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Fedeli D, Ciullo G, Demichelis G, Medina Carrion JP, Bruzzone MG, Ciusani E, Erbetta A, Ferraro S, Grisoli M, Guastafierro E, D'Amico D, Raggi A, Nigri A, Grazzi L. Longitudinal neurofunctional changes in medication overuse headache patients after mindfulness practice in a randomized controlled trial (the MIND-CM study). J Headache Pain 2024; 25:97. [PMID: 38858629 PMCID: PMC11165872 DOI: 10.1186/s10194-024-01803-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/31/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Mindfulness practice has gained interest in the management of Chronic Migraine associated with Medication Overuse Headache (CM-MOH). Mindfulness is characterized by present-moment self-awareness and relies on attention control and emotion regulation, improving headache-related pain management. Mindfulness modulates the Default Mode Network (DMN), Salience Network (SN), and Fronto-Parietal Network (FPN) functional connectivity. However, the neural mechanisms underlying headache-related pain management with mindfulness are still unclear. In this study, we tested neurofunctional changes after mindfulness practice added to pharmacological treatment as usual in CM-MOH patients. METHODS The present study is a longitudinal phase-III single-blind Randomized Controlled Trial (MIND-CM study; NCT03671681). Patients had a diagnosis of CM-MOH, no history of neurological and severe psychiatric comorbidities, and were attending our specialty headache centre. Patients were divided in Treatment as Usual (TaU) and mindfulness added to TaU (TaU + MIND) groups. Patients underwent a neuroimaging and clinical assessment before the treatment and after one year. Longitudinal comparisons of DMN, SN, and FPN connectivity were performed between groups and correlated with clinical changes. Vertex-wise analysis was performed to assess cortical thickness changes. RESULTS 177 CM-MOH patients were randomized to either TaU group or TaU + MIND group. Thirty-four patients, divided in 17 TaU and 17 TaU + MIND, completed the neuroimaging follow-up. At the follow-up, both groups showed an improvement in most clinical variables, whereas only TaU + MIND patients showed a significant headache frequency reduction (p = 0.028). After one year, TaU + MIND patients showed greater SN functional connectivity with the left posterior insula (p-FWE = 0.007) and sensorimotor cortex (p-FWE = 0.026). In TaU + MIND patients only, greater SN-insular connectivity was associated with improved depression scores (r = -0.51, p = 0.038). A longitudinal increase in cortical thickness was observed in the insular cluster in these patients (p = 0.015). Increased anterior cingulate cortex thickness was also reported in TaU + MIND group (p-FWE = 0.02). CONCLUSIONS Increased SN-insular connectivity might modulate chronic pain perception and the management of negative emotions. Enhanced SN-sensorimotor connectivity could reflect improved body-awareness of painful sensations. Expanded cingulate cortex thickness might sustain improved cognitive processing of nociceptive information. Our findings unveil the therapeutic potential of mindfulness and the underlying neural mechanisms in CM-MOH patients. TRIAL REGISTRATION Name of Registry; MIND-CM study; Registration Number ClinicalTrials.gov identifier: NCT0367168; Registration Date: 14/09/2018.
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Affiliation(s)
- Davide Fedeli
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, Italy
| | - Giuseppe Ciullo
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, Italy
- Department of Medicine and Surgery, University of Parma, Via Volturno 39, Parma, 43125, Italy
| | - Greta Demichelis
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, Italy
| | - Jean Paul Medina Carrion
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, Italy
| | - Maria Grazia Bruzzone
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, Italy
| | - Emilio Ciusani
- Department of Diagnostic and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Alessandra Erbetta
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, Italy
| | - Stefania Ferraro
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, Italy
- School of Life Science and Technology, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Marina Grisoli
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, Italy
| | - Erika Guastafierro
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Domenico D'Amico
- Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Anna Nigri
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, Italy.
| | - Licia Grazzi
- Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
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Podvalny E, Sanchez-Romero R, Cole MW. Functionality of arousal-regulating brain circuitry at rest predicts human cognitive abilities. Cereb Cortex 2024; 34:bhae192. [PMID: 38745558 DOI: 10.1093/cercor/bhae192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 05/16/2024] Open
Abstract
Arousal state is regulated by subcortical neuromodulatory nuclei, such as locus coeruleus, which send wide-reaching projections to cortex. Whether higher-order cortical regions have the capacity to recruit neuromodulatory systems to aid cognition is unclear. Here, we hypothesized that select cortical regions activate the arousal system, which, in turn, modulates large-scale brain activity, creating a functional circuit predicting cognitive ability. We utilized the Human Connectome Project 7T functional magnetic resonance imaging dataset (n = 149), acquired at rest with simultaneous eye tracking, along with extensive cognitive assessment for each subject. First, we discovered select frontoparietal cortical regions that drive large-scale spontaneous brain activity specifically via engaging the arousal system. Second, we show that the functionality of the arousal circuit driven by bilateral posterior cingulate cortex (associated with the default mode network) predicts subjects' cognitive abilities. This suggests that a cortical region that is typically associated with self-referential processing supports cognition by regulating the arousal system.
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Affiliation(s)
- Ella Podvalny
- Center for Molecular and Behavioral Neuroscience, Rutgers University, 197 University Ave, Newark, NJ 07102, United States
| | - Ruben Sanchez-Romero
- Center for Molecular and Behavioral Neuroscience, Rutgers University, 197 University Ave, Newark, NJ 07102, United States
| | - Michael W Cole
- Center for Molecular and Behavioral Neuroscience, Rutgers University, 197 University Ave, Newark, NJ 07102, United States
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Joss D, Teicher MH, Lazar SW. Beneficial effects of mindfulness-based intervention on hippocampal volumes and episodic memory for childhood adversity survivors. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2024; 16:100769. [PMID: 38737193 PMCID: PMC11086948 DOI: 10.1016/j.jadr.2024.100769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background Adverse Childhood Experience (ACE) has detrimental impacts on neural development, especially hippocampal morphometry. Mindfulness-Based Interventions (MBI) has been shown to induce adaptive hippocampal changes especially at the subiculum. The present study aims to investigate the effects of MBI on subiculum volumes among ACE survivors, as well as the effects on episodic memory as a probe into hippocampal functionality. Methods We analyzed anatomical MRI data and performance indices from an episodic memory task called the Mnemonic Similarity Task (MST) collected from a randomized controlled longitudinal study that compared an 8-week MBI (N = 20) to an active control condition of Stress Management Education (SME) (N = 19). FreeSurfer 6.0 was used for automated hippocampal subfield segmentation and volumetric estimation. Results Significant group differences were observed with the volumetric changes of the right whole hippocampus and right subiculum. Only the MBI group showed improved pattern separation capability from MST, which was associated with stress reduction and right subiculum volumetric changes. Limitations Modest sample size. MST task was performed outside of MRI. Conclusions These findings suggest beneficial effects of MBI for hippocampal volumes and episodic memory, while highlighting the importance of the subiculum for MBI-induced neural and cognitive changes. The subiculum's known role in inhibitory control was interpreted as a potential mechanism for it to exhibit MBI-induced volumetric changes, which sheds light on the potential neural underpinnings of mindfulness meditation for reducing stress reactivity among ACE survivors.
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Affiliation(s)
- Diane Joss
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Martin H. Teicher
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Sara W. Lazar
- Department of Psychiatry, Massachusetts General Hospital, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
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Podvalny E, Sanchez-Romero R, Cole MW. Functionality of arousal-regulating brain circuitry at rest predicts human cognitive abilities. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.09.574917. [PMID: 38617344 PMCID: PMC11014470 DOI: 10.1101/2024.01.09.574917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Arousal state is regulated by subcortical neuromodulatory nuclei, such as locus coeruleus, which send wide-reaching projections to cortex. Whether higher-order cortical regions have the capacity to recruit neuromodulatory systems to aid cognition is unclear. Here, we hypothesized that select cortical regions activate the arousal system, which in turn modulates large-scale brain activity, creating a functional circuit predicting cognitive ability. We utilized the Human Connectome Project 7T functional magnetic resonance imaging dataset (N=149), acquired at rest with simultaneous eye tracking, along with extensive cognitive assessment for each subject. First, we discovered select frontoparietal cortical regions that drive large-scale spontaneous brain activity specifically via engaging the arousal system. Second, we show that the functionality of the arousal circuit driven by bilateral posterior cingulate cortex (associated with the default mode network) predicts subjects' cognitive abilities. This suggests that a cortical region that is typically associated with self-referential processing supports cognition by regulating the arousal system.
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Affiliation(s)
- Ella Podvalny
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA
| | - Ruben Sanchez-Romero
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA
| | - Michael W. Cole
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA
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Torske A, Bremer B, Hölzel BK, Maczka A, Koch K. Mindfulness meditation modulates stress-eating and its neural correlates. Sci Rep 2024; 14:7294. [PMID: 38538663 PMCID: PMC10973375 DOI: 10.1038/s41598-024-57687-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/20/2024] [Indexed: 04/07/2024] Open
Abstract
Stress-related overeating can lead to excessive weight gain, increasing the risk of metabolic and cardiovascular disease. Mindfulness meditation has been demonstrated to reduce stress and increase interoceptive awareness and could, therefore, be an effective intervention for stress-related overeating behavior. To investigate the effects of mindfulness meditation on stress-eating behavior, meditation-naïve individuals with a tendency to stress-eat (N = 66) participated in either a 31-day, web-based mindfulness meditation training or a health training condition. Behavioral and resting-state fMRI data were acquired before and after the intervention. Mindfulness meditation training, in comparison to health training, was found to significantly increase mindfulness while simultaneously reducing stress- and emotional-eating tendencies as well as food cravings. These behavioral results were accompanied by functional connectivity changes between the hypothalamus, reward regions, and several areas of the default mode network in addition to changes observed between the insula and somatosensory areas. Additional changes between seed regions (i.e., hypothalamus and insula) and brain areas attributed to emotion regulation, awareness, attention, and sensory integration were observed. Notably, these changes in functional connectivity correlated with behavioral changes, thereby providing insight into the underlying neural mechanisms of the effects of mindfulness on stress-eating.Clinical trial on the ISRCTN registry: trial ID ISRCTN12901054.
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Affiliation(s)
- Alyssa Torske
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, Munich, Germany.
- TUM-Neuroimaging Center (TUM-NIC), Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany.
- Graduate School of Systemic Neurosciences, Ludwig Maximilians Universität München, Martinsried, Germany.
| | - Benno Bremer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center (TUM-NIC), Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Britta Karen Hölzel
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center (TUM-NIC), Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Alexander Maczka
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center (TUM-NIC), Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Kathrin Koch
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center (TUM-NIC), Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig Maximilians Universität München, Martinsried, Germany
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Anthony M, Turnbull A, Tadin D, Lin FV. Positive affect disrupts neurodegeneration effects on cognitive training plasticity in older adults. Soc Cogn Affect Neurosci 2024; 19:nsae004. [PMID: 38252656 PMCID: PMC10939393 DOI: 10.1093/scan/nsae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 11/02/2023] [Accepted: 01/18/2024] [Indexed: 01/24/2024] Open
Abstract
Cognitive training for older adults varies in efficacy, but it is unclear why some older adults benefit more than others. Positive affective experience (PAE), referring to high positive valence and/or stable arousal states across everyday scenarios, and associated functional networks can protect plasticity mechanisms against Alzheimer's disease neurodegeneration, which may contribute to training outcome variability. The objective of this study is to investigate whether PAE explains variability in cognitive training outcomes by disrupting the adverse effect of neurodegeneration on plasticity. The study's design is a secondary analysis of a randomized control trial of cognitive training with concurrent real or sham brain stimulation (39 older adults with mild cognitive impairment; mean age, 71). Moderation analyses, with change in episodic memory or executive function as the outcome, PAE or baseline resting-state connectivity as the moderator and baseline neurodegeneration as the predictor are the methods used in the study. The result of the study is that PAE stability and baseline default mode network (DMN) connectivity disrupted the effect of neurodegeneration on plasticity in executive function but not episodic memory. The study concludes that PAE stability and degree of DMN integrity both explained cognitive training outcome variability, by reducing the adverse effect of neurodegeneration on cognitive plasticity. We highlight the need to account for PAE, brain aging factors and their interactions with plasticity in cognitive training.
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Affiliation(s)
- Mia Anthony
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY 14627, USA
- Department of Psychiatry and Behavioral Science, Stanford University, Palo Alto, CA 94304, USA
| | - Adam Turnbull
- Department of Psychiatry and Behavioral Science, Stanford University, Palo Alto, CA 94304, USA
| | - Duje Tadin
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY 14627, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY 14642, USA
- Center for Visual Science, University of Rochester, Rochester, NY 14627, USA
| | - F Vankee Lin
- Department of Psychiatry and Behavioral Science, Stanford University, Palo Alto, CA 94304, USA
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Rahrig H, Ma L, Brown KW, Martelli AM, West SJ, Lasko EN, Chester DS. Inside the mindful moment: The effects of brief mindfulness practice on large-scale network organization and intimate partner aggression. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:1581-1597. [PMID: 37880570 PMCID: PMC10842035 DOI: 10.3758/s13415-023-01136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/27/2023]
Abstract
Mindfulness can produce neuroplastic changes that support adaptive cognitive and emotional functioning. Recently interest in single-exercise mindfulness instruction has grown considerably because of the advent of mobile health technology. Accordingly, the current study sought to extend neural models of mindfulness by investigating transient states of mindfulness during single-dose exposure to focused attention meditation. Specifically, we examined the ability of a brief mindfulness induction to attenuate intimate partner aggression via adaptive changes to intrinsic functional brain networks. We employed a dual-regression approach to examine a large-scale functional network organization in 50 intimate partner dyads (total n = 100) while they received either mindfulness (n = 50) or relaxation (n = 50) instruction. Mindfulness instruction reduced coherence within the Default Mode Network and increased functional connectivity within the Frontoparietal Control and Salience Networks. Additionally, mindfulness decoupled primary visual and attention-linked networks. Yet, this induction was unable to elicit changes in subsequent intimate partner aggression, and such aggression was broadly unassociated with any of our network indices. These findings suggest that minimal doses of focused attention-based mindfulness can promote transient changes in large-scale brain networks that have uncertain implications for aggressive behavior.
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Affiliation(s)
- Hadley Rahrig
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA.
| | - Liangsuo Ma
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kirk Warren Brown
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Carnegie Mellon University, Pittsburgh, PA, USA
| | | | | | - Emily N Lasko
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - David S Chester
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Lu C, Moliadze V, Nees F. Dynamic processes of mindfulness-based alterations in pain perception. Front Neurosci 2023; 17:1253559. [PMID: 38027503 PMCID: PMC10665508 DOI: 10.3389/fnins.2023.1253559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Mindfulness-based processes have been shown to enhance attention and related behavioral responses, including analgesia, which is discussed as an effective method in the context of pain interventions. In the present review, we introduce the construct of mindfulness, delineating the concepts, factors, and processes that are summarized under this term and might serve as relevant components of the underlying mechanistic pathways in the field of pain. We also discuss how differences in factors such as definitions of mindfulness, study design, and strategies in mindfulness-based attention direction may need to be considered when putting the findings from previous studies into a whole framework. In doing so, we capitalize on a potential dynamic process model of mindfulness-based analgesia. In this respect, the so-called mindfulness-based analgesia may initially result from improved cognitive regulation strategies, while at later stages of effects may be driven by a reduction of interference between both cognitive and affective factors. With increasing mindfulness practice, pathways and mechanisms of mindfulness analgesia may change dynamically, which could result from adaptive coping. This is underlined by the fact that the neural mechanism of mindfulness analgesia is manifested as increased activation in the ACC and aINS at the beginner level while increased activation in the pINS and reduced activation in the lPFC at the expert level.
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Affiliation(s)
| | | | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
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de Entrambasaguas M, Díaz-Silveira C, Burgos-Julián FA, Santed MA. Can mindfulness-based interventions improve outcomes in cognitive-behavioural therapy for chronic insomnia disorder in the general population? Systematic review and meta-analysis. Clin Psychol Psychother 2023; 30:965-978. [PMID: 37271575 DOI: 10.1002/cpp.2874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023]
Abstract
Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first-line therapy for adults with chronic insomnia disorder (ID), which is characterized by hyperarousal. Mindfulness-based interventions (MBIs) are protocols aimed at stress reduction based on non-judgmental attention control in the present moment. However, MBIs have been increasingly used without a clear scientific basis. The objective of this analysis was to examine if MBIs could be useful as a component of the CBT-I therapeutic system through a systematic review and meta-analysis of randomized controlled trials (RCTs) and non-randomized studies (NRS) searched in PubMed, PsycINFO, Cochrane and WoS. The Insomnia Severity Index (ISI) was the primary outcome, while the Pittsburgh Sleep Quality Index (PSQI) and a composite sleep variable (CSV) were secondary outcomes. Thirteen articles corresponding to nine studies (three pragmatic RCTs, three explanatory RCTs and three NRS) were included. The omnibus test found that MBIs had a small to medium effect size on ISI nearing signification when comparing active control groups in the pretest-posttest period [Δ = 0.44, p = 0.07], a medium, non-significant, effect size on PSQI [Δ = 0.52, p = 0.18], and a significant though small effect size on CSV [Δ = 0.05, p < 0.01]. No heterogeneity was found. The analysis could not demonstrate that MBIs, combined with CBT-I components in some studies, positively affected ID in the general adult population. This was probably due to the lack of pragmatic designs and suitable measuring instruments. Recommendations are made for designing further studies to address these issues.
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Affiliation(s)
- Manuel de Entrambasaguas
- Sleep Unit, Clinical Neurophysiology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Cintia Díaz-Silveira
- Department of Psychology, Health of Sciences Campus, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - Miguel A Santed
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Bang M, Kim B, Lee KS, Choi TK, Lee SH. Long-term benefits of mindfulness on white matter tracts underlying the cortical midline structures in panic disorder: A 2-year longitudinal study. Psychiatry Clin Neurosci 2023; 77:355-364. [PMID: 36917206 DOI: 10.1111/pcn.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023]
Abstract
AIMS We aimed to examine the long-term benefits of mindfulness-based cognitive therapy (MBCT) on white matter plasticity in the cortical midline structures (CMS) for a period of 2 years in patients with panic disorder and the relationships between white matter changes in the CMS and severity of state and trait symptoms. METHODS Seventy-one participants were enrolled and underwent diffusion tensor imaging at baseline and after 2 years (26 who received MBCT as an adjunct to pharmacotherapy [MBCT+PT], 20 treated with pharmacotherapy alone [PT-alone], and 25 healthy controls [HCs]). The severity of symptoms and fractional anisotropy (FA) in white matter regions underlying the CMS were assessed at baseline and 2-year follow-up. RESULTS The MBCT+PT group showed better outcomes after 2 years than the PT-alone group. The groups showed different FA changes: the MBCT+PT group showed decreased FA in the left anterior cingulate cortex (ACC); the PT-alone group showed increased FA in the bilateral dorsomedial prefrontal cortex, posterior cingulate cortex (PCC), and precuneus. Decreased white matter FA in the ACC, PCC, and precuneus was associated with improvements in the severity of state and trait symptoms in patients with panic disorder. CONCLUSION Alleviation of excessive white matter connectivity in the CMS after MBCT leads to improvements in clinical symptoms and trait vulnerability in patients with panic disorder. Our study provides new evidence for the long-term benefits of MBCT on white matter plasticity and its clinical applicability as a robust treatment for panic disorder.
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Affiliation(s)
- Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Borah Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Kang Soo Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
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