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The elucidation of this distinction confirms the existence of multiple, cognitively driven, supraspinal mechanisms for pain modulation. This study is the first to demonstrate that mindfulness-related pain relief is mechanistically distinct from placebo analgesia.

Sham mindfulness meditation-induced analgesia was not correlated with significant neural activity, but rather by greater reductions in respiration rate. In contrast, placebo analgesia was associated with activation of the dorsolateral prefrontal cortex and deactivation of sensory processing regions (secondary somatosensory cortex).

Mindfulness-meditation-related pain relief was associated with greater activation in brain regions associated with the cognitive modulation of pain, including the orbitofrontal, subgenual anterior cingulate, and anterior insular cortex. Mindfulness meditation also reduced pain intensity ( p = 0.030) and pain unpleasantness ( p = 0.043) ratings more than sham mindfulness meditation. Mindfulness meditation reduced pain intensity ( p = 0.032) and pain unpleasantness ( p < 0.001) ratings more than placebo analgesia. Importantly, all cognitive manipulations (i.e., mindfulness meditation, placebo conditioning, sham mindfulness meditation) significantly attenuated pain intensity and unpleasantness ratings when compared to rest and the control condition ( p < 0.05). We assessed intervention efficacy using psychophysical evaluation of experimental pain and functional neuroimaging. To determine whether the analgesic mechanisms of mindfulness meditation are different from placebo, we randomly assigned 75 healthy, human volunteers to 4 d of the following: (1) mindfulness meditation, (2) placebo conditioning, (3) sham mindfulness meditation, or (4) book-listening control intervention. However, it remains unknown whether mindfulness meditation engages pain-relieving mechanisms other than those associated with the placebo effect (e.g., conditioning, psychosocial context, beliefs). Mindfulness meditation reduces pain in experimental and clinical settings.