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. 2018 Summer;9(2):285-303.
doi: 10.1086/697685. Epub 2018 Apr 27.

Enhancing Natural Reward Responsiveness Among Opioid Users Predicts Chronic Pain Relief: EEG Analyses From a Trial of Mindfulness-Oriented Recovery Enhancement

Eric L Garland  1 , Matthew O Howard  2
Affiliations

Enhancing Natural Reward Responsiveness Among Opioid Users Predicts Chronic Pain Relief: EEG Analyses From a Trial of Mindfulness-Oriented Recovery Enhancement

Eric L Garland et al. J Soc Social Work Res. 2018 Summer.

Abstract

Objective: Although opioid-treated chronic pain patients evidence blunted responsiveness to natural rewards, focusing on naturally rewarding stimuli can produce analgesia in these patients. A prior randomized controlled trial (RCT) demonstrated that a social work intervention-Mindfulness-Oriented Recovery Enhancement (MORE)-enhanced natural reward processing as indicated by event-related brain potentials (ERPs). The aim of the present study was to perform a secondary data analysis on ERPs collected in this RCT to explore whether improvements in electrocortical response to natural reward predicted pain relief.

Method: The sample for this secondary analysis included opioid-treated chronic pain patients with complete ERP data (N = 29). Participants were randomized to 8 weeks of MORE or a support group control condition, and ERPs to images representing naturally rewarding stimuli were measured before and after 8 weeks of treatment. We explored associations between changes in brain reward response, chronic pain symptoms, and pain coping.

Results: Increases in ERP reward response were significantly associated with decreased pain severity from pretreatment to posttreatment (β = -.48, p = .007) and improvements in pain catastrophizing (β = -.36, p = .05) and diverting attention as a means of pain coping (β = .38, p = .043). Increased ERP reward response predicted decreased pain interference by 3-month follow-up (β = -.37, p = .048).

Conclusions: Chronic pain may be alleviated by enhancing brain response to natural rewards.

Keywords: chronic pain; late positive potential; mindfulness; opioid; reward.

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Figures

Figure 1
Figure 1
Effects of Mindfulness-Oriented Recovery Enhancement (MORE) versus a Support Group (SG) control condition on the late positive potential (LPP) of the EEG in response to natural reward-related images presented during an affective picture-viewing task, depicted in two time windows (400–700 ms and 700–1000 ms) following image onset. For a depiction of the entire event-related potential (ERP) time series from −150 ms to 1000 ms, see Garland et al. (2015b). LPP voltage is depicted in microvolts (μV), and time is represented in milliseconds (ms).
Figure 2
Figure 2
Scatterplot depicting within-group associations between pre–post treatment increases in natural reward late positive potential (LPP) response (in microvolts) and pre–post treatment decreases in pain severity (on the Brief Pain Inventory). Positive values indicate increases in LPP and pain severity.
Figure 3
Figure 3
Scatterplot depicting within-group associations between pre–post treatment increases in natural reward late positive potential (LPP) response (in microvolts) and pre–post treatment decreases in pain interference (on the Brief Pain Inventory). Positive values indicate increases in LPP and pain interference.
See this image and copyright information in PMC

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