Mindfulness-based stress reduction alters brain activity for breast cancer survivors with chronic neuropathic pain: preliminary evidence from resting-state fMRI

Purpose: Breast cancer continues to be the most commonly diagnosed cancer among Canadian women, with as many as 25-60% of women suffering from chronic neuropathic pain (CNP) as a pervasive consequence of treatment. While pharmacological interventions have shown limited efficacy for the management of CNP to date, psychological interventions, such as mindfulness-based stress reduction (MBSR), may be a promising alterative for improving pain-related problems. The purpose of this study was to use brain imaging methods to investigate this potential.

Methods: Resting-state fMRI was used in female breast cancer survivors with CNP before and after an 8-week MBSR course (n = 13) and compared with a waitlist control group (n = 10).

Results: Focusing on the default mode network, the most significant results show greater posterior cingulate connectivity with medial prefrontal regions post-MBSR intervention. Moreover, this change in connectivity correlated with reduced pain severity for the MBSR group.

Conclusions: These results provide empirical evidence of a change in the brain following MBSR intervention associated with changes in the subjective experience of pain.

Implications for cancer survivors: This study gives hope for a non-invasive method of easing the struggle of CNP in women following breast cancer treatment.

Keywords: Breast cancer; Chronic neuropathic pain; Default mode network; Mindfulness-based stress reduction; Oncology; Resting-state fMRI.