Mindfulness and Chronic Low Back Pain

NCT ID: NCT03354585

Last Updated: 2024-04-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-02

Study Completion Date

2024-02-05

Brief Summary

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The purpose of this study is to see if mindfulness, a form of mental training, or listening to a book alters brain activation in response to raising your leg that may produce the feeling of pain. A technique called functional magnetic resonance imaging (fMRI) allows scientists to determine which parts of the brain are active during a particular task. This study will provide new information about how mindfulness affects the brain.

Detailed Description

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To determine if mindfulness meditation-induced reductions in chronic low back pain (cLBP) patients will be associated with greater anterior insula (aINS), orbitofrontal cortex (OFC), subgenual anterior cingulate cortex (sgACC), and/or thalamic deactivation when compared to rest, the sham-mindfulness meditation and the book-listening control groups. One-hundred and twenty individuals will be randomized to a mindfulness meditation (n=40), non-mindfulness meditation (n=40) and book-listening-control (n=40). Each participants will be administered noxious heat and the chronic low back pain evoking, straight leg raise test during fMRI.

Conditions

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Chronic Low Back Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This intervention study will utilize an unbiased randomized study design. Pain intensity and pain unpleasantness ratings will be assessed using before and after all sessions where low back pain is induced. Study volunteers will be randomized and subsequently participate in a six session mindfulness meditation, non-mindfulness meditation or book-listening control regimen. Study volunteers will be required to complete two MRI scans over the course of the study.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Only the study physician, research coordinator, and intervention facilitators will be aware of group assignment.

Study Groups

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mindfulness group

Study volunteers will participate in a six-session meditation training regimen. In brief, subjects will be taught that perceived sensory events are "momentary" and "fleeting" and do not require further evaluation. There will be an emphasis on breath focus and altering one's perspective of discursive sensory events. This intervention has been found to reliably attenuate the subjective experience of pain.

Group Type EXPERIMENTAL

mindfulness training

Intervention Type BEHAVIORAL

A well-validated brief mindfulness-based mental training regimen \[20 min/session(s)\] will be used to teach patients to independently practice mindfulness. Participants will be asked to close their eyes acknowledge distracting thoughts and feelings.

non-mindfulness group

Study volunteers will participate in a six-session meditation training regimen. In brief, subjects will be taught to take deep breaths and relax.

Group Type SHAM_COMPARATOR

non-mindfulness training

Intervention Type BEHAVIORAL

A well-validated brief meditation-based mental training regimen \[20 min/session(s)\] will be used to teach patients to independently practice deep breathing. Participants will be asked to close their eyes acknowledge distracting thoughts and feelings.

book-listening

Study volunteers will listen to an audio recording of the Natural History of Selborne across each session.This 6 session intervention is meant to provide the control attention to the facilitator, room setting, social support, conditioning, and the time elapsed during the other respective interventions. We do not expect that this group will demonstrate significant cerebral blood flow changes as a function of the intervention.

Group Type ACTIVE_COMPARATOR

book-listening

Intervention Type BEHAVIORAL

Study volunteers will listen to The Natural History and Antiquities of Selborne throughout the intervention.

Interventions

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mindfulness training

A well-validated brief mindfulness-based mental training regimen \[20 min/session(s)\] will be used to teach patients to independently practice mindfulness. Participants will be asked to close their eyes acknowledge distracting thoughts and feelings.

Intervention Type BEHAVIORAL

non-mindfulness training

A well-validated brief meditation-based mental training regimen \[20 min/session(s)\] will be used to teach patients to independently practice deep breathing. Participants will be asked to close their eyes acknowledge distracting thoughts and feelings.

Intervention Type BEHAVIORAL

book-listening

Study volunteers will listen to The Natural History and Antiquities of Selborne throughout the intervention.

Intervention Type BEHAVIORAL

Other Intervention Names

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mental training mental training

Eligibility Criteria

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Inclusion Criteria

* Participants must have a medical evaluation that demonstrates chronic low back pain that is evoked by lifting the legs. Existing medical records, per physician discretion and low back examinations will confirm diagnosis. This will be determined over the phone during the (pre) screening and at study session 1, and will not be contingent on MRI.
* Participants must be between the ages of 18-65 years.
* Participants must rate their daily chronic pain intensity at a 3 or greater on 0-10 visual analog scale.
* Participants must have experienced their radicular pain for at least 3 months duration.
* Participants must be right-handed.
* Participants must have no prior meditative experience

Exclusion Criteria

* Participants must not be participating in any new (within 2 weeks prior or anytime after enrollment) pain management procedures during the study period.
* Participants must not have had back surgery within the last year before their enrollment into the study.
* Participants must not have had any other sensory or motor deficits that precludes participation in this study.
* Participants must not have known anomalies of the central nervous system including: stroke, dementia, aneurysm, a personal history of psychosis.
* Participants must not have metal implants including ferrous arterial stints or coils, spinal stimulators, pacemakers, or defibrillators, permanently implanted hearing aides, bullets, BBs, or pellets, retinal eye implants, infusion pump for insulin or other medicines, ferrous surgical clips, staples, metal sutures, orthopedic hardware above or including the shoulders, body piercings that cannot be removed.
* Participants must not be claustrophobic.
* Participants must not produce negative straight leg test (i.e. a test is considered positive when the person reports reproducible pain at 40 degrees of hip flexion or less).
* Participants must not be pregnant
* Participants must not be over 275 pounds
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of California, San Diego

OTHER

Sponsor Role lead

Responsible Party

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Fadel Zeidan

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Fadel Zeidan, PhD

Role: PRINCIPAL_INVESTIGATOR

Principal Investigator

Locations

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UC San Diego

La Jolla, California, United States

Site Status

UC San Diego Center for Functional MRI

La Jolla, California, United States

Site Status

Countries

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United States

References

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Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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181814

Identifier Type: -

Identifier Source: org_study_id

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