Acceptance and Commitment Therapy, a Mindfulness-Based Approach for Treatment of Chronic Musculoskeletal Pain

Completed · Not applicable

Conditions studied: Chronic Musculoskeletal Disease

In brief

Acceptance and Commitment Therapy (ACT) has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions. However, little is known about the neurologic mechanisms underlying ACT. The investigators conducted an ACT intervention in women (n=9) with chronic musculoskeletal pain. Functional magnetic resonance imaging (fMRI) data were collected pre- and post-ACT, and changes in functional connectivity (FC) were measured using Network-Based Statistics (NBS). Behavioral outcomes were measured using validated assessments such as the Acceptance \& Action Questionnaire (AAQ-II), the Chronic Pain Acceptance Questionnaire (CPAQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and the NIH Toolbox Neuro-QoLTM (Quality of Life in Neurological Disorders) scales. Results suggest that, following the four-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection (default mode, DMN), emotion (salience, SN), and cognitive control (frontal parietal, FPN). These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies.

Key facts

Study ID: NCT04502992
Run by: University of New Hampshire
People needed: 9
Starts: 2018-08-31
Expected to finish: 2020-06-15
Last updated by the study team: 2020-08-06

Who can join

Age: 18 and older, up to 65. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

greater than or equal to 18 years of age
Chronic musculoskeletal pain duration for greater than or equal to 3 months
Pain interference greater than or equal to 4 on Brief Pain Inventory (BPI; 0-10 scale)
No known contraindication to participate
Access to regular transportation
No plans to move or become pregnant in the next 3 months
MRI safe
Personal cell phone with the ability to receive text messages and access web-based material (e.g. short surveys)

You may not qualify if…

Unstable medical condition, including a movement disorder, such as restless leg syndrome or Parkinson's disease, a neurological disorder such as Alzheimer's disease, history of stroke or brain lesion, a psychiatric disorder such as schizophrenia or bipolar disorder
Significant cognitive impairment
Pregnancy(a test must be conducted on each scan day)
A recent history of: cancer, malignancy, accident or trauma, palliative care, acupuncture, chiropractic care, cognitive-based psychotherapy, other form of alternative care to treat pain condition
Metal in the body of any sort - implants, pacemaker, pins, screws

Where it is running

Communication Science and Disorders Research Laboratory, University of New Hampshier — Durham, New Hampshire, United States

Full record on ClinicalTrials.gov

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