NCT04034004

Brief Summary

The purpose of this research study is to see if and how mindfulness meditation affects pain. Specifically, we are interested in assessing if mindfulness is associated with the release of naturally occurring opiates in the body, in response to intravenous (IV) administration of the opioid antagonist naloxone during a chronic low back pain provoking procedure.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
88

participants targeted

Target at P75+ for early_phase_1 pain

Timeline
Completed

Started Jan 2021

Typical duration for early_phase_1 pain

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 9, 2019

Completed
3 months until next milestone

First Posted

Study publicly available on registry

July 26, 2019

Completed
1.4 years until next milestone

Study Start

First participant enrolled

January 1, 2021

Completed
2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 22, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 22, 2022

Completed
8 months until next milestone

Results Posted

Study results publicly available

August 4, 2023

Completed
Last Updated

October 11, 2023

Status Verified

October 1, 2023

Enrollment Period

2 years

First QC Date

May 9, 2019

Results QC Date

February 9, 2023

Last Update Submit

October 4, 2023

Conditions

Keywords

MindfulnessOpioidsPainNaloxone

Outcome Measures

Primary Outcomes (1)

  • Pain Ratings

    Numerical pain ratings (NRS) will be assessed while lying on the back and in response to the straight leg raise test (SLR). Pain ratings will be collected during SLR 1 and SLR 2 in the baseline, saline and naloxone sessions, respectively. The 11 point scan will include a minimum rating of "0" which is characterized as "no pain" whereas the maximum ("10") is labeled as "most intense imaginable"." Higher numbers correspond to higher pain.

    Pain ratings were collected while lying supine and in response to the straight leg raise test. Collected twice, once in the first half and one in the second half of the baseline, saline infusion and naloxone infusion sessions. Up to 8 weeks total.

Secondary Outcomes (3)

  • Pain Catastrophizing Scale

    The Pain Catastrophizing Scale was administered at the baseline, post-intervention session 6 and session 7. Outcome measurements will compare change in Pain Catastrophizing Scale from baseline to session 7.

  • The Roland-Morris Disability Questionnaire (RMDQ)

    The Roland-Morris Disability Questionnaire was administered at the baseline, post-intervention session 6 and session 7. Outcome measurements will compare RMDQ from baseline to session 7.

  • Brief Pain Inventory (BPI)

    Administered at the baseline, post-intervention session 6 and post-intervention session 7. Outcome measurements will compare in BPI severity and interference from baseline to session 7.

Other Outcomes (1)

  • SF-12 Health Survey (SF-12) Physical Functioning

    Up to 8 weeks. Administered at visit 1, 6 and 7. Outcome measurements will compare SF-12 health survey from baseline to session 7.

Study Arms (2)

Meditation

EXPERIMENTAL

Subjects will participate in four sessions (20 min/session) of mindfulness training. Participants will be taught that perceived sensory events are "momentary" and "fleeting" and require no further evaluation.

Behavioral: MindfulnessDrug: NaloxoneOther: SalineBehavioral: Meditation

meditation

EXPERIMENTAL

Subjects will participate in four sessions (20 min/session) of mindfulness training. Participants will be taught that perceived sensory events are "momentary" and "fleeting" and require no further evaluation.

Behavioral: MindfulnessDrug: NaloxoneOther: SalineBehavioral: Meditation

Interventions

MindfulnessBEHAVIORAL

A well-validated brief meditation-based mental training regimen \[four sessions; 20 min/session\] is used to teach patients to independently practice closing their eyes and take a deep breath every few minutes.

Also known as: mental training
Meditationmeditation

A 0.15 mg/kg bolus dose of naloxone (Naloxone hydrochloride, Amphastar Pharmaceuticals, Inc., Rancho Cucamonga, California) in 25ml normal saline will be administered over 10 minutes. The investigators also will administer a supplementary IV infusion dose of 0.1mg/kg/hour naloxone immediately after bolus infusion will cease till the end of the experiment.

Meditationmeditation
SalineOTHER

A 0.15 mg/kg bolus dose of saline in 25ml normal saline will be administered over 10 minutes. The investigators also will administer a supplementary IV infusion dose of 0.1mg/kg/hour saline immediately after bolus infusion will cease till the end of the experiment.

Meditationmeditation
MeditationBEHAVIORAL

A well-validated brief meditation-based mental training regimen \[four sessions; 20 min/session\] is used to teach patients to independently practice closing their eyes and take a deep breath every few minutes.

Also known as: mental training
Meditationmeditation

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • 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
  • Participants must be between 18 and 65 years of age
  • Participants must rate their daily chronic pain intensity at a 3 or higher on 0-10 visual analog scale
  • Participants must have experienced their chronic low back pain for at least 3 months
  • Participants must have no prior meditative experience
  • Participants must be straight leg raise test positive

You may not qualify if:

  • 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 be taking opioids
  • Participants must not be pregnant or nursing mothers
  • Participants must have not had back surgery within the last year before their enrollment into the study
  • Participants must have not had any other sensory or motor deficits that preclude participation in this study
  • Participants must not have known anomalies of the central nervous system including: stroke, dementia, aneurysm, and a personal history of psychosis
  • Participants must not have any known allergies to naloxone or similar drugs
  • Participants must not have a history of syncope and/or fear of needles/blood

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Altman Clinical and Translational Research Institute

La Jolla, California, 92093, United States

Location

UC San Diego Center for Mindfulness

San Diego, California, 92122, United States

Location

Related Publications (55)

  • Anderson WS, Sheth RN, Bencherif B, Frost JJ, Campbell JN. Naloxone increases pain induced by topical capsaicin in healthy human volunteers. Pain. 2002 Sep;99(1-2):207-16. doi: 10.1016/s0304-3959(02)00103-3.

    PMID: 12237198BACKGROUND
  • Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999 Aug 14;354(9178):581-5. doi: 10.1016/S0140-6736(99)01312-4.

    PMID: 10470716BACKGROUND
  • Apkarian AV, Krauss BR, Fredrickson BE, Szeverenyi NM. Imaging the pain of low back pain: functional magnetic resonance imaging in combination with monitoring subjective pain perception allows the study of clinical pain states. Neurosci Lett. 2001 Feb 16;299(1-2):57-60. doi: 10.1016/s0304-3940(01)01504-x.

    PMID: 11166937BACKGROUND
  • Bencherif B, Fuchs PN, Sheth R, Dannals RF, Campbell JN, Frost JJ. Pain activation of human supraspinal opioid pathways as demonstrated by [11C]-carfentanil and positron emission tomography (PET). Pain. 2002 Oct;99(3):589-598. doi: 10.1016/S0304-3959(02)00266-X.

    PMID: 12406535BACKGROUND
  • Brown CA, Matthews J, Fairclough M, McMahon A, Barnett E, Al-Kaysi A, El-Deredy W, Jones AKP. Striatal opioid receptor availability is related to acute and chronic pain perception in arthritis: does opioid adaptation increase resilience to chronic pain? Pain. 2015 Nov;156(11):2267-2275. doi: 10.1097/j.pain.0000000000000299.

    PMID: 26176892BACKGROUND
  • Bruehl S, Burns JW, Passik SD, Gupta R, Buvanendran A, Chont M, Schuster E, Orlowska D, France CR. The Contribution of Differential Opioid Responsiveness to Identification of Opioid Risk in Chronic Pain Patients. J Pain. 2015 Jul;16(7):666-75. doi: 10.1016/j.jpain.2015.04.001. Epub 2015 Apr 16.

    PMID: 25892658BACKGROUND
  • Bruehl S, Chung OY. Parental history of chronic pain may be associated with impairments in endogenous opioid analgesic systems. Pain. 2006 Oct;124(3):287-294. doi: 10.1016/j.pain.2006.04.018. Epub 2006 May 24.

    PMID: 16725261BACKGROUND
  • Bruehl S, Chung OY, Burns JW, Biridepalli S. The association between anger expression and chronic pain intensity: evidence for partial mediation by endogenous opioid dysfunction. Pain. 2003 Dec;106(3):317-324. doi: 10.1016/S0304-3959(03)00319-1.

    PMID: 14659514BACKGROUND
  • Bruehl S, Chung OY, Burns JW, Diedrich L. Trait anger expressiveness and pain-induced beta-endorphin release: support for the opioid dysfunction hypothesis. Pain. 2007 Aug;130(3):208-215. doi: 10.1016/j.pain.2006.11.013. Epub 2007 Jan 2.

    PMID: 17197088BACKGROUND
  • Bruno PA, Millar DP, Goertzen DA. Inter-rater agreement, sensitivity, and specificity of the prone hip extension test and active straight leg raise test. Chiropr Man Therap. 2014 Jun 16;22:23. doi: 10.1186/2045-709X-22-23. eCollection 2014.

    PMID: 24982755BACKGROUND
  • Burns JW, Bruehl S, France CR, Schuster E, Orlowska D, Chont M, Gupta RK, Buvanendran A. Endogenous Opioid Function and Responses to Morphine: The Moderating Effects of Anger Expressiveness. J Pain. 2017 Aug;18(8):923-932. doi: 10.1016/j.jpain.2017.02.439. Epub 2017 Mar 30.

    PMID: 28365372BACKGROUND
  • Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Carragee E, Carrino J, Chou R, Cook K, DeLitto A, Goertz C, Khalsa P, Loeser J, Mackey S, Panagis J, Rainville J, Tosteson T, Turk D, Von Korff M, Weiner DK. Report of the NIH Task Force on Research Standards for Chronic Low Back Pain. Int J Ther Massage Bodywork. 2015 Sep 1;8(3):16-33. doi: 10.3822/ijtmb.v8i3.295. eCollection 2015 Sep.

    PMID: 26388962BACKGROUND
  • Deyo RA, Mirza SK, Turner JA, Martin BI. Overtreating chronic back pain: time to back off? J Am Board Fam Med. 2009 Jan-Feb;22(1):62-8. doi: 10.3122/jabfm.2009.01.080102.

    PMID: 19124635BACKGROUND
  • DosSantos MF, Martikainen IK, Nascimento TD, Love TM, Deboer MD, Maslowski EC, Monteiro AA, Vincent MB, Zubieta JK, DaSilva AF. Reduced basal ganglia mu-opioid receptor availability in trigeminal neuropathic pain: a pilot study. Mol Pain. 2012 Sep 24;8:74. doi: 10.1186/1744-8069-8-74.

    PMID: 23006894BACKGROUND
  • Fardon DF. Nomenclature and classification of lumbar disc pathology. Spine (Phila Pa 1976). 2001 Mar 1;26(5):461-2. doi: 10.1097/00007632-200103010-00007. No abstract available.

    PMID: 11242371BACKGROUND
  • Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J. 2014 Nov 1;14(11):2525-45. doi: 10.1016/j.spinee.2014.04.022. Epub 2014 Apr 24.

    PMID: 24768732BACKGROUND
  • Han B, Compton WM, Jones CM, Cai R. Nonmedical Prescription Opioid Use and Use Disorders Among Adults Aged 18 Through 64 Years in the United States, 2003-2013. JAMA. 2015 Oct 13;314(14):1468-78. doi: 10.1001/jama.2015.11859.

    PMID: 26461997BACKGROUND
  • Harris RE, Clauw DJ, Scott DJ, McLean SA, Gracely RH, Zubieta JK. Decreased central mu-opioid receptor availability in fibromyalgia. J Neurosci. 2007 Sep 12;27(37):10000-6. doi: 10.1523/JNEUROSCI.2849-07.2007.

    PMID: 17855614BACKGROUND
  • Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012 Jun;64(6):2028-37. doi: 10.1002/art.34347. Epub 2012 Jan 9.

    PMID: 22231424BACKGROUND
  • Institute of Medicine (US) Committee on Advancing Pain Research, Care, and Education. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington (DC): National Academies Press (US); 2011. Available from http://www.ncbi.nlm.nih.gov/books/NBK91497/

    PMID: 22553896BACKGROUND
  • Jacob JA. As Opioid Prescribing Guidelines Tighten, Mindfulness Meditation Holds Promise for Pain Relief. JAMA. 2016 Jun 14;315(22):2385-7. doi: 10.1001/jama.2016.4875. No abstract available.

    PMID: 27203730BACKGROUND
  • Jamison RN, Ross EL, Michna E, Chen LQ, Holcomb C, Wasan AD. Substance misuse treatment for high-risk chronic pain patients on opioid therapy: a randomized trial. Pain. 2010 Sep;150(3):390-400. doi: 10.1016/j.pain.2010.02.033. Epub 2010 Mar 23.

    PMID: 20334973BACKGROUND
  • Jones AK, Cunningham VJ, Ha-Kawa S, Fujiwara T, Luthra SK, Silva S, Derbyshire S, Jones T. Changes in central opioid receptor binding in relation to inflammation and pain in patients with rheumatoid arthritis. Br J Rheumatol. 1994 Oct;33(10):909-16. doi: 10.1093/rheumatology/33.10.909.

    PMID: 7921749BACKGROUND
  • Jones AK, Kitchen ND, Watabe H, Cunningham VJ, Jones T, Luthra SK, Thomas DG. Measurement of changes in opioid receptor binding in vivo during trigeminal neuralgic pain using [11C] diprenorphine and positron emission tomography. J Cereb Blood Flow Metab. 1999 Jul;19(7):803-8. doi: 10.1097/00004647-199907000-00011.

    PMID: 10413036BACKGROUND
  • Jones AK, Watabe H, Cunningham VJ, Jones T. Cerebral decreases in opioid receptor binding in patients with central neuropathic pain measured by [11C]diprenorphine binding and PET. Eur J Pain. 2004 Oct;8(5):479-85. doi: 10.1016/j.ejpain.2003.11.017.

    PMID: 15324779BACKGROUND
  • Klega A, Eberle T, Buchholz HG, Maus S, Maihofner C, Schreckenberger M, Birklein F. Central opioidergic neurotransmission in complex regional pain syndrome. Neurology. 2010 Jul 13;75(2):129-36. doi: 10.1212/WNL.0b013e3181e7ca2e.

    PMID: 20625165BACKGROUND
  • Kwong EH, Virani N, Robert M, Gerry K, Harding A, Rose MS, Dukelow SP, Barton PM. Inter-rater reliability of the Active Straight-Leg Raise and One-Leg Standing tests in non-pregnant women. J Rehabil Med. 2013 Nov;45(10):1058-64. doi: 10.2340/16501977-1213.

    PMID: 23995959BACKGROUND
  • Loggia ML, Kim J, Gollub RL, Vangel MG, Kirsch I, Kong J, Wasan AD, Napadow V. Default mode network connectivity encodes clinical pain: an arterial spin labeling study. Pain. 2013 Jan;154(1):24-33. doi: 10.1016/j.pain.2012.07.029. Epub 2012 Oct 27.

    PMID: 23111164BACKGROUND
  • Maarrawi J, Peyron R, Mertens P, Costes N, Magnin M, Sindou M, Laurent B, Garcia-Larrea L. Differential brain opioid receptor availability in central and peripheral neuropathic pain. Pain. 2007 Jan;127(1-2):183-94. doi: 10.1016/j.pain.2006.10.013. Epub 2006 Nov 29.

    PMID: 17137714BACKGROUND
  • Martikainen IK, Pecina M, Love TM, Nuechterlein EB, Cummiford CM, Green CR, Harris RE, Stohler CS, Zubieta JK. Alterations in endogenous opioid functional measures in chronic back pain. J Neurosci. 2013 Sep 11;33(37):14729-37. doi: 10.1523/JNEUROSCI.1400-13.2013.

    PMID: 24027273BACKGROUND
  • May LM, Kosek P, Zeidan F, Berkman ET. Enhancement of Meditation Analgesia by Opioid Antagonist in Experienced Meditators. Psychosom Med. 2018 Nov/Dec;80(9):807-813. doi: 10.1097/PSY.0000000000000580.

    PMID: 29595707BACKGROUND
  • Mens JM, Vleeming A, Snijders CJ, Stam HJ, Ginai AZ. The active straight leg raising test and mobility of the pelvic joints. Eur Spine J. 1999;8(6):468-73. doi: 10.1007/s005860050206.

    PMID: 10664304BACKGROUND
  • Nelson LS, Juurlink DN, Perrone J. Addressing the Opioid Epidemic. JAMA. 2015 Oct 13;314(14):1453-4. doi: 10.1001/jama.2015.12397. No abstract available.

    PMID: 26461995BACKGROUND
  • Ngai SH, Berkowitz BA, Yang JC, Hempstead J, Spector S. Pharmacokinetics of naloxone in rats and in man: basis for its potency and short duration of action. Anesthesiology. 1976 May;44(5):398-401. doi: 10.1097/00000542-197605000-00008.

    PMID: 1267205BACKGROUND
  • Rebain R, Baxter GD, McDonough S. A systematic review of the passive straight leg raising test as a diagnostic aid for low back pain (1989 to 2000). Spine (Phila Pa 1976). 2002 Sep 1;27(17):E388-95. doi: 10.1097/00007632-200209010-00025.

    PMID: 12221373BACKGROUND
  • Roussel NA, Nijs J, Truijen S, Smeuninx L, Stassijns G. Low back pain: clinimetric properties of the Trendelenburg test, active straight leg raise test, and breathing pattern during active straight leg raising. J Manipulative Physiol Ther. 2007 May;30(4):270-8. doi: 10.1016/j.jmpt.2007.03.001.

    PMID: 17509436BACKGROUND
  • Saloner B, Karthikeyan S. Changes in Substance Abuse Treatment Use Among Individuals With Opioid Use Disorders in the United States, 2004-2013. JAMA. 2015 Oct 13;314(14):1515-7. doi: 10.1001/jama.2015.10345. No abstract available.

    PMID: 26462001BACKGROUND
  • Sharma HA, Gupta R, Olivero W. fMRI in patients with lumbar disc disease: a paradigm to study patients over time. J Pain Res. 2011;4:401-5. doi: 10.2147/JPR.S24393. Epub 2011 Dec 7.

    PMID: 22247623BACKGROUND
  • Steglitz J, Buscemi J, Ferguson MJ. The future of pain research, education, and treatment: a summary of the IOM report "Relieving pain in America: a blueprint for transforming prevention, care, education, and research". Transl Behav Med. 2012 Mar;2(1):6-8. doi: 10.1007/s13142-012-0110-2.

    PMID: 24073092BACKGROUND
  • Summers B, Malhan K, Cassar-Pullicino V. Low back pain on passive straight leg raising: the anterior theca as a source of pain. Spine (Phila Pa 1976). 2005 Feb 1;30(3):342-5. doi: 10.1097/01.brs.0000152378.93868.c8.

    PMID: 15682017BACKGROUND
  • Thompson SJ, Pitcher MH, Stone LS, Tarum F, Niu G, Chen X, Kiesewetter DO, Schweinhardt P, Bushnell MC. Chronic neuropathic pain reduces opioid receptor availability with associated anhedonia in rat. Pain. 2018 Sep;159(9):1856-1866. doi: 10.1097/j.pain.0000000000001282.

    PMID: 29794614BACKGROUND
  • Wasan AD, Davar G, Jamison R. The association between negative affect and opioid analgesia in patients with discogenic low back pain. Pain. 2005 Oct;117(3):450-461. doi: 10.1016/j.pain.2005.08.006.

    PMID: 16154274BACKGROUND
  • Wasan AD, Loggia ML, Chen LQ, Napadow V, Kong J, Gollub RL. Neural correlates of chronic low back pain measured by arterial spin labeling. Anesthesiology. 2011 Aug;115(2):364-74. doi: 10.1097/ALN.0b013e318220e880.

    PMID: 21720241BACKGROUND
  • Zeidan F, Adler-Neal AL, Wells RE, Stagnaro E, May LM, Eisenach JC, McHaffie JG, Coghill RC. Mindfulness-Meditation-Based Pain Relief Is Not Mediated by Endogenous Opioids. J Neurosci. 2016 Mar 16;36(11):3391-7. doi: 10.1523/JNEUROSCI.4328-15.2016.

    PMID: 26985045BACKGROUND
  • Zeidan F, Emerson NM, Farris SR, Ray JN, Jung Y, McHaffie JG, Coghill RC. Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms Than Placebo and Sham Mindfulness Meditation-Induced Analgesia. J Neurosci. 2015 Nov 18;35(46):15307-25. doi: 10.1523/JNEUROSCI.2542-15.2015.

    PMID: 26586819BACKGROUND
  • Zeidan F, Gordon NS, Merchant J, Goolkasian P. The effects of brief mindfulness meditation training on experimentally induced pain. J Pain. 2010 Mar;11(3):199-209. doi: 10.1016/j.jpain.2009.07.015. Epub 2009 Oct 22.

    PMID: 19853530BACKGROUND
  • Zeidan F, Grant JA, Brown CA, McHaffie JG, Coghill RC. Mindfulness meditation-related pain relief: evidence for unique brain mechanisms in the regulation of pain. Neurosci Lett. 2012 Jun 29;520(2):165-73. doi: 10.1016/j.neulet.2012.03.082. Epub 2012 Apr 6.

    PMID: 22487846BACKGROUND
  • Zeidan F, Johnson SK, Diamond BJ, David Z, Goolkasian P. Mindfulness meditation improves cognition: evidence of brief mental training. Conscious Cogn. 2010 Jun;19(2):597-605. doi: 10.1016/j.concog.2010.03.014. Epub 2010 Apr 3.

    PMID: 20363650BACKGROUND
  • Zeidan F, Johnson SK, Gordon NS, Goolkasian P. Effects of brief and sham mindfulness meditation on mood and cardiovascular variables. J Altern Complement Med. 2010 Aug;16(8):867-73. doi: 10.1089/acm.2009.0321.

    PMID: 20666590BACKGROUND
  • Zeidan F, Lobanov OV, Kraft RA, Coghill RC. Brain mechanisms supporting violated expectations of pain. Pain. 2015 Sep;156(9):1772-1785. doi: 10.1097/j.pain.0000000000000231.

    PMID: 26083664BACKGROUND
  • Zeidan F, Martucci KT, Kraft RA, Gordon NS, McHaffie JG, Coghill RC. Brain mechanisms supporting the modulation of pain by mindfulness meditation. J Neurosci. 2011 Apr 6;31(14):5540-8. doi: 10.1523/JNEUROSCI.5791-10.2011.

    PMID: 21471390BACKGROUND
  • Zeidan F, Martucci KT, Kraft RA, McHaffie JG, Coghill RC. Neural correlates of mindfulness meditation-related anxiety relief. Soc Cogn Affect Neurosci. 2014 Jun;9(6):751-9. doi: 10.1093/scan/nst041. Epub 2013 Apr 24.

    PMID: 23615765BACKGROUND
  • Zubieta JK, Smith YR, Bueller JA, Xu Y, Kilbourn MR, Jewett DM, Meyer CR, Koeppe RA, Stohler CS. Regional mu opioid receptor regulation of sensory and affective dimensions of pain. Science. 2001 Jul 13;293(5528):311-5. doi: 10.1126/science.1060952.

    PMID: 11452128BACKGROUND
  • Zubieta JK, Smith YR, Bueller JA, Xu Y, Kilbourn MR, Jewett DM, Meyer CR, Koeppe RA, Stohler CS. mu-opioid receptor-mediated antinociceptive responses differ in men and women. J Neurosci. 2002 Jun 15;22(12):5100-7. doi: 10.1523/JNEUROSCI.22-12-05100.2002.

    PMID: 12077205BACKGROUND
  • Khatib L, Dean JG, Oliva V, Riegner G, Gonzalez NE, Birenbaum J, Cruanes GF, Miller J, Patterson M, Kim HC, Chakravarthy K, Zeidan F. The role of endogenous opioids in mindfulness and sham mindfulness-meditation for the direct alleviation of evoked chronic low back pain: a randomized clinical trial. Neuropsychopharmacology. 2024 Jun;49(7):1069-1077. doi: 10.1038/s41386-023-01766-2. Epub 2023 Nov 20.

MeSH Terms

Conditions

Pain

Interventions

MindfulnessNaloxoneSodium ChlorideMeditation

Condition Hierarchy (Ancestors)

Neurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Cognitive Behavioral TherapyBehavior TherapyPsychotherapyBehavioral Disciplines and ActivitiesMorphinansOpiate AlkaloidsAlkaloidsHeterocyclic CompoundsHeterocyclic Compounds, Bridged-RingHeterocyclic Compounds, 4 or More RingsHeterocyclic Compounds, Fused-RingPhenanthrenesPolycyclic Aromatic HydrocarbonsPolycyclic CompoundsChloridesHydrochloric AcidChlorine CompoundsInorganic ChemicalsSodium CompoundsMind-Body TherapiesComplementary TherapiesTherapeuticsSpiritual TherapiesRelaxation Therapy

Limitations and Caveats

The most significant limitation was performing highly invasive pain and pharmacologic testing during the coronavirus pandemic.

Results Point of Contact

Title
Dr. Fadel Zeidan
Organization
UC San Diego

Study Officials

  • Fadel Zeidan, PhD

    UC San Diego

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
early phase 1
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Only the study physician, research coordinator, and research pharmacist will be aware of drug assignments. Research staff (nurses; research technicians) and the PI will be blinded to drug assignment.
Purpose
BASIC SCIENCE
Intervention Model
CROSSOVER
Model Details: The study will employ a double blinded crossover factorial design. Baseline pain ratings will be assessed using visual analog scales obtained during three sessions where low back pain is induced. Study volunteers will participate in a four session (20min/session) meditation intervention. After meditation training, subjects will report to the UCSD Altman Clinical and Translational Research Institute across two separate experimental sessions. Half of the volunteers will be administered naloxone (opioid antagonist; 0.15 mg/kg bolus+ 0.1 mg/kg/hour infusion) and the other in the subsequent session will be administered IV placebo-saline, vice versa.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor

Study Record Dates

First Submitted

May 9, 2019

First Posted

July 26, 2019

Study Start

January 1, 2021

Primary Completion

December 22, 2022

Study Completion

December 22, 2022

Last Updated

October 11, 2023

Results First Posted

August 4, 2023

Record last verified: 2023-10

Locations