Case Report: Zen meditation-integrated CBT normalized the impaired brain function of a chronic low back pain patient—from the findings of brain blood flow SPECT imaging

Abstract

Background: Mindfulness meditation for chronic pain is popular globally, but evidence of its efficacy is limited. Moreover, there are no established methods on the objective evaluation of the effectiveness of interventions for chronic pain. In this study, a chronic low back pain patient was treated with traditional Japanese Buddhism meditation-integrated cognitive behavioral therapy and the pre- and post-intervention brain single-photon emission computed tomography (SPECT) images were compared. Case: A 45-year-old man was experiencing continuous back pain after a vehicular accident and experienced insufficient improvement after drug treatment. The patient underwent a 3-month outpatient mindfulness meditation-integrated cognitive behavioral therapy program executed by a multidisciplinary team: physician visits (once a week for 30 min), multidisciplinary medical and meditation education (Zen breath counting meditation and mantra), physiotherapy interventions (twice weekly), occupational therapy interventions (twice weekly), psychiatric occupational therapy interventions (twice weekly), and nutritional interventions (twice weekly). After treatment, the patient reported a decrease in subjective pain overall, based on whether or not a pain attack occurred. Brain SPECT imaging revealed an improvement in excess blood flow from the right temporoparietal junction to the inferior parietal lobe. Conclusions: These findings indicate that Zen meditation is an effective intervention method for chronic pain and SPECT is a useful tool for measuring its effectiveness.