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Erschienen in: Journal of Cancer Survivorship 6/2020

19.06.2020

Breast cancer survivors living with chronic neuropathic pain show improved brain health following mindfulness-based stress reduction: a preliminary diffusion tensor imaging study

verfasst von: Ola Mioduszewski, Taylor Hatchard, Zhuo Fang, Patricia Poulin, Eve-Ling Khoo, Heather Romanow, Yaad Shergill, Emily Tennant, Maiko A. Schneider, Nikisha Browne, Andra M. Smith

Erschienen in: Journal of Cancer Survivorship | Ausgabe 6/2020

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Abstract

Purpose

The present study explores the benefits of an 8-week mindfulness-based stress reduction (MBSR) program to white matter integrity among breast cancer survivors experiencing chronic neuropathic pain (CNP).

Methods

Twenty-three women were randomly assigned to either a MBSR treatment group (n = 13) or a waitlist control group (n = 10). Participants were imaged with MRI prior to and post-MBSR training using diffusion tensor imaging.

Results

Compared with controls, the MBSR group showed a significant increase in fractional anisotropy (FA), particularly in the left subcortical regions including the uncinate fasciculus, amygdala, and hippocampus, as well as in the external capsule and in the left sagittal stratum. No decreases to FA were found in any brain regions following MBSR training. The FA values also negatively correlated with the pain severity and pain interference scores from the BRIEF pain questionnaire.

Conclusions

The present findings demonstrate that MBSR training may enhance the integrity of cerebral white matter that coincides with a reduction in pain perception. Further research with a larger sample size is required.

Implications for Cancer Survivors

This study highlights the potential for MBSR, as a non-pharmacological intervention, to provide both brain health improvement and pain perception relief for female breast cancer survivors experiencing CNP.
Literatur
1.
Zurück zum Zitat 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.CrossRef 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.CrossRef
2.
Zurück zum Zitat Conley CC, Bishop BT, Andersen BL. Emotions and emotion regulation in breast cancer survivorship. Healthcare. 2016;4(3):56–78.CrossRef Conley CC, Bishop BT, Andersen BL. Emotions and emotion regulation in breast cancer survivorship. Healthcare. 2016;4(3):56–78.CrossRef
3.
Zurück zum Zitat Epplein M, Zheng Y, Zheng W, Chen Z, Gu K, Penson D, et al. Quality of life after breast cancer diagnosis and survival. J Clin Oncol. 2011;29(4):406–12.CrossRef Epplein M, Zheng Y, Zheng W, Chen Z, Gu K, Penson D, et al. Quality of life after breast cancer diagnosis and survival. J Clin Oncol. 2011;29(4):406–12.CrossRef
4.
Zurück zum Zitat Burton AW, Fanciullo GJ, Beasley RD, Fisch ML. Chronic pain in the cancer survivor: a new frontier. Pain Med. 2007;8(2):189–98.CrossRef Burton AW, Fanciullo GJ, Beasley RD, Fisch ML. Chronic pain in the cancer survivor: a new frontier. Pain Med. 2007;8(2):189–98.CrossRef
5.
Zurück zum Zitat Zainal NZ, Nik-Jaafar NR, Baharudin A, Sabki ZA, Ng CG. Prevalence of depression in breast cancer survivors: a systematic review of observational studies. Asian Pac J Cancer P. 2013;14(4):2649–56.CrossRef Zainal NZ, Nik-Jaafar NR, Baharudin A, Sabki ZA, Ng CG. Prevalence of depression in breast cancer survivors: a systematic review of observational studies. Asian Pac J Cancer P. 2013;14(4):2649–56.CrossRef
6.
Zurück zum Zitat Bokhari F, Sawatzky JAV. Chronic neuropathic pain in women after breast cancer treatment. Pain Manag Nurs. 2009;10(4):197–205.CrossRef Bokhari F, Sawatzky JAV. Chronic neuropathic pain in women after breast cancer treatment. Pain Manag Nurs. 2009;10(4):197–205.CrossRef
7.
Zurück zum Zitat Bouhassira DB, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E, et al. Development and validation of the neuropathic pain symptom inventory. Pain. 2004;108:248–57.CrossRef Bouhassira DB, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E, et al. Development and validation of the neuropathic pain symptom inventory. Pain. 2004;108:248–57.CrossRef
8.
Zurück zum Zitat Jung BF, Ahrendt GM, Oaklander AL, Dworkin RH. Neuropathic pain following breast cancer surgery: proposed classification and research update. Pain. 2003;104:1–13.CrossRef Jung BF, Ahrendt GM, Oaklander AL, Dworkin RH. Neuropathic pain following breast cancer surgery: proposed classification and research update. Pain. 2003;104:1–13.CrossRef
9.
Zurück zum Zitat Lin CS. Brain signature of chronic orofacial pain: a systematic review of trigeminal neuropathic pain and temporomandibular joint disorders. PLOS One. 2014;9(4):e94300.CrossRef Lin CS. Brain signature of chronic orofacial pain: a systematic review of trigeminal neuropathic pain and temporomandibular joint disorders. PLOS One. 2014;9(4):e94300.CrossRef
10.
Zurück zum Zitat Gustin SM, Wrigley PJ, Siddall PJ, Henderson LA. Brain Anatomy changes associated with persistent neuropathic pain following spinal cord injury. Cereb Cortex. 2011;20:1409–19.CrossRef Gustin SM, Wrigley PJ, Siddall PJ, Henderson LA. Brain Anatomy changes associated with persistent neuropathic pain following spinal cord injury. Cereb Cortex. 2011;20:1409–19.CrossRef
11.
Zurück zum Zitat DeSouza DD, Hodaie M, Davis KD. Abnormal trigeminal nerve microstructure and brain white matter in idiopathic trigeminal neuralgia. Pain. 2014;155(1):37–44.CrossRef DeSouza DD, Hodaie M, Davis KD. Abnormal trigeminal nerve microstructure and brain white matter in idiopathic trigeminal neuralgia. Pain. 2014;155(1):37–44.CrossRef
12.
Zurück zum Zitat Mu A, Weinberg E, Moulin DE, Clarke H. Pharmacologic management of chronic neuropathic pain. Can Fam Physician. 2017;63(11):844–52.PubMedPubMedCentral Mu A, Weinberg E, Moulin DE, Clarke H. Pharmacologic management of chronic neuropathic pain. Can Fam Physician. 2017;63(11):844–52.PubMedPubMedCentral
13.
Zurück zum Zitat Niazi AK, Niazi SK. Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses. N Am J Med Sci. 2011;3(1):20–3.CrossRef Niazi AK, Niazi SK. Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses. N Am J Med Sci. 2011;3(1):20–3.CrossRef
14.
Zurück zum Zitat Doll A, Holzel BK, Boucard CC, Wohlschlager AM, Sorg C. Mindfulness is associated with intrinsic functional connectivity between default mode and salience networks. Front Hum Neurosci. 2015;9:1–11.CrossRef Doll A, Holzel BK, Boucard CC, Wohlschlager AM, Sorg C. Mindfulness is associated with intrinsic functional connectivity between default mode and salience networks. Front Hum Neurosci. 2015;9:1–11.CrossRef
15.
Zurück zum Zitat Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. Bantam Dell: New York, New York; 1990. Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. Bantam Dell: New York, New York; 1990.
16.
Zurück zum Zitat Ngamkham S, Holden JE, Smith EL. A systematic review: mindfulness intervention for cancer-related pain. Asia Pac J Oncol Nurs. 2019;6(2):161–9.CrossRef Ngamkham S, Holden JE, Smith EL. A systematic review: mindfulness intervention for cancer-related pain. Asia Pac J Oncol Nurs. 2019;6(2):161–9.CrossRef
17.
Zurück zum Zitat 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). 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).
18.
Zurück zum Zitat 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]. 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].
19.
Zurück zum Zitat 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.CrossRef 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.CrossRef
20.
Zurück zum Zitat 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.CrossRef 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.CrossRef
21.
Zurück zum Zitat Fields RD. Neuroscience. Change in the brain’s white matter. Science. 2010;330(6005):768–9.CrossRef Fields RD. Neuroscience. Change in the brain’s white matter. Science. 2010;330(6005):768–9.CrossRef
22.
Zurück zum Zitat Beer JS, John OP, Scabini D, Knight RT. Orbitofrontal cortex and social behaviour: integrating self-monitoring and emotion-cognition interactions. J Cognitive Neurosci. 2006;18(6):871–9.CrossRef Beer JS, John OP, Scabini D, Knight RT. Orbitofrontal cortex and social behaviour: integrating self-monitoring and emotion-cognition interactions. J Cognitive Neurosci. 2006;18(6):871–9.CrossRef
23.
Zurück zum Zitat Veinante P, Yalcin I, Barrot M. The amygdala between sensation and affect: a role in pain. J Mol Psychiatry. 2013;1(9):1–14. Veinante P, Yalcin I, Barrot M. The amygdala between sensation and affect: a role in pain. J Mol Psychiatry. 2013;1(9):1–14.
24.
Zurück zum Zitat Apkarian AV, Bushnell MC, Treede RD, Zubieta JK. Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain. 2005;9(4):463–84.CrossRef Apkarian AV, Bushnell MC, Treede RD, Zubieta JK. Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain. 2005;9(4):463–84.CrossRef
25.
Zurück zum Zitat Kaouane N, Porte Y, Vallée M, Brayda-Bruno L, Mons N, Calendreau L, et al. Glucocorticoids can induce PTSD-like memory impairments in mince. Science. 2012;335(6075):1510–3.CrossRef Kaouane N, Porte Y, Vallée M, Brayda-Bruno L, Mons N, Calendreau L, et al. Glucocorticoids can induce PTSD-like memory impairments in mince. Science. 2012;335(6075):1510–3.CrossRef
26.
Zurück zum Zitat Hansen GR, Streltzer J. The psychology of pain. Emerg Med Clin N Am. 2005;23(2):339–48.CrossRef Hansen GR, Streltzer J. The psychology of pain. Emerg Med Clin N Am. 2005;23(2):339–48.CrossRef
27.
Zurück zum Zitat Luders E, Clark K, Narr KL, Toga AW. Enhanced brain connectivity in long-term meditation practitioners. Neuroimage. 2011;57(4):1308–16.CrossRef Luders E, Clark K, Narr KL, Toga AW. Enhanced brain connectivity in long-term meditation practitioners. Neuroimage. 2011;57(4):1308–16.CrossRef
28.
Zurück zum Zitat Holzel BK, Brunsch V, Gard T, Greve DN, Sorg C, Lazar SW, et al. Mindfulness-based stress reduction, fear conditioning, and the uncinate fasciculus: a pilot study. Front Behav Neurosci. 2016;10:1–12.CrossRef Holzel BK, Brunsch V, Gard T, Greve DN, Sorg C, Lazar SW, et al. Mindfulness-based stress reduction, fear conditioning, and the uncinate fasciculus: a pilot study. Front Behav Neurosci. 2016;10:1–12.CrossRef
29.
Zurück zum Zitat Boekel NB, Jacobse JN, Schaapveld M, Hooning MJ, Gietema JA, Duane FK, et al. Cardiovascular disease incidence after internal mammary chain irradiation and anthracycline-based chemotherapy for breast cancer. Brit J Cancer. 2018;119:408–18.CrossRef Boekel NB, Jacobse JN, Schaapveld M, Hooning MJ, Gietema JA, Duane FK, et al. Cardiovascular disease incidence after internal mammary chain irradiation and anthracycline-based chemotherapy for breast cancer. Brit J Cancer. 2018;119:408–18.CrossRef
30.
Zurück zum Zitat Hwang KJ, Park KC, Yoon SS, Ahn TB. Unusual lesion in the bilateral external capsule following status epilepticus: a case report. J Epilepsy Res. 2014;4:88–90.CrossRef Hwang KJ, Park KC, Yoon SS, Ahn TB. Unusual lesion in the bilateral external capsule following status epilepticus: a case report. J Epilepsy Res. 2014;4:88–90.CrossRef
31.
Zurück zum Zitat Korgaonkar MS, Grieve SM, Koslow SH, Gabrieli JDE, Gordon E, Williams LM. Loss of white matter integrity in major depressive disorder: evidence using tract-based spatial statistical analysis of diffusion tensor imaging. Hum Brain Mapp. 2011;32(12):2161–71.CrossRef Korgaonkar MS, Grieve SM, Koslow SH, Gabrieli JDE, Gordon E, Williams LM. Loss of white matter integrity in major depressive disorder: evidence using tract-based spatial statistical analysis of diffusion tensor imaging. Hum Brain Mapp. 2011;32(12):2161–71.CrossRef
32.
Zurück zum Zitat Jellison BJ, Field AS, Medow J, Lazar M, Salamat MS, Alexander AL. Diffusion tensor imaging of cerebral white matter: a pictorial review of physics, fiber tract anatomy, and tumor imaging patterns. Am J Neuroradiol. 2004;25(3):356–69.PubMed Jellison BJ, Field AS, Medow J, Lazar M, Salamat MS, Alexander AL. Diffusion tensor imaging of cerebral white matter: a pictorial review of physics, fiber tract anatomy, and tumor imaging patterns. Am J Neuroradiol. 2004;25(3):356–69.PubMed
33.
Zurück zum Zitat Tang Y-Y, Lu Q, Fan M, Yang Y, Posner MI. Mechanisms of white matter changes induced by meditation. Proc Natl Acad Sci U S A. 2012;109(26):10570–4.CrossRef Tang Y-Y, Lu Q, Fan M, Yang Y, Posner MI. Mechanisms of white matter changes induced by meditation. Proc Natl Acad Sci U S A. 2012;109(26):10570–4.CrossRef
34.
Zurück zum Zitat Fox KCR, Nijeboer S, Dixon ML, Floman JL, Ellamil M, Rumak SP, et al. Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neurosci Biobehav Rev. 2014;43:48–73.CrossRef Fox KCR, Nijeboer S, Dixon ML, Floman JL, Ellamil M, Rumak SP, et al. Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neurosci Biobehav Rev. 2014;43:48–73.CrossRef
35.
Zurück zum Zitat Piervincenzi C, Ben-Soussan TD, Mauro F, Mallio CA, Errante Y, Quattrocchi CC, et al. White matter microstructural changes following Quadrato Motor Training: a longitudinal study. Front Hum Neurosci. 2017;11:1–16.CrossRef Piervincenzi C, Ben-Soussan TD, Mauro F, Mallio CA, Errante Y, Quattrocchi CC, et al. White matter microstructural changes following Quadrato Motor Training: a longitudinal study. Front Hum Neurosci. 2017;11:1–16.CrossRef
36.
Zurück zum Zitat Davidson RJ, Kabat-Zinn J, Schumacher J, Rosenkranz M, Muller D, Santorelli SF, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med. 2003;65:564–70.CrossRef Davidson RJ, Kabat-Zinn J, Schumacher J, Rosenkranz M, Muller D, Santorelli SF, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med. 2003;65:564–70.CrossRef
37.
Zurück zum Zitat 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.CrossRef 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.CrossRef
38.
Zurück zum Zitat Liu Y, Latremoliere A, Li X, Zhang Z, Chen M, Wang X, et al. Touch and tactile neuropathic pain sensitivity are set by corticospinal projections. Nature. 2018;561(7724):547–50.CrossRef Liu Y, Latremoliere A, Li X, Zhang Z, Chen M, Wang X, et al. Touch and tactile neuropathic pain sensitivity are set by corticospinal projections. Nature. 2018;561(7724):547–50.CrossRef
Metadaten
Titel
Breast cancer survivors living with chronic neuropathic pain show improved brain health following mindfulness-based stress reduction: a preliminary diffusion tensor imaging study
verfasst von
Ola Mioduszewski
Taylor Hatchard
Zhuo Fang
Patricia Poulin
Eve-Ling Khoo
Heather Romanow
Yaad Shergill
Emily Tennant
Maiko A. Schneider
Nikisha Browne
Andra M. Smith
Publikationsdatum
19.06.2020
Verlag
Springer US
Erschienen in
Journal of Cancer Survivorship / Ausgabe 6/2020
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-020-00903-w

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