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

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By bhadmin February 2, 2021

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.

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