# Mechanisms of Mindfulness Meditation and Self-Hypnosis for Pain in Older Adults with Chronic Pain

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2024 · $672,286

## Abstract

Abstract
Chronic pain is common and often inadequately treated in older individuals. Although opioids are often used to
treat chronic pain, their use in older adults is associated with increased rates of falls, fractures, and mortality.
Advancing our understanding of non-pharmacological chronic pain treatment in Americans ≥60 years of age
will substantially alleviate the burdens caused by this condition. Experimental pain paradigms mimic the
experience of clinical pain (both neuropathic via thermal paradigms, as well as musculoskeletal via mechanical
paradigms) and provide a rigorously controlled approach to advancing the understanding of pain treatments.
Two efficacious, non-pharmacological chronic pain treatments are mindfulness meditation (MM) and self-
hypnosis (HYP). Prior research using functional magnetic resonance imaging (fMRI) has shown MM and HYP
may target changes in both unique and shared central pain mechanisms. However, it is not yet known whether
these same neuromodulatory changes underlie treatment-related reductions in chronic pain in older persons.
Given that aging affects the prefrontal cortex and both MM and HYP effectively target this region, these
interventions may be particularly well suited to enhance descending inhibitory pain control in older adults via
prefrontal cortical mechanisms. There is also a critical lack of research examining patient characteristics that
moderate treatment outcome. Our preliminary research using electroencephalography (EEG) has identified
pre-treatment brain-state variables that may predict who benefits most from MM and HYP. To identify the
neuromodulatory mechanisms of MM and HYP for chronic pain in older individuals, the proposed study will
include formal statistical tests of both mediation and moderation in a fully-powered clinical trial with N = 375
older adults with chronic pain (enrolled). The design will employ a 3-arm (MM, HYP, attention control) trial,
resulting in tightly controlled tests of treatment mechanisms to accomplish the study aims. Treatment will
consist of four, 20-minute sessions delivered over four consecutive days. The primary outcome will be change
in chronic pain intensity from pre- to post-training. Aim 1 will use perfusion-based arterial spin labelling fMRI to
determine the neuromodulatory mediators of treatment-related chronic pain intensity reductions, relative to the
control. Aim 2 will identify pre-treatment psychological and EEG-assessed moderators of reduced chronic pain
intensity in response to MM and HYP, relative to the control condition. The knowledge gained from adequately
powered, formal tests of mediation will provide an empirical basis for developing more efficacious pain
interventions that may also have a preventative-medicine role in older adults, thereby reducing the public
health burden incurred with chronic pain in this population. Elucidating the moderators of MM and HYP will
inform precision medicine and will also optimize the cost-effectiveness...

## Key facts

- **NIH application ID:** 10800050
- **Project number:** 1R01AG079832-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Melissa Anne Day
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $672,286
- **Award type:** 1
- **Project period:** 2024-09-26 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10800050

## Citation

> US National Institutes of Health, RePORTER application 10800050, Mechanisms of Mindfulness Meditation and Self-Hypnosis for Pain in Older Adults with Chronic Pain (1R01AG079832-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10800050. Licensed CC0.

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