Meditation’s Reduction of Pain is Independent of Brain Opioid Systems

Meditation’s Reduction of Pain is Independent of Brain Opioid Systems


By John M. de Castro, Ph.D.


Bit by bit, as I sat noticing my breath and body sensations, I began to feel the deep knots of pain in my body start to untie themselves.” – Avi Craimer


We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. Opioids act on a system in the brain that contains receptors that respond to these drugs. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.


Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain in adults. It is not known whether meditations effects on pain are mediated by the same system that responds to opioids.


In today’s Research News article “Enhancement of Meditation Analgesia by Opioid Antagonist in Experienced Meditators.” (See summary below or view the full text of the study at:  ), May and colleagues recruited adult experienced meditators who were free of chronic pain and not taking opioid drugs. They were measured for pain responses to an electric shock delivered to the ring finger of the non-dominant hand. They rated the level of pain on a 10-point scale. The participants first rated pain under normal conditions and later while meditating. Those participants who demonstrated a 15% or more reduction in pain while meditating (meditation analgesia) participated in the second half of the experiment. Half the participants received a saline injection and half an injection of Naloxone (an opioid receptor blocker) and repeated the pain testing while meditating. In the next session the participants received either the saline or Naloxone injection that they did not receive in the first session. So, all participants received both saline and Naloxone injections and were tested for their pain sensitivity.


They found in the initial test that 85% of the participants demonstrated a 15% or more reduction in pain while meditating (meditation analgesia). This high rate suggests that meditation routinely produces a reduced experience of pain in experienced meditators. In the second phase they found that meditation analgesia was not only not reduced by Naloxone injection but actually significant increased, with larger reductions in both pain intensity and pain unpleasantness to the electric shock after Naloxone injection than after saline injections.


The opioid system of the brain is a well-established pain processing system. Its function is blocked by Naloxone. So, the reduction in pain produced by meditation was not affected by disrupting the opioid system. So, meditation analgesia must not be due to changes in this opioid system. It must be processed by a different system in the brain. The increase in meditation analgesia after Naloxone was a surprise, for which there is no viable explanation at this time. Hence, meditation reduces pain sensitivity and does so independent of the brain system that responds to opiates.


So, meditation reduces pain sensitivity independent of brain opioid systems.


Mindfulness meditation is believed to be a viable alternative to drugs when it comes to pain management. Although research is still in the beginning phases, pilot studies focusing on the benefits of mindfulness have shown promising outcomes for patients suffering from chronic ailments such as fibromyalgia, back pain, migraines, etc.” – Mindworks


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+ and on Twitter @MindfulResearch


Study Summary


May, L. M., Kosek, P., Zeidan, F., & Berkman, E. T. (2018). Enhancement of Meditation Analgesia by Opioid Antagonist in Experienced Meditators. Psychosomatic medicine, 80(9), 807-813.




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.


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.


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.


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.


Improve Brain Metabolism and Muscle Energetics in Older Adults with Tai Chi

Improve Brain Metabolism and Muscle Energetics in Older Adults with Tai Chi


By John M. de Castro, Ph.D.


”A comparison of the effects of regular sessions of tai chi, walking, and social discussion, has found tai chi was associated with the biggest gains in brain volume and improved cognition.”  – Fiona McPherson


The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities which decline with age including impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. Using modern neuroimaging techniques, scientists have been able to view the changes that occur in the nervous system with aging. In addition, they have been able to investigate various techniques that might slow the process of neurodegeneration that accompanies normal aging. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.


Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Because it is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for an elderly population. Indeed, Tai Chi and Qigong have been shown to be beneficial in slowing or delaying physical and mental decline with aging and to increase brain matter in the elderly.


In today’s Research News article “Tai Chi Improves Brain Metabolism and Muscle Energetics in Older Adults.” (See summary below or view the full text of the study at: ), Zhou and colleagues recruited healthy older people (>55 years of age) and trained them in Tai Chi practice with a one hour, twice a week, for 12 weeks instruction. They were measured before and after training for leg strength while having their brains scanned for metabolites with Magnetic Resonance Imaging (MRI). N‐acetylaspartate (NAA) is a neuronal marker of neuronal health. They also measured the rate of recovery of phosphocreatine (PCr) in the leg following exercise, a marker of muscular fitness.


They found that after training there was a significant increase in N‐acetylaspartate (NAA). NAA is a marker of the number of neurons present in the brain. Hence it’s increase in this study suggests that Tai Chi training increases the number of brain cells in the elderly. This further suggests that Tai Chi training is neuroprotective and may reduce the degeneration of the brain that occurs in normal aging.


They also found that after training there was a significant decrease in the rate of recovery of phosphocreatine (PCr) in the leg following exercise. A PCr decrease indicates that the capacity of muscles to use oxygen has increased. This, then, is a measure of muscular fitness. Hence it’s decrease in this study suggests that Tai Chi training improves exercise fitness in older adults helping to counter the age related decline in strength.


These results suggest the biochemical mechanisms that may underlie the ability of Tai Chi training to slow or delay physical and mental decline and to increase brain matter. These results not only further support the benefits of Tai Chi training for aging adults but also indicate how this training may change the chemistry of the brain and muscles to counter the effects of aging.


So, improve brain metabolism and muscle energetics in older adults with Tai Chi.


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+ and on Twitter @MindfulResearch


“Studies have shown that the incorporation of Tai Chi to an elders’ exercise program can be beneficial. Tai Chi practice was “beneficial to improve the balance control ability and flexibility of older adults, which may be the reason of preventing falls.” – Eric Edelman


In today’s Research News article “Tai Chi Improves Brain Metabolism and Muscle Energetics in

Study Summary


Zhou, M., Liao, H., Sreepada, L. P., Ladner, J. R., Balschi, J. A., & Lin, A. P. (2018). Tai Chi Improves Brain Metabolism and Muscle Energetics in Older Adults. Journal of Neuroimaging, 28(4), 359–364.




Tai Chi is a mind‐body exercise that has been shown to improve both mental and physical health. As a result, recent literature suggests the use of Tai Chi to treat both physical and psychological disorders. However, the underlying physiological changes have not been characterized. The aim of this pilot study is to assess the changes in brain metabolites and muscle energetics after Tai Chi training in an aging population using a combined brain‐muscle magnetic resonance spectroscopy (MRS) examination.


Six healthy older adults were prospectively recruited and enrolled into a 12‐week Tai Chi program. A brain 1H MRS and a muscle 31P MRS were scanned before and after the training, and postprocessed to measure N‐acetylaspartate to creatine (NAA/Cr) ratios and phosphocreatine (PCr) recovery time. Wilcoxon‐signed rank tests were utilized to assess the differences between pre‐ and post‐Tai Chi training.


A significant within‐subject increase in both the NAA/Cr ratios (P = .046) and the PCr recovery time (P =.046) was observed between the baseline and the posttraining scans. The median percentage changes were 5.38% and 16.51% for NAA/Cr and PCr recovery time, respectively.


Our pilot study demonstrates significant increase of NAA/Cr ratios in posterior cingulate gyrus and significantly improved PCr recovery time in leg muscles in older adults following short‐term Tai Chi training, and thus provides insight into the beneficial mechanisms.


Slow Mental Decline in the Elderly with Tai Chi

Slow Mental Decline in the Elderly with Tai Chi


By John M. de Castro, Ph.D.


“improvement of heart function combined with increased muscular power meant that the martial art should be considered the preferred technique for elderly people to maintain good health.” – The Telegraph


We celebrate the increasing longevity of the population. But, aging is a mixed blessing. The aging process involves a systematic progressive decline of the body and the brain. Every system in the body deteriorates including cognitive function (thinking ability) and motor function with a decline in strength, flexibility, and balance. It is inevitable. In addition, many elderly experience withdrawal and isolation from social interactions. There is some hope as there is evidence that these declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical and cognitive decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline.


Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Tai Chi practice been scrutinized with empirical research and found to be effective for an array of physical and psychological issues. Tai Chi has been shown to help the elderly improve attentionbalance, reducing fallsarthritiscognitive functionmemory, and reduce age related deterioration of the brain. Because Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion.


In today’s Research News article “Tai Chi Improves Cognition and Plasma BDNF in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial.”  Sungkarat and colleagues recruited elderly participants with mild cognitive impairments and randomly assigned them to either receive educational instruction related to cognitive impairment and fall prevention or practice Tai Chi at home guided by a 50-minute video, 3 times per week, for 6 months. They were measured at the beginning and end of training for cognitive performance, including memory, visuospatial ability, and executive function, and plasma markers for inflammation and neuroprotection, including plasma BDNF, TNF-α, and IL-10 levels.


They found that compared to baseline and control participants, the elderly who practiced Tai Chi had significantly improved levels of cognitive function, including improvements in memory and thinking ability (executive function). In addition, Tai Chi practice was found to significantly increase the levels of brain-derived neurotrophic factor (BDNF). BDNF is a neurotrophic factor that works to protect the brain from deterioration and promote the growth of brain cells. Hence, they found that Tai Chi practice reduces cognitive decline with aging and increases neuroprotection.


The cognitive decline with aging has been associated with degeneration of neural tissues. On the other hand, mindfulness practices have been found to change the brain and protect it against age related decline. The present results add further evidence that mindfulness practices, Tai Chi  in particular, improves memory and cognitive performance and promotes neuroprotection in the elderly. The attractiveness of the low intensity, low cost, convenient, and socially fun nature of Tai Chi practice makes it a great treatment for the prevention of age related decline.


So, slow mental decline in the elderly with Tai Chi.


“Scientists . . . found increases in brain volume and improvements on tests of memory and thinking in Chinese seniors who practiced Tai Chi three times a week.” – Science Daily


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+ and on Twitter @MindfulResearch


Study Summary


Somporn Sungkarat, PhD, SirinunBoripuntakul, PhD, Sirinart Kumfu, PhD, Stephen R. Lord, PhD, Nipon Chattipakorn, MD, PhD. Tai Chi Improves Cognition and Plasma BDNF in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial. Neurorehabilitation and Neural Repair. First Published January 20, 2018,



Background. Effects of Tai Chi (TC) on specific cognitive function and mechanisms by which TC may improve cognition in older adults with amnestic mild cognitive impairment (a-MCI) remain unknown. Objective. To examine the effects of TC on cognitive functions and plasma biomarkers (brain-derived neurotrophic factor [BDNF], tumor necrosis factor-α [TNF-α], and interleukin-10 [IL-10]) in a-MCI. Methods. A total of 66 older adults with a-MCI (mean age = 67.9 years) were randomized to either a TC (n = 33) or a control group (n = 33). Participants in the TC group learned TC with a certified instructor and then practiced at home for 50 min/session, 3 times/wk for 6 months. The control group received educational material that covered information related to cognition. The primary outcome was cognitive performance, including Logical Memory (LM) delayed recall, Block Design, Digit Span, and Trail Making Test B minus A (TMT B-A). The secondary outcomes were plasma biomarkers, including BDNF, TNF-α, and IL-10. Results. At the end of the trial, performance on the LM and TMT B-A was significantly better in the TC group compared with the control group after adjusting for age, gender, and education (P < .05). Plasma BDNF level was significantly increased for the TC group, whereas the other outcome measures were similar between the 2 groups after adjusting for age and gender (P < .05). Conclusions. TC training significantly improved memory and the mental switching component of executive function in older adults with a-MCI, possibly via an upregulation of BDNF.

Change Major Depression Brain Chemistry with Mindfulness

MBCT Major Depression2 Li

By John M. de Castro, Ph.D.


“Mindfulness-based cognitive therapy helps participants in the classes to see more clearly the patterns of the mind; and to learn how to recognize when their mood is beginning to go down. It helps break the link between negative mood and the negative thinking that it would normally have triggered. Participants develop the capacity to allow distressing mood, thoughts and sensations to come and go, without having to battle with them. They find that they can stay in touch with the present moment, without having to ruminate about the past, or worry about the future.” – Center for Suicide Research


Major Depressive Disorder (MDD) is a severe mood disorder that includes mood dysregulation and cognitive impairment. It is estimated that 16 million adults in the U.S. (6.9% of the population suffered from major depression in the past year and affects females (8.4%) to a great extent than males (5.2%). It’s the second-leading cause of disability in the world following heart disease. It has also been shown that depression is, to a large extent, inherited, but can also be affected by the environment. Since the genes basically encode when, where, and how chemicals are produced, it is likely that there are changes in brain chemistry produced by the genes responsible for Major Depressive Disorder.


The usual treatment of choice for MDD is drug treatment. This supports the altered brain chemistry notion for MDD since the most effective treatment for MDD, drug treatment, changes brain chemistry. In fact, it is estimated that 10% of the U.S. population is taking some form of antidepressant medication. But a substantial proportion of patients (~40%) do not respond to drug treatment. In addition, the drugs can have nasty side effects. So, there is need to explore other treatment options.


Mindfulness meditation is a safe alternative that has been shown to be effective for major depressive disorder even in individuals who do not respond to drug treatment. Mindfulness Based Cognitive Therapy (MBCT) was developed specifically to treat depression and has been shown to be very effective in treating existing depression and preventing relapse when depression is in remission. It makes sense that if altered brain chemistry underlies MDD and that MBCT is an effective treatment for MDD, then MBCT must in some way change brain chemistry. In today’s Research News article “Evaluating metabolites in patients with major depressive disorder who received mindfulness-based cognitive therapy and healthy controls using short echo MRSI at 7 Tesla”

Li and colleagues explore brain chemistry changes in Major Depressive Disorder (MDD) and the effects of Mindfulness Based Cognitive Therapy (MBCT) on those brain chemistry changes.


They recruited patients who were diagnosed with MDD but who were not currently taking antidepressant drugs and who were not practicing meditation or yoga. The brains of these patients and healthy controls were scanned with a powerful imaging technique called Magnetic Resonance Spectroscopic Imaging (MRSI). It is capable of non-invasively detecting levels of particular chemicals in the brain. The patients then received an 8-week MBCT group therapy followed by rescanning of the brains for the same chemicals.


They found that the MDD patients compared to healthy controls had elevated levels of choline-containing compounds and decreased levels of N-acetyl aspartate, myo-inositol, and glutathione.

These chemicals are breakdown products of active brain chemicals (metabolites). These are all markers of brain function. The heightened levels of choline-containing compounds suggests that there is with increased cell density and/or membrane turnover in MDD. The decreased levels of N-acetyl aspartate suggest that there is a loss of neurons or neuronal function in MDD. The decreased levels of myo-inositol suggest that there is a loss of or dysfunction of glial cells in MDD. Finally, the decreased levels of glutathione suggest that there is a lower level of neuron excitation in the brain in MDD.


Importantly, Li and colleagues found that MBCT significantly reduced depression levels and at the same time normalized the levels of all of the metabolites that had abnormal levels in the patients. These are potentially important results. They demonstrate altered brain chemistry in MDD suggestive of dysfunction in the normal activities of the nervous system and point to potential causal factors in MDD. They also provide suggestions as to how MBCT changes the brain to effectively treat MDD.


It should be noted that the changes in metabolites in Major Depressive Disorder may be the result of the depression rather than its cause. The fact that the changes vanished after treatment reduced depression tends to support this contention. It is a complex disease effecting the most complex entity in the universe, the human brain. Hence, there is still a lot of work to do to determine the causal factors in MDD.


Regardless, change major depression brain chemistry with mindfulness.


 “Mindfulness is the only thing I know to do that can dig me out of despair and give me even a few seconds of time out from me,” – Ruby Wax


CMCS – Center for Mindfulness and Contemplative Studies