Previous studies have provided some evidence that Mindfulness-Based Stress Reduction (MBSR) may be beneficial for patients with chronic pain. This effect may be mediated by an improved ability to regulate emotional responses to pain due to improved attentional control. Event-Related Potentials (ERPs) are useful for measuring the time-course of anticipatory and pain-evoked responses and their modulation by attention. We aim to investigate whether improved attentional modulation of pain-evoked potentials mediate the clinical outcome of a 9-week mindfulness-based pain management program in a group of patients with chronic musculoskeletal pain. 40 patients with chronic pain will be split into intervention (mindfulness-based pain management) and control (usual treatment) groups. Before and after the intervention (or a period of the same duration for the control group) we will measure anticipatory and pain-evoked potentials as patients attend to either the sensory characteristics of a laser pain stimulus (i.e. its location), or its emotional aspects (i.e. its unpleasantness) in different blocks. We will determine the extent to which attention is able to modulate pain processing in regions of the brain associated with pain affect. We will also take a number of behavioral and psychometric measures of attention, affect and awareness in order to explain the changes in the ERP data. These will include the Continuous Performance Task (CPT) with and with pain distractions, pain threshold and tolerance, the Implicit Association Test, and questionnaire measures of attention, mindfulness, implicit and explicit emotional state, and acceptance of pain. Results: Data to be collected between October 2008 and July 2009. Conclusion: We are currently in the process of collecting for this study, and anticipate being in a position to report the results by the end of 2009.

Christopher Brown

University of Manchester