundaram, Craig Mackie, and Sandy Williams; (3) Chris Lepage for his assistance with programming the fMRI task; and (4) Aziza Byron-Alhassan and Jason Berard for providing additional support during imaging sessions.

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Authors and Affiliations

Authors

Contributions

TH: designed and programmed the fMRI task, executed the study, and assisted with writing the paper. OM: executed the study. ELK: provided clinical measures and assisted with clinical data analysis. HR: assisted with recruitment and execution of the study. YS: assisted with recruitment, clinical measures, and execution of the study, and collaborated on writing the paper. ET: assisted with clinical measures and analysis of clinical data. AL: assisted with data analysis. ZF: assisted with fMRI data analysis and write up of methods and results sections. PP: conceptualization of study, supervision, resources, funding acquisition, and editing of paper. AMS: conceptualization of study, design of fMRI, supervision, resources, funding acquisition, and writing of manuscript.

Corresponding author

Correspondence to Andra M. Smith.

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All research procedures received University of Ottawa and The Ottawa Hospital Research Ethics Board approval. Informed consent was obtained from all participants.

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The authors declare that they have no conflicts of interest.

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Hatchard, T., Mioduszewski, O., Khoo, EL. et al. Reduced Emotional Reactivity in Breast Cancer Survivors with Chronic Neuropathic Pain Following Mindfulness-Based Stress Reduction (MBSR): an fMRI Pilot Investigation. Mindfulness 12, 751–762 (2021). https://doi.org/10.1007/s12671-020-01546-9

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