Neural activations during self-related processing in patients with chronic pain and effects of a brief self-compassion training - A pilot study
Berry, Michael P.
Edwards, Robert R.
UMass Chan AffiliationsCenter for Integrated Primary Care
Department of Family Medicine and Community Health
Document TypeJournal Article
Keywordscorticial midline regions
dorsolateral prefrontal cortex
Cognition and Perception
Health Services Administration
Health Services Research
Neuroscience and Neurobiology
Psychiatry and Psychology
MetadataShow full item record
AbstractChronic 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.
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