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有经验的冥想者中阿片受体拮抗剂增强冥想镇痛。

Enhancement of Meditation Analgesia by Opioid Antagonist in Experienced Meditators.

机构信息

From the Prevention Science Institute and Department of Psychology (May), University of Oregon; Pain Consultants of Oregon (Kosek), Eugene, Oregon; Department of Neurobiology and Anatomy (Zeidan), Wake Forest School of Medicine, Winston-Salem, North Carolina; and Department of Psychology and Center for Translational Neuroscience (Berkman), University of Oregon, Eugene, Oregon.

出版信息

Psychosom Med. 2018 Nov/Dec;80(9):807-813. doi: 10.1097/PSY.0000000000000580.


DOI:10.1097/PSY.0000000000000580
PMID:29595707
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6162167/
Abstract

OBJECTIVE: Studies have consistently shown that long-term meditation practice is associated with reduced pain, but the neural mechanisms by which long-term meditation practice reduces pain remain unclear. This study tested endogenous opioid involvement in meditation analgesia associated with long-term meditation practice. METHODS: Electrical pain was induced with randomized, double-blind, cross-over administration of the opioid antagonist naloxone (0.15-mg/kg bolus dose, then 0.2-mg/kg per hour infusion dose) with 32 healthy, experienced meditation practitioners and a standardized open monitoring meditation. RESULTS: Under saline, pain ratings were significantly lower during meditation (pain intensity: 6.41 ± 1.32; pain unpleasantness: 3.98 ± 2.17) than at baseline (pain intensity: 6.86 ±1.04, t(31) = 2.476, p = .019, Cohen's d = 0.46; pain unpleasantness: 4.96 ±1.75, t(31) = 3.746, p = .001, Cohen's d = 0.68), confirming the presence of meditation analgesia. Comparing saline and naloxone revealed significantly lower pain intensity (t(31) = 3.12, p = .004, d = 0.56), and pain unpleasantness (t(31) = 3.47, p = .002, d = 0.62), during meditation under naloxone (pain intensity: 5.53 ± 1.54; pain unpleasantness: 2.95 ± 1.88) than under saline (pain intensity: 6.41 ± 1.32; pain unpleasantness: 3.98 ± 2.17). Naloxone not only failed to eliminate meditation analgesia but also made meditation analgesia stronger. CONCLUSIONS: Long-term meditation practice does not rely on endogenous opioids to reduce pain. Naloxone's blockade of opioid receptors enhanced meditation analgesia; pain ratings during meditation were significantly lower under naloxone than under saline. Possible biological mechanisms by which naloxone-induced opioid receptor blockade enhances meditation analgesia are discussed.

摘要

目的:研究一致表明,长期冥想练习与疼痛减轻有关,但长期冥想练习减轻疼痛的神经机制仍不清楚。本研究测试了内源性阿片参与与长期冥想练习相关的冥想镇痛。

方法:通过随机、双盲、交叉给予阿片拮抗剂纳洛酮(0.15mg/kg 推注剂量,然后 0.2mg/kg/h 输注剂量),并结合标准化的开放监测冥想,对 32 名经验丰富的冥想练习者进行电刺激疼痛诱导。

结果:在生理盐水条件下,冥想时的疼痛评分明显低于基线时(疼痛强度:6.41 ± 1.32;疼痛不适:3.98 ± 2.17)(t(31)=2.476,p=.019,Cohen's d=0.46;疼痛不适:4.96 ± 1.75,t(31)=3.746,p=.001,Cohen's d=0.68),证实了冥想镇痛的存在。比较生理盐水和纳洛酮发现,纳洛酮下冥想时的疼痛强度(t(31)=3.12,p=.004,d=0.56)和疼痛不适(t(31)=3.47,p=.002,d=0.62)明显低于生理盐水(疼痛强度:6.41 ± 1.32;疼痛不适:3.98 ± 2.17)。纳洛酮不仅没有消除冥想镇痛,反而使冥想镇痛更强。

结论:长期冥想练习不依赖内源性阿片类物质来减轻疼痛。纳洛酮阻断阿片受体增强了冥想镇痛;纳洛酮下的疼痛评分明显低于生理盐水下。讨论了纳洛酮诱导的阿片受体阻断增强冥想镇痛的可能生物学机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/323b/6221397/0783d0b886e6/psm-80-807-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/323b/6221397/7133fb0d2c4b/psm-80-807-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/323b/6221397/0783d0b886e6/psm-80-807-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/323b/6221397/7133fb0d2c4b/psm-80-807-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/323b/6221397/0783d0b886e6/psm-80-807-g004.jpg

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本文引用的文献

[1]
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J Orthop Sci. 2018-1

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Cereb Cortex. 2017-8-1

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Am J Med. 2016-11

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Mindfulness Meditation Modulates Pain Through Endogenous Opioids.

Am J Med. 2016-4-1

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Mindfulness-Meditation-Based Pain Relief Is Not Mediated by Endogenous Opioids.

J Neurosci. 2016-3-16

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