Brief meditation training induces smoking reduction

Efficacy and Neural Mechanisms of Mindfulness Meditation Among Adults With Internet Gaming Disorder: A Randomized Clinical Trial

Importance

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), recently identified internet gaming disorder (IGD) as a condition warranting more research, and few empirically validated treatments exist. Mindfulness meditation (MM) has multiple health benefits; however, its efficacy in treating IGD and potential neural mechanisms underlying MM treatment of the disorder remain largely unknown.

Objective

To explore the efficacy of MM used to treat adults with IGD and to identify neural mechanisms underlying MM.

Design, Setting, and Participants

This randomized clinical trial was performed from October 1 to November 30, 2023, at Hangzhou Normal University in Hangzhou, China. Adults (aged ≥18 years) who met at least 6 of the 9 DSM-5-TR proposed criteria for IGD were recruited to receive either MM or progressive muscle relaxation (PMR). Data analysis was performed on December 1, 2023.

Intervention

Participants underwent MM training (an 8-session meditation program that focuses on attention and acceptance) and PMR training (an 8-time program for body relaxation) delivered in groups that met 2 times each week for 4 weeks.

Main Outcomes and Measures

This per-protocol analysis included only participants who finished the pretest assessment, 8 training sessions, and posttest assessment. The main outcomes were addiction severity (measured with the DSM-5-TR proposed criteria for IGD and with Internet Addiction Test scores), gaming craving (measured with Questionnaire for Gaming Urges scores), and blood oxygen level-dependent signals assessed with cue-craving tasks on fMRI. Behavioral and brain measurements were compared using analysis of variance. Functional connectivity (FC) among identified brain regions was measured to test connectivity changes associated with MM.

Results

This study included 64 adults with IGD. A total of 32 participants received MM (mean [SD] age, 20.3 [1.9] years; 17 women [53%]) and 32 received PMR (mean [SD] age, 20.2 [1.5] years; 16 women [50%]). The severity of IGD decreased in the MM group (pretest vs posttest: mean [SD], 7.0 [1.1] vs 3.6 [0.8]; P < .001) and in the PMR group (mean [SD], 7.1 [0.9] vs 6.0 [0.9]; P = .04). The MM group had a greater decrease in IGD severity than the PMR group (mean [SD] score change for the MM group vs the PMR group, -3.6 [0.3] vs -1.1 [0.2]; P < .001). Mindfulness meditation was associated with decreased brain activation in the bilateral lentiform nuclei (r = 0.40; 95% CI, 0.19 to 0.60; P = .02), insula (r = 0.35; 95% CI, 0.09 to 0.60; P = .047), and medial frontal gyrus (MFG; r = 0.43; 95% CI, 0.16 to 0.70; P = .01). Increased MFG-lentiform FC and decreased craving (pretest vs posttest: mean [SD], 58.8 [15.7] vs 33.6 [12.0]; t = -8.66; ƞ2 = 0.30; P < .001) was observed after MM, and changes in MFG-lentiform FC mediated the relationship between increased mindfulness and decreased craving (mediate effect, -0.17; 95% CI, -0.32 to -0.08; P = .03).

Conclusions and Relevance

In this study, MM was more effective in decreasing addiction severity and gaming cravings compared with PMR. These findings indicate that MM may be an effective treatment for IGD and may exert its effects by altering frontopallidal pathways.

Trial Registration

Chinese Clinical Trial Registry Identifier: ChiCTR2300075869.

The Effectiveness of Mindfulness in the Treatment of Methamphetamine Addiction Symptoms: Does Neuroplasticity Play a Role?

INTRODUCTION

Methamphetamine is a highly stimulating psychoactive drug that causes life-threatening addictions and affects millions of people around the world. Its effects on the brain are complex and include disturbances in the neurotransmitter systems and neurotoxicity. There are several known treatment methods, but their effectiveness is moderate. It must be emphasised that no drugs have been approved for treatment. For this reason, there is an urgent need to develop new, effective, and safe treatments for methamphetamine. One of the potential treatments is mindfulness meditation. In recent years, this technique has been researched extensively in the context of many neurological and psychiatric disorders.

METHODS

This review explores the use of mindfulness in the treatment of methamphetamine addiction. Searches were conducted in the PubMed/Medline, Research Gate, and Cochrane databases.

RESULTS

Ten studies were identified that used mindfulness-based interventions in the treatment of methamphetamine addiction. The results show that mindfulness is an effective form of reducing hunger, risk of relapses, stress indicators, depression, and aggression, alone or in combination with transcranial direct current stimulation (tDCS). Mindfulness also improved the cognitive function in addicts. The included studies used only behavioural measures. The potential mechanisms of mindfulness in addiction were explained, and it was proposed that it can induce neuroplasticity, alleviating the symptoms of addiction.

CONCLUSIONS

Evidence from the studies suggest that mindfulness may be an effective treatment option for methamphetamine addiction, used alone or in combination with tDCS. However, further high-quality research is required to establish the role of this treatment option in this field. The use of neuroimaging and neurophysiological measures is fundamental to understand the mechanisms of mindfulness.

The resting-state brain activity signatures for addictive disorders

BACKGROUND

Addiction is a chronic and relapsing brain disorder. Despite numerous neuroimaging and neurophysiological studies on individuals with substance use disorder (SUD) or behavioral addiction (BEA), currently a clear neural activity signature for the addicted brain is lacking.

METHODS

We first performed systemic coordinate-based meta-analysis and partial least-squares regression to identify shared or distinct brain regions across multiple addictive disorders, with abnormal resting-state activity in SUD and BEA based on 46 studies (55 contrasts), including regional homogeneity (ReHo) and low-frequency fluctuation amplitude (ALFF) or fractional ALFF. We then combined Neurosynth, postmortem gene expression, and receptor/transporter distribution data to uncover the potential molecular mechanisms underlying these neural activity signatures.

FINDINGS

The overall comparison between addiction cohorts and healthy subjects indicated significantly increased ReHo and ALFF in the right striatum (putamen) and bilateral supplementary motor area, as well as decreased ReHo and ALFF in the bilateral anterior cingulate cortex and ventral medial prefrontal cortex, in the addiction group. On the other hand, neural activity in cingulate cortex, ventral medial prefrontal cortex, and orbitofrontal cortex differed between SUD and BEA subjects. Using molecular analyses, the altered resting activity recapitulated the spatial distribution of dopaminergic, GABAergic, and acetylcholine system in SUD, while this also includes the serotonergic system in BEA.

CONCLUSIONS

These results indicate both common and distinctive neural substrates underlying SUD and BEA, which validates and supports targeted neuromodulation against addiction.

FUNDING

This work was supported by the National Natural Science Foundation of China and Intramural Research Program of the National Institute on Drug Abuse, National Institutes of Health.

Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders

The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.

Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions

This review provides an overview of the most prominent neurocognitive effects of cognitive bias modification (CBM), cue-exposure therapy and mindfulness interventions for targeting addictive responses. It highlights the key insights that have stemmed from cognitive neuroscience and brain imaging research and combines these with insights from behavioural science in building a conceptual model integrating mindfulness with response-focused CBM or cue-exposure interventions. This furthers our understanding of whether and how mindfulness strategies may i) facilitate or add to the induced response-focused effects decreasing cue-induced craving, and ii) further weaken the link between craving and addictive responses. Specifically, awareness/monitoring may facilitate, and decentering may add to, response-focused effects. Combined awareness acceptance strategies may also diminish the craving-addiction link. The conceptual model presented in this review provides a specific theoretical framework to deepen our understanding of how mindfulness strategies and CBM or cue-exposure interventions can be combined to greatest effect. This is important in both suggesting a roadmap for future research, and for the further development of clinical interventions.

Optimizing Dietary Patterns and Lifestyle to Reduce Atherosclerotic Cardiovascular Risk Among South Asian Individuals

South Asians are at an elevated risk of atherosclerotic cardiovascular disease (ASCVD) when compared with other age-matched subjects of varied ethnicities. The elevated ASCVD risk is multifactorial including a constellation of hypertension, dyslipidemia, metabolic syndrome, overweight/obesity, prediabetes, and type 2 diabetes mellitus. Although traditional ASCVD risk factors remain highly prevalent in South Asians living in the United States, modifiable risk factors of diet, lack of physical activity/increased sedentary time, smoking (of all forms), and excessive alcohol consumption further accelerate the disease process. In this review, we take a deep dive into optimizing lifestyle to reduce the risk of cardiovascular disease in this high-risk ethnic group.

Mental and Physical Health Impacts of Mindfulness Training for College Undergraduates: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background

Universities increasingly offer mindfulness-based programs (MBPs) to improve student health and reduce their impact on overburdened psychological services. It is critical for evidence-based policy to determine for what health outcomes mindfulness programs are effective and under what conditions. Objectives were to: (a) perform a comprehensive analysis of the effects of mindfulness interventions on physical, mental, and behavioral health outcomes in college undergraduate students, and (b) examine moderators of intervention effects to identify factors that may help improve existing university mindfulness programs and guide the design of new programs.

Method

Systematic searches of five databases identified MBP randomized controlled trials for undergraduate students, measuring any health outcome. Analyses using robust variance estimation focused on standardized mean differences for outcomes between groups and modeled through coded study features.

Results

The 58 studies in the review primarily focused on mental health with fewer assessments of physical health or health behaviors. Overall, mindfulness interventions significantly outperformed both active and inactive controls (ps<.05), with the most marked effects on anxiety symptoms, depressive symptoms, and mindfulness; greater success appeared for clinical populations. Online programs performed equivalent to in-person, and non-MBP programs were equivalent to MBP programs after controlling for other factors. Publication bias and other quality issues also emerged.

Conclusions

Mindfulness programs improve well-being in college students, with the strongest evidence for reducing anxiety and depressive symptoms. More studies utilizing stronger methods are needed to evaluate mindfulness programs' effects on additional health outcomes and online interventions in clinical populations.

Altered neural associations with cognitive and emotional functions in cannabis dependence

Negative emotional state has been found to correlate with poor cognitive performance in cannabis-dependent (CD) individuals, but not healthy controls (HCs). To examine the neural substrates underlying such unusual emotion-cognition coupling, we analyzed the behavioral and resting state fMRI data from the Human Connectome Project and found opposite brain-behavior associations in the CD and HC groups: (i) although the cognitive performance was positively correlated with the within-network functional connectivity strength and segregation (i.e. clustering coefficient and local efficiency) of the cognitive network in HCs, these correlations were inversed in CDs; (ii) although the cognitive performance was positively correlated with the within-network Granger effective connectivity strength and integration (i.e. characteristic path length) of the cognitive network in CDs, such associations were not significant in HCs. In addition, we also found that the effective connectivity strength within cognition network mediated the behavioral coupling between emotional state and cognitive performance. These results indicate a disorganization of the cognition network in CDs, and may help improve our understanding of substance use disorder.

Do mindfulness-based interventions change brain function in people with substance dependence? A systematic review of the fMRI evidence

BACKGROUND

Substance use disorders (SUDs) affect ~ 35 million people globally and are associated with strong cravings, stress, and brain alterations. Mindfulness-based interventions (MBIs) can mitigate the adverse psychosocial outcomes of SUDs, but the underlying neurobiology is unclear. Emerging findings were systematically synthesised from fMRI studies about MBI-associated changes in brain function in SUDs and their associations with mindfulness, drug quantity, and craving.

METHODS

PsycINFO, Medline, CINAHL, PubMed, Scopus, and Web of Science were searched. Seven studies met inclusion criteria.

RESULTS

Group by time effects indicated that MBIs in SUDs (6 tobacco and 1 opioid) were associated with changes in the function of brain pathways implicated in mindfulness and addiction (e.g., anterior cingulate cortex and striatum), which correlated with greater mindfulness, lower craving and drug quantity.

CONCLUSIONS

The evidence for fMRI-related changes with MBI in SUD is currently limited. More fMRI studies are required to identify how MBIs mitigate and facilitate recovery from aberrant brain functioning in SUDs.

The Treatment of Substance Use Disorders: Recent Developments and New Perspectives

Substance-related disorders are complex psychiatric disorders that are characterized by continued consumption in spite of harmful consequences. Addiction affects various brain networks critically involved in learning, reward, and motivation, as well as inhibitory control. Currently applied therapeutic approaches aim at modification of behavior that ultimately leads to decrease of consumption or abstinence in individuals with substance use disorders. However, traditional treatment methods might benefit from recent neurobiological and cognitive neuroscientific research findings. Novel cognitive-behavioral approaches in the treatment of addictive behavior aim at enhancement of strategies to cope with stressful conditions as well as craving-inducing cues and target erroneous learning mechanisms, including cognitive bias modification, reconsolidation-based interventions, mindfulness-based interventions, virtual-reality-based cue exposure therapy as well as pharmacological augmentation strategies. This review discusses therapeutic strategies that target dysregulated neurocognitive processes associated with the development and maintenance of disordered substance use and may hold promise as effective treatments for substance-related disorders.

Beyond the veil of duality-topographic reorganization model of meditation

Meditation can exert a profound impact on our mental life, with proficient practitioners often reporting an experience free of boundaries between a separate self and the environment, suggesting an explicit experience of "nondual awareness." What are the neural correlates of such experiences and how do they relate to the idea of nondual awareness itself? In order to unravel the effects that meditation has on the brain's spatial topography, we review functional magnetic resonance imaging brain findings from studies specific to an array of meditation types and meditator experience levels. We also review findings from studies that directly probe the interaction between meditation and the experience of the self. The main results are (i) decreased posterior default mode network (DMN) activity, (ii) increased central executive network (CEN) activity, (iii) decreased connectivity within posterior DMN as well as between posterior and anterior DMN, (iv) increased connectivity within the anterior DMN and CEN, and (v) significantly impacted connectivity between the DMN and CEN (likely a nonlinear phenomenon). Together, these suggest a profound organizational shift of the brain's spatial topography in advanced meditators-we therefore propose a topographic reorganization model of meditation (TRoM). One core component of the TRoM is that the topographic reorganization of DMN and CEN is related to a decrease in the mental-self-processing along with a synchronization with the more nondual layers of self-processing, notably interoceptive and exteroceptive-self-processing. This reorganization of the functionality of both brain and self-processing can result in the explicit experience of nondual awareness. In conclusion, this review provides insight into the profound neural effects of advanced meditation and proposes a result-driven unifying model (TRoM) aimed at identifying the inextricably tied objective (neural) and subjective (experiential) effects of meditation.

The impact of mindfulness meditation on social and moral behavior: Does mindfulness enhance other-oriented motivation or decrease monetary reward salience?

This perspective article provides an overview of the impact of mindfulness meditation (MM) on social and moral behavior. In mindfulness research, prosocial behavior has been operationalized as helping behavior, altruistic redistribution of funds, reparative behavior, or monetary donation. Studies concerning moral behavior are still scarce. Despite inconsistent evidence, several studies found a beneficial effect of mindfulness on prosocial outcomes (i.e., a higher propensity to spend or give away money for the sake of other individuals). However, since the employed tasks were reward-based, participants’ decisions also directly affected their own payoff by reducing it. Crucially, MM also affects self-control circuitry and reduces reward-seeking behaviors and reward salience by making rewards less tempting. We have discussed evidence suggesting how challenging it may be to dissociate the specific weight of enhanced other-oriented motivation from one of the decreased monetary reward salience in explaining meditators’ behavior. Future higher-quality studies are needed to address this open issue.

Classification of Mindfulness Meditation and Its Impact on Neural Measures in the Clinical Population

Different forms of mindfulness meditation are increasingly integrated in the clinical practice in the last three decades. Previous studies have identified changes in the neurophysiology and neurochemistry of the brain resulting from different mindfulness meditation practices in the general population. However, research on neural correlates of different types of meditation, particularly on the clinical outcomes, is still very sparse. Therefore, the aim of this article is to review the neural impact of mindfulness meditation interventions on different mental disorders via the classification of main components of mindfulness meditation. The clearer classification of mindfulness meditation may inform future clinical practice and research directions.

Yoga as a Preventive Intervention for Cardiovascular Diseases and Associated Comorbidities: Open-Label Single Arm Study

Aim

Common Yoga Protocol (CYP) is a standardized yoga protocol authored by experts from all over the world under the aegis of the Ministry of AYUSH, Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Rigpa and Homeopathy (AYUSH). The potential of CYP can be determined as a cost-effective lifestyle modification to prevent the risk of developing cardiovascular diseases (CVD).

Methods

In this prospective trial, we compared the effect of CYP at baseline and after 1 month. A total of 374 yoga-naïve participants performed CYP under the supervision of experienced trainers. Physiological [body mass index (BMI), blood pressure, percent oxygen saturation], biochemical (fasting blood glucose and lipid profile), and neurocognitive parameters were measured before and after the intervention.

Results

At day 30 of yoga practice, serum levels of low-density lipoprotein (LDL), total cholesterol (TC), and high-density lipoprotein (HDL) were found significantly improved as compared to the baseline levels observed at the time of enrollment. Similarly, the lipid profile was also obtained from experienced trainers and found to be significantly different from those of yoga-naïve volunteers. When the intervention was compared between the healthy yoga-naïve participants with yoga-naïve participants suffering from medical issues, it was found that cholesterol profile improved significantly in the healthy-naive group as compared to the diseased group (hypertension, diabetes, underwent surgery, and CVD).

Conclusion

These results highlight the need for further research to better understand the effects of yoga on the primary prevention of CVD.

The heart-brain axis: A proteomics study of meditation on the cardiovascular system of Tibetan Monks

Background

There have been mixed reports on the beneficial effects of meditation in cardiovascular disease (CVD), which is widely considered the leading cause of death worldwide.

Methods

To clarify the role of meditation in modulating the heart-brain axis, we implemented an extreme phenotype strategy, i.e., Tibetan monks (BMI > 30) who practised 19.20 ± 7.82 years of meditation on average and their strictly matched non-meditative Tibetan controls. Hypothesis-free advanced proteomics strategies (Data Independent Acquisition and Targeted Parallel Reaction Monitoring) were jointly applied to systematically investigate and target the plasma proteome underlying meditation. Total cholesterol, low-density lipoprotein cholesterol  (LDL-C), apolipoprotein B (Apo B) and lipoprotein (a) [Lp(a)] as the potential cardiovascular risk factors were evaluated. Heart rate variability (HRV) was assessed by electrocardiogram.

Findings

Obesity, hypertension, and reduced HRV is offset by long-term meditation. Notably, meditative monks have blood pressure and HRV comparable to their matched Tibetan controls. Meditative monks have a protective plasma proteome, related to decreased atherosclerosis, enhanced glycolysis, and oxygen release, that confers resilience to the development of CVD. In addition, clinical risk factors in plasma were significantly decreased in monks compared with controls, including total cholesterol, LDL-C, Apo B, and Lp(a).

Interpretation

To our knowledge, this work is the first well-controlled proteomics investigation of long-term meditation, which opens up a window for individuals characterized by a sedentary lifestyle to improve their cardiovascular health with an accessible method practised for more than two millennia.

Funding

See the Acknowledgements section.

Mindfulness for smoking cessation

BACKGROUND

Mindfulness-based smoking cessation interventions may aid smoking cessation by teaching individuals to pay attention to, and work mindfully with, negative affective states, cravings, and other symptoms of nicotine withdrawal. Types of mindfulness-based interventions include mindfulness training, which involves training in meditation; acceptance and commitment therapy (ACT); distress tolerance training; and yoga.

OBJECTIVES

To assess the efficacy of mindfulness-based interventions for smoking cessation among people who smoke, and whether these interventions have an effect on mental health outcomes.

SEARCH METHODS

We searched the Cochrane Tobacco Addiction Group's specialised register, CENTRAL, MEDLINE, Embase, PsycINFO, and trial registries to 15 April 2021. We also employed an automated search strategy, developed as part of the Human Behaviour Change Project, using Microsoft Academic.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) and cluster-RCTs that compared a mindfulness-based intervention for smoking cessation with another smoking cessation programme or no treatment, and assessed smoking cessation at six months or longer. We excluded studies that solely recruited pregnant women.

DATA COLLECTION AND ANALYSIS

We followed standard Cochrane methods. We measured smoking cessation at the longest time point, using the most rigorous definition available, on an intention-to-treat basis. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for smoking cessation for each study, where possible. We grouped eligible studies according to the type of intervention and type of comparator. We carried out meta-analyses where appropriate, using Mantel-Haenszel random-effects models. We summarised mental health outcomes narratively.

MAIN RESULTS

We included 21 studies, with 8186 participants. Most recruited adults from the community, and the majority (15 studies) were conducted in the USA. We judged four of the studies to be at low risk of bias, nine at unclear risk, and eight at high risk. Mindfulness-based interventions varied considerably in design and content, as did comparators, therefore, we pooled small groups of relatively comparable studies. We did not detect a clear benefit or harm of mindfulness training interventions on quit rates compared with intensity-matched smoking cessation treatment (RR 0.99, 95% CI 0.67 to 1.46; I² = 0%; 3 studies, 542 participants; low-certainty evidence), less intensive smoking cessation treatment (RR 1.19, 95% CI 0.65 to 2.19; I² = 60%; 5 studies, 813 participants; very low-certainty evidence), or no treatment (RR 0.81, 95% CI 0.43 to 1.53; 1 study, 325 participants; low-certainty evidence). In each comparison, the 95% CI encompassed benefit (i.e. higher quit rates), harm (i.e. lower quit rates) and no difference. In one study of mindfulness-based relapse prevention, we did not detect a clear benefit or harm of the intervention over no treatment (RR 1.43, 95% CI 0.56 to 3.67; 86 participants; very low-certainty evidence). We did not detect a clear benefit or harm of ACT on quit rates compared with less intensive behavioural treatments, including nicotine replacement therapy alone (RR 1.27, 95% CI 0.53 to 3.02; 1 study, 102 participants; low-certainty evidence), brief advice (RR 1.27, 95% CI 0.59 to 2.75; 1 study, 144 participants; very low-certainty evidence), or less intensive ACT (RR 1.00, 95% CI 0.50 to 2.01; 1 study, 100 participants; low-certainty evidence). There was a high level of heterogeneity (I² = 82%) across studies comparing ACT with intensity-matched smoking cessation treatments, meaning it was not appropriate to report a pooled result. We did not detect a clear benefit or harm of distress tolerance training on quit rates compared with intensity-matched smoking cessation treatment (RR 0.87, 95% CI 0.26 to 2.98; 1 study, 69 participants; low-certainty evidence) or less intensive smoking cessation treatment (RR 1.63, 95% CI 0.33 to 8.08; 1 study, 49 participants; low-certainty evidence). We did not detect a clear benefit or harm of yoga on quit rates compared with intensity-matched smoking cessation treatment (RR 1.44, 95% CI 0.40 to 5.16; 1 study, 55 participants; very low-certainty evidence). Excluding studies at high risk of bias did not substantially alter the results, nor did using complete case data as opposed to using data from all participants randomised. Nine studies reported on changes in mental health and well-being, including depression, anxiety, perceived stress, and negative and positive affect. Variation in measures and methodological differences between studies meant we could not meta-analyse these data. One study found a greater reduction in perceived stress in participants who received a face-to-face mindfulness training programme versus an intensity-matched programme. However, the remaining eight studies found no clinically meaningful differences in mental health and well-being between participants who received mindfulness-based treatments and participants who received another treatment or no treatment (very low-certainty evidence).

AUTHORS' CONCLUSIONS

We did not detect a clear benefit of mindfulness-based smoking cessation interventions for increasing smoking quit rates or changing mental health and well-being. This was the case when compared with intensity-matched smoking cessation treatment, less intensive smoking cessation treatment, or no treatment. However, the evidence was of low and very low certainty due to risk of bias, inconsistency, and imprecision, meaning future evidence may very likely change our interpretation of the results. Further RCTs of mindfulness-based interventions for smoking cessation compared with active comparators are needed. There is also a need for more consistent reporting of mental health and well-being outcomes in studies of mindfulness-based interventions for smoking cessation.

Differences in Emotional Conflict Processing between High and Low Mindfulness Adolescents: An ERP Study

Mindfulness is a state of concentration that allows individuals to focus on their feelings and thoughts without judgment. However, little is known regarding the underlying neural processes of mindfulness. This study used ERPs to investigate the differences between high and low trait mindfulness adolescents during emotional conflict processing. Nineteen low mindfulness adolescents (LMSs) and sixteen high mindfulness adolescent (HMSs) individuals were asked to complete a face Stroop task. The task superimposed emotional words on emotional faces to generate congruent (CC) and incongruent (IC) conditions. Continuous electroencephalogram data were recorded during the face Stroop task. Results revealed that for N450, the interaction of congruency and group was significant. The incongruent trials evoked a larger N450 than the congruent trials in the HMSs, whereas there were no significant differences between the two conditions in the LMSs. There were significant main effects of congruency for SP (slow potential). The incongruent trials evoked a larger SP than the congruent trials. The results suggest that mindfulness may only affect early conflict monitoring rather than later conflict resolution. The findings expand the neural basis of the effect of mindfulness on inhibitory control.

Boosting healthier choices

Thomas Rouyard and colleagues discuss use of the boosting approach as an alternative to nudging in developing non-coercive interventions to promote health

The Dynamic Interplay of Healthy Lifestyle Behaviors for Cardiovascular Health

PURPOSE OF REVIEW

The recent rise in cardiovascular disease (CVD) deaths in the USA has sparked interest in identifying and implementing effective strategies to reverse this trend. Healthy lifestyle behaviors (i.e., healthy diet, regular physical activity, achieve and maintain a healthy weight, avoid tobacco exposure, good quality sleep, avoiding and managing stress) are the cornerstone for CVD prevention.

RECENT FINDINGS

Achieving all of these behaviors significantly benefits heart health; however, even small changes lower CVD risk. Moreover, there is interplay among healthy lifestyle behaviors where changing one may result in concomitant changes in another behavior. In contrast, the presence of one or more unhealthy lifestyle behaviors may attenuate changing another lifestyle behavior(s) (poor diet, inadequate physical activity, overweight/obesity, poor sleep quality, tobacco exposure, and poor stress management). It is important to assess all of these lifestyle behaviors with patients to plan an intervention program that is best positioned for adherence.

Mindfulness and Behavior Change

Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.

Four-week Tai Chi intervention decreases attention bias to drug cues in individuals with methamphetamine use disorder

Background: Mind-body exercise is used for the rehabilitation of individuals with methamphetamine use disorder (MUD). Attention bias to substances is an important index of MUD. However, whether a mind-body exercise intervention can decrease attention bias is unclear.Objective: This study aimed to test the effect of a four-week Tai Chi (a Chinese traditional mind-body exercise) exercise program on the attention bias of individuals with MUD.Methods: Thirty-two men with MUD and without Tai Chi practice experience were recruited and randomly assigned to either a Tai Chi exercise group or a control group. The Tai Chi group received four-week Tai Chi training, while the control group engaged in daily exercise (including radio gymnastics and Jianxincao, two kinds of free-hand exercises). During a drug-related Stroop task, participants were instructed to respond to the color of the word ignoring the word type (drug-related or neutral words). The reaction time and d' (the index of sensitivity) were measured.Results: The participants showed attention bias to substance cues; the reaction time was slower for drug-related words than for neutral words (p < .05). After the Tai Chi intervention, the Tai Chi group showed a faster reaction time (ps < .05) and a smaller d' (ps < .05) than the baseline across all the word types. In contrast, the control group showed no differences (ps > .05).Conclusion: Four-week Tai Chi intervention reduced sensitivity and attentional bias to drug-related cues in individuals with MUD, suggesting that mind-body exercise might enhance recovery from MUD via attention control.

Changes in Prefrontal Gamma-Aminobutyric Acid and Perfusion After the Computerized Relaxation Training in Women With Psychological Distress: A Preliminary Report

Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid (GABA) levels and cerebral blood flow (CBF) in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress (t = 4.02, P < 0.001), anxiety (z = 2.33, P = 0.02), fatigue (t = 3.35, P = 0.004), and sleep quality (t = 4.14, P < 0.001) improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms (t = -5.25, P < 0.001). The prefrontal GABA levels decreased (t = 2.53, P = 0.02), while relative CBF increased (t = -3.32, P = 0.004) after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention (t = 2.22, P = 0.04). The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress.

Altered patterns of fractional amplitude of low-frequency fluctuation and regional homogeneity in abstinent methamphetamine-dependent users

Methamphetamine (MA) could induce functional and structural brain alterations in dependent subjects. However, few studies have investigated resting-state activity in methamphetamine-dependent subjects (MADs). We aimed to investigate alterations of brain activity during resting-state in MADs using fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo). We analyzed fALFF and ReHo between MADs (n = 70) and healthy controls (HCs) (n = 84) and performed regression analysis using MA use variables. Compared to HCs, abstinent MADs showed increased fALFF and ReHo values in the bilateral striatum, decreased fALFF in the left inferior frontal gyrus, and decreased ReHo in the bilateral anterior cingulate cortex, sensorimotor cortex, and left precuneus. We also observed the fALFF values of bilateral striatum were positively correlated with the age of first MA use, and negatively correlated with the duration of MA use. The fALFF value of right striatum was also positively correlated with the duration of abstinence. The alterations of spontaneous cerebral activity in abstinent MADs may help us probe into the neurological pathophysiology underlying MA-related dysfunction and recovery. Since MADs with higher fALFF in the right striatum had shorter MA use and longer abstinence, the increased fALFF in the right striatum might implicate early recovery during abstinence.

Smoking-induced craving relief relates to increased DLPFC-striatal coupling in nicotine-dependent women

BACKGROUND

Craving is a major contributor to drug-seeking and relapse. Although the ventral striatum (VS) is a primary neural correlate of craving, strategies aimed at manipulating VS function have not resulted in efficacious treatments. This incongruity may be because the VS does not influence craving in isolation. Instead, craving is likely mediated by communication between the VS and other neural substrates. Thus, we examined how striatal functional connectivity (FC) with key nodes of networks involved in addiction affects relief of craving, which is an important step in identifying viable treatment targets.

METHODS

Twenty-four nicotine-dependent non-abstinent women completed two resting-state (rs) fMRI scans, one before and one following smoking a cigarette in the scanner, and provided craving ratings before and after smoking the cigarette. A seed-based approach was used to examine rsFC between the VS, putamen and germane craving-related brain regions; the dorsolateral prefrontal cortex (dlPFC), the posterior cingulate cortex, and the anterior ventral insula.

RESULTS

Smoking a cigarette was associated with a decrease in craving. Relief of craving correlated with increases in right dlPFC- bilateral VS (r = 0.57, p = 0.003, corrected) as did increased right dlPFC-left putamen coupling (r = 0.62, p = 0.001, corrected).

CONCLUSIONS

Smoking-induced relief of craving is associated with enhanced rsFC between the dlPFC, a region that plays a pivotal role in decision making, and the striatum, the neural structure underlying motivated behavior. These findings are highly consistent with a burgeoning literature implicating dlPFC-striatal interactions as a neurobiological substrate of craving.

Endogenous theta stimulation during meditation predicts reduced opioid dosing following treatment with Mindfulness-Oriented Recovery Enhancement

Veterans experience chronic pain at greater rates than the rest of society and are more likely to receive long-term opioid therapy (LTOT), which, at high doses, is theorized to induce maladaptive neuroplastic changes that attenuate self-regulatory capacity and exacerbate opioid dose escalation. Mindfulness meditation has been shown to modulate frontal midline theta (FMT) and alpha oscillations that are linked with marked alterations in self-referential processing. These adaptive neural oscillatory changes may promote reduced opioid use and remediate the neural dysfunction occasioned by LTOT. In this study, we used electroencephalography (EEG) to assess the effects of a mindfulness-based, cognitive training intervention for opioid misuse, Mindfulness-Oriented Recovery Enhancement (MORE), on alpha and theta power and FMT coherence during meditation. We then examined whether these neural effects were associated with reduced opioid dosing and changes in self-referential processing. Before and after 8 weeks of MORE or a supportive psychotherapy control, veterans receiving LTOT (N = 62) practiced mindfulness meditation while EEG was recorded. Participants treated with MORE demonstrated significantly increased alpha and theta power (with larger theta power effect sizes) as well as increased FMT coherence relative to those in the control condition-neural changes that were associated with altered self-referential processing. Crucially, MORE significantly reduced opioid dose over time, and this dose reduction was partially statistically mediated by changes in frontal theta power. Study results suggest that mindfulness meditation practice may produce endogenous theta stimulation in the prefrontal cortex, thereby enhancing inhibitory control over opioid dose escalation behaviors.

Brief mindfulness training for smoking cessation in Chinese women in workplaces: A pilot randomized controlled trial

INTRODUCTION

Mindfulness training (MT) has shown preliminary efficacy as a behavioral treatment for smoking cessation. We examined the effect of a brief-MT intervention on smoking cessation for Chinese women in workplaces in Hong Kong, China.

METHODS

In this pilot randomized controlled trial, 213 daily smokers were recruited from workplaces and computer-randomized into the intervention (n = 114) or control (n = 99) groups. Participants in both groups received a self-help booklet. Participants in the intervention group additionally attended 2 sessions of a brief-MT workshop. The primary outcome was self-reported 7-day point-prevalence abstinence (PPA) at 6 months. Secondary outcomes were biochemically validated abstinence (exhaled CO < 4 ppm and salivary cotinine < 10 ng/mL) and smoking reduction at 6 months. Analyses were done by intention to treat. We conducted a post-trial qualitative evaluation on participants in the intervention group (n = 14). Data were analyzed thematically.

RESULTS

At 6-month follow-up, self-reported 7-day PPA were similar between the intervention and control groups (18.4% vs. 21.2%; P = 0.61). Very few participated in biochemical validation (n = 17), and validated abstinence and smoking reduction rates showed no significant difference (5.3% vs. 11.1%, P = 0.12 and 20.2% vs. 20.2%, P = 1.00, respectively). A posteriori analysis showed that brief-MT participants who were psychologically engaged with the intervention had greater 6-month PPA. Qualitative evaluation showed brief-MT reduced stress but its effectiveness was restrained by the insufficient home practice.

CONCLUSIONS

This pilot trial on a brief-MT intervention for smoking cessation on Chinese women in workplaces showed feasibility, but improving compliance is needed to maximize the efficacy in future fully powered trials.

Does addition of craving management tools in a stop smoking app improve quit rates among adult smokers? Results from BupaQuit pragmatic pilot randomised controlled trial

OBJECTIVES

Delivery of craving management tools via smartphone applications (apps) may improve smoking cessation rates, but research on such programmes remains limited, especially in real-world settings. This study evaluated the effectiveness of adding craving management tools in a cessation app (BupaQuit).

METHODS

The study was a two-arm pragmatic pilot parallel randomised controlled trial, comparing a fully-automated BupaQuit app with craving management tool with a control app version without craving management tool. A total of 425 adult UK-based daily smokers were enrolled through open online recruitment (February 2015-March 2016), with no researcher involvement, and individually randomised within the app to the intervention (n = 208) or control (n = 217). The primary outcome was self-reported 14-day continuous abstinence assessed at 4-week follow-up. Secondary outcomes included 6-month point-prevalence and sustained abstinence, and app usage. The primary outcome was assessed with Fisher's exact test using intent to treat with those lost to follow-up counted as smoking. Participants were not reimbursed.

RESULTS

Re-contact rates were 50.4% at 4 weeks and 40.2% at 6 months. There was no significant difference between intervention and control arms on the primary outcome (13.5% vs 15.7%; p = 0.58; relative risk = 0.86, 95% confidence interval = 0.54-1.36) or secondary cessation outcomes (6-month point prevalence: 14.4% vs 17.1%, p = 0.51; relative risk = 0.85, 95% confidence interval = 0.54-1.32; 6-month sustained: 11.1% vs 13.4%, p = 0.55; relative risk = 0.83, 95% confidence interval = 0.50-1.38). Bayes factors supported the null hypothesis (B[0, 0, 1.0986] = 0.20). Usage was similar across the conditions (mean/median logins: 9.6/4 vs 10.5/5; time spent: 401.8/202 s vs 325.8/209 s).

CONCLUSIONS

The addition of craving management tools did not affect cessation, and the limited engagement with the app may have contributed to this.

A mindful path to the COVID-19 pandemic: an approach to promote physical distancing behavior

Purpose

The present situation is marked by the threat of COVID-19 pandemic on entire humankind and researchers across the globe are looking forward to vaccines or medicines to tackle COVID-19. However, according to the scholars and health-care agencies, vaccines alone would not be of much help and in the longer run adhering to the physical distancing policy along with sanitation could be the only solution. Moreover, extant studies across different areas have noted a positive association between various human psychological factors and prosocial behaviours. Additionally, an empirical study undertaken in the western context has tried exploring the association between human psychological factors and physical distancing behaviour (a kind of prosocial behaviour) in the COVID-19 context. The results of the extant study seem intriguing and encouraging enough to undertake a more robust exploratory study in this developing area. Against this background, this study aims to explore the relationship between individuals’ mindfulness and physical distancing behaviour, along with the mediating role of empathy during the COVID-19 pandemic.

Design/methodology/approach

To achieve the study objectives, this study has used an online survey method and has collected responses from the general adult population in India spread across all six regions. The survey was conducted during May 2020 when India was under a nationwide lockdown to mitigate the risk of COVID-19 pandemic. The respondents were identified based on convenience and snowball sampling techniques. Using social media platforms, the prospective respondents were contacted through WhatsApp, LinkedIn and Facebook or e-mails. Post data cleaning, a total of 315 responses were found to be suitable for analysis. For analysis, confirmatory factor analysis was conducted to establish the validity and reliability of the conceptual model, whereas Pearson correlation was undertaken to study the relationship between variables and mediation was examined using the PROCESS macro of Hayes.

Findings

The findings were encouraging and could become the foundation stone for further research and a practical guide for policymakers, agencies working in the health-care areas and even corporate leaders. As expected, an individual’s mindfulness was noted to be positively-related and influencing physical distancing behaviour. The mediation analysis indicated the intervening role of empathy in the association between an individual’s mindfulness and physical distancing behaviour.

Practical implications

The findings of the present could be a game-changer in restricting the spread of the COVID-19 pandemic. As espoused by various scholars, as well as health-care organizations about the use of physical distancing in mitigating the risk of COVID-19, policymakers, health-care authorities and even corporate leaders could look forward to strategizing and execute the dissemination of various mindfulness-based programs among the individuals. These mindfulness-based programs, which could be disseminated offline and online through smartphones, could, in turn, help in positively influence physical distancing behaviour among the individuals leading to the success of physical distancing policy.

Social implications

This study relates and extends the mechanism of mindfulness in influencing individuals’ physical distancing behaviour in the pandemic situation, notably the COVID-19 pandemic. Moreover, based on the “empathy-altruism hypothesis”, as well as Schwartz’s theory of fundamental values, the intervening role of empathy has been explored and the findings further helped in extended these two theories in the domain of pandemic.

Originality/value

This study could be the first to conceptualize and examine the human psychological factors, particularly the relationship and role of an individual’s mindfulness with physical distancing behaviour among the general public during the COVID-19 pandemic. Additionally, this could also be the first study to conceptualize and explore the intervening role of empathy in the relationship between an individual’s mindfulness and physical distancing behaviour. Moreover, in conceptualizing and exploring the relationship between an individual’s mindfulness and physical distancing behaviour, this study explored and extended the “reperceiving” mechanism of mindfulness and the “empathy-altruism hypothesis” along with Schwartz’s theory of fundamental values in the domain of pandemic.

A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults

Low income and low educational attainment are among the strongest predictors of both smoking prevalence and lapse (i.e., return) to smoking after cessation attempts. Treatment refinement is limited by inadequate knowledge of the specific lapse- or relapse-relevant vulnerabilities characteristic of populations that should be the target of treatment. In the context of a randomized clinical trial design, we describe an experimental medicine approach for evaluating the role of 2 specific lapse-relevant targets relative to the higher stress characteristic of low-socioeconomic contexts: low distress tolerance and low working memory capacity. Furthermore, we use an innovative approach for understanding risk of smoking lapse in smokers undergoing a quit attempt to examine candidate mechanistic targets assessed not only during nicotine use, but also during the conditions smokers will face upon a cessation attempt-during stressful nicotine-deprivation windows. This study is designed to show the incremental value of assessments during deprivation windows, in part because of the way in which specific vulnerabilities are modified by, and interact with, the heightened stress and withdrawal symptoms inherent to nicotine-deprivation states. Specifically, the study is designed to evaluate whether a novel mindfulness intervention (mindfulness combined with interoceptive exposure) can improve upon existing mindfulness interventions and extend therapeutic gains to the modification of mechanistic targets assessed in high-stress or negative affectivity contexts. The overall goal is to validate mechanistic targets and associated interventions for the purpose of expanding treatment options for at-risk smokers. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

(Neuro)therapeutic Approaches in the Field of Alcohol Use Disorders

Purpose of Review

Alcohol use disorder (AUD) is a burdening chronic condition that is characterized by high relapse rates despite severe negative consequences. There has been a recent emergence of interest in (neuro)therapeutic intervention strategies that largely involve the detrimental change in mechanisms linked to addiction disorders. Most prominently, the latter include habitual decision-making, cue-induced behavioral tendencies, as well as the amplifying effects of stressful events on drinking behavior. This article discusses these learning mechanisms and modification thereof as possible targets of (neuro)therapeutic interventions for AUD.

Recent Findings

Psychological therapies that target dysregulated neurocognitive processes underlying addictive behavior may hold promise as effective treatments for AUD.

Summary

Despite the progression in psychological and neuroscience research in the field of AUD, many behavioral interventions fail to systematically integrate and apply such findings into treatment development. Future research should focus on the targeted modification of the aforementioned processes.

Using mind control to modify cue-reactivity in AUD: the impact of mindfulness-based relapse prevention on real-time fMRI neurofeedback to modify cue-reactivity in alcohol use disorder: a randomized controlled trial

BACKGROUND

Alcohol Use Disorder is a severe mental disorder affecting the individuals concerned, their family and friends and society as a whole. Despite its high prevalence, novel treatment options remain rather limited. Two innovative interventions used for treating severe disorders are the use of real-time functional magnetic resonance imaging neurofeedback that targets brain regions related to the disorder, and mindfulness-based treatments. In the context of the TRR SFB 265 C04 "Mindfulness-based relapse prevention as an addition to rtfMRI NFB intervention for patients with Alcohol Use Disorder (MiND)" study, both interventions will be combined to a state-of-the art intervention that will use mindfulness-based relapse prevention to improve the efficacy of a real-time neurofeedback intervention targeting the ventral striatum, which is a brain region centrally involved in cue-reactivity to alcohol-related stimuli.

METHODS/DESIGN

After inclusion, N = 88 patients will be randomly assigned to one of four groups. Two of those groups will receive mindfulness-based relapse prevention. All groups will receive two fMRI sessions and three real-time neurofeedback sessions in a double-blind manner and will regulate either the ventral striatum or the auditory cortex as a control region. Two groups will additionally receive five sessions of mindfulness-based relapse prevention prior to the neurofeedback intervention. After the last fMRI session, the participants will be followed-up monthly for a period of 3 months for an assessment of the relapse rate and clinical effects of the intervention.

DISCUSSION

The results of this study will give further insights into the efficacy of real-time functional magnetic resonance imaging neurofeedback interventions for the treatment of Alcohol Use Disorder. Additionally, the study will provide further insight on neurobiological changes in the brain caused by the neurofeedback intervention as well as by the mindfulness-based relapse prevention. The outcome might be useful to develop new treatment approaches targeting mechanisms of Alcohol Use Disorder with the goal to reduce relapse rates after discharge from the hospital.

TRIAL REGISTRATION

This trial is pre-registered at clinicaltrials.gov (trial identifier: NCT04366505; WHO Universal Trial Number (UTN): U1111-1250-2964). Registered 30 March 2020, published 29 April 2020.

Ultra-brief breath counting (mindfulness) training promotes recovery from stress-induced alcohol-seeking in student drinkers

The therapeutic effect of mindfulness interventions on problematic drinking is thought to be driven by increased resilience to the impact of stress on negative mood and alcohol-seeking behaviour, but this claim needs empirical support. To address this hypothesis, the current study tested whether brief training of one component of mindfulness - breath counting - would reduce drinkers' sensitivity to the effect of noise stress on subjective mood and alcohol-seeking behaviour. Baseline alcohol-seeking was measured by choice to view alcohol versus food thumbnail pictures in 192 student drinkers. Participants then received a 6-minute audio file which either trained breath counting or recited a popular science extract, in separate groups. All participants were then stressed by a loud industrial noise and alcohol-seeking was measured again simultaneously to quantify the change from baseline. Subjective mood was measured after all three stages (baseline, post intervention, post stress test). The breath counting group were instructed to deploy this technique during the stress test. Results showed that the breath counting versus control intervention improved subjective mood relative to baseline, attenuated the worsening of subjective mood produced by stress induction, and accelerated recovery from a stress induced increase in alcohol-seeking behaviour. Exploratory moderation analysis showed that this accelerated recovery from stress induced alcohol-seeking by breath counting was weaker in more alcohol dependent participants. Mindfulness therapies may improve problematic drinking by increasing resilience to stress induced negative mood and alcohol-seeking, as observed in this study. The weaker therapeutic effect of breath counting in more dependent drinkers may reveal limitations to this intervention strategy.

History of withdrawal modulates drug- and food-cue reactivity in cocaine dependent participants

While the centrality of withdrawal in the diagnosis of addiction has been decreasing with each successive edition of the Diagnostic and Statistical Manual of Mental Disorders, psychometric and neurobiological evidence provides withdrawal a central role in the development and maintenance of addiction. The current study offers insight into these conflicting positions by using secondary analyses to assess how a history of DSM-assessed withdrawal influences the magnitude of bias in neural reactivity to drug- and/or food-related reward cues. To this end, we separated an existing sample of cocaine-dependent participants (Denomme et al., 2018) into those with (WD) and without (N-WD) a history of withdrawal, and compared food- and drug-cue reactivity between these groups, and to a non-dependent control group (ND). Analyses indicated that biases in neural reactivity towards drug- versus food-related cues only occurred among the WD participants (within: left dorsomedial prefrontal cortex, left anterior cingulate cortex, left orbitofrontal cortex, left caudate nucleus, and right ventrolateral prefrontal cortex). Thus, withdrawal status may be an important factor to consider when interpreting dependence-related biases in neural reactivity following reward-related cues. Interestingly, while N-WD participants did not show these broad biases in neural reactivity, the magnitude of their bias correlated positively with years of lifetime substance use history, particularly when psychopathic traits were low. It may be that for individuals who's addiction has not yet reached a compulsive state (see Wise and Koob, 2014), the magnitude of their drug > food bias could serve as a valuable biomarker of addiction severity.

Verbal suggestions of nicotine content modulate ventral tegmental neural activity during the presentation of a nicotine-free odor in cigarette smokers

Expectancies of nicotine content have been shown to impact smokers' subjective responses and smoking behaviors. However, little is known about the neural substrates modulated by verbally induced expectancies in smokers. In this study we used functional magnetic resonance imaging (fMRI) to investigate how verbally induced expectations, regarding the presence or absence of nicotine, modulated smokers' neural response to a nicotine-free odor. While laying in the scanner, all participants (N = 24) were given a nicotine-free odor, but whereas one group was correctly informed about the absence of nicotine (control group n = 12), the other group was led to believe that the presented odor contained nicotine (expectancy group n = 12). Smokers in the expectancy group had significantly increased blood-oxygen-level-dependent (BOLD) responses during the presentation of the nicotine-free odor in the left ventral tegmental area (VTA), and in the right insula, as compared to smokers in the control group (Regions of interest analysis with pFWE-corrected p ≤ 0.05). At a more liberal uncorrected statistical level (p-unc ≤ 0.001), increased bilateral reactivity in the dorsolateral prefrontal cortex (dlPFC) was also observed in the expectancy group as compared with the control group. Our findings suggest that nicotine-expectancies induced through verbal instructions can modulate nicotine relevant brain regions, without nicotine administration, and provide further neural support for the key role that cognitive expectancies play in the cause and treatment of nicotine dependence.

The Effect of Meditation on Comprehension of Statements About One-Self and Others: A Pilot ERP and Behavioral Study

The main goal of this study was to examine the effect of long-term meditation practice on behavioral indicators and ERP peak characteristics during an error-recognition task, where participants were presented with emotionally negative (evoking anxiety or aggression) written sentences describing self-related or non-self-related emotional state and personality traits. In total, 200 sentences written in Russian with varying emotional coloring were presented during the task, with half of the sentences containing a grammatical error that the participants were asked to identify. The EEG was recorded in age-matched control individuals (n = 17) and two groups of Samatha meditators with relatively short- (3–5 years’ experience, n = 18) and long-term (10–30 years’ experience, n = 18) practice experience. Task performance time (TPT) and accuracy of error detection (AED) were chosen as behavioral values. Amplitude, time latency and cortical distribution of P300 and P600 peaks of ERP were used as a value of speech-related brain activity. All statistical effects of meditation were estimated, controlling for age and sex. No behavioral differences between two groups of meditators were found. General TPT was shorter for both groups of meditators compared to the control group. Non-meditators reacted significantly slower to sentences about aggression than to sentences about anxiety or non-emotional sentences, whereas no significance was found between meditator groups. Non-meditators had better AED for the sentences about one-self than for the sentences about other people, whereas the meditators did not show any significant difference. The amplitude of P300 peak in frontal and left temporal scalp regions was higher for long-term meditators in comparison with both intermediate and control groups. The latency of P300 and P600 in left frontal and temporal regions positively correlated with TPT, whereas the amplitude of P300 in these regions had a negative correlation with TPT. We demonstrate that long-term meditation practice increases the ability of an individual to process negative emotional stimuli. The differences in behavioral reactions after onset of negative information that was self-related and non-self-related, which is typical for non-meditators, disappeared due to the influence of meditation. ERP results could be interpreted as a value of increase in voluntary control over emotional state during meditational practice.

Expert Opinion: Meditation and Cardiovascular Health: What is the Link?

Meditation as a form of body–mind interaction for primary and secondary prevention in cardiovascular disease has been discussed critically in the past. However, data that aimed to link this intervention to a reduction of various aspects of cardiovascular disease, rendering it a potential part of a cost-effective treatment approach in patients at risk, remain scarce and inconclusive. This article aims to provide an overview of currently available evidence in the literature and the potential impact of meditation on cardiovascular health. However, the data highlighted in this article cannot render with certainty directly reproducible effects of meditation on patients’ cardiovascular disease profiles. Meditation may be suggested only as an additional link in the chain of primary and secondary prevention until future research provides sufficient data on this topic.

From State-to-Trait Meditation: Reconfiguration of Central Executive and Default Mode Networks

While brain default mode network (DMN) activation in human subjects has been associated with mind wandering, meditation practice has been found to suppress it and to increase psychological well-being. In addition to DMN activity reduction, experienced meditators (EMs) during meditation practice show an increased connectivity between the DMN and the central executive network (CEN).

While brain default mode network (DMN) activation in human subjects has been associated with mind wandering, meditation practice has been found to suppress it and to increase psychological well-being. In addition to DMN activity reduction, experienced meditators (EMs) during meditation practice show an increased connectivity between the DMN and the central executive network (CEN). However, the gradual change between DMN and CEN configuration from pre-meditation, during meditation, and post-meditation is unknown. Here, we investigated the change in DMN and CEN configuration by means of brain activity and functional connectivity (FC) analyses in EMs across three back-to-back functional magnetic resonance imaging (fMRI) scans: pre-meditation baseline (trait), meditation (state), and post-meditation (state-to-trait). Pre-meditation baseline group comparison was also performed between EMs and healthy controls (HCs). Meditation trait was characterized by a significant reduction in activity and FC within DMN and increased anticorrelations between DMN and CEN. Conversely, meditation state and meditation state-to-trait periods showed increased activity and FC within the DMN and between DMN and CEN. However, the latter anticorrelations were only present in EMs with limited practice. The interactions between networks during these states by means of positive diametric activity (PDA) of the fractional amplitude of low-frequency fluctuations (fALFFs) defined as CEN fALFF¯ − DMN fALFF¯ revealed no trait differences but significant increases during meditation state that persisted in meditation state-to-trait. The gradual reconfiguration in DMN and CEN suggest a neural mechanism by which the CEN negatively regulates the DMN and is probably responsible for the long-term trait changes seen in meditators and reported psychological well-being.

Restoring Attention Networks

The attention networks of the human brain have been under intensive study for more than twenty years and deficits of attention accompany many neurological and psychiatric conditions. There is more dispute about the centrality of attention deficits to these conditions. It appears to be time to study whether reducing deficits of attention alleviate the neurological or psychiatric disorder as a whole. In this paper we review human and animal research indicating the possibility of improving the function of brain networks underlying attention and their potential clinical role.

The neuroscience of meditation: classification, phenomenology, correlates, and mechanisms

Rising from its contemplative and spiritual traditions, the science of meditation has seen huge growth over the last 30 years. This chapter reviews the classifications, phenomenology, neural correlates, and mechanisms of meditation. Meditation classification types are still varied and largely subjective. Broader models to describe meditation practice along multidimensional parameters may improve classification in the future. Phenomenological studies are few but growing, highlighting the subjective experience and correlations to neurophysiology. Oscillatory EEG studies are not conclusive likely due to the heterogeneous nature of the meditation styles and practitioners being assessed. Neuroimaging studies find common patterns during meditation and in long-term meditators reflecting the basic similarities of meditation in general; however, mostly the patterns differ across unique meditation traditions. Research on the mechanisms of meditation, specifically attention and emotion regulation is also discussed. There is a growing body of evidence demonstrating positive benefits from meditation in some clinical populations especially for stress reduction, anxiety, depression, and pain improvement, although future research would benefit by addressing the remaining methodological and conceptual issues. Meditation research continues to grow allowing us to understand greater nuances of how meditation works and its effects.

Highlighting the Role of Cognitive and Brain Reserve in the Substance use Disorder Field

BACKGROUND

Cognitive reserve (CR) refers to the ability of an individual to cope with brain pathology remaining free of cognitive symptoms. This protective factor has been related to compensatory and more efficient brain mechanisms involved in resisting brain damage. For its part, Brain reserve (BR) refers to individual differences in the structural properties of the brain which could also make us more resilient to suffer from neurodegenerative and mental diseases.

OBJECTIVE

This review summarizes how this construct, mainly mediated by educational level, occupational attainment, physical and mental activity, as well as successful social relationships, has gained scientific attention in the last years with regard to diseases, such as neurodegenerative diseases, stroke or traumatic brain injury. Nevertheless, although CR has been studied in a large number of disorders, few researches have addressed the role of this concept in drug addiction.

METHODS

We provide a selective overview of recent literature about the role of CR and BR in preventing substance use onset. Likewise, we will also discuss how variables involved in CR (healthy leisure, social support or job-related activities, among others) could be trained and included as complementary activities of substance use disorder treatments.

RESULTS

Evidence about this topic suggests a preventive role of CR and BR on drug use onset and when drug addiction is established, these factors led to less severe addiction-related problems, as well as better treatment outcomes.

CONCLUSION

CR and BR are variables not taken yet into account in drug addiction. However, they could give us a valuable information about people at risk, as well as patient's prognosis.

Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications

Substance use disorders (SUDs) are a pervasive public health problem with deleterious consequences for individuals, families, and society. Furthermore, SUD intervention is complicated by the continuous possibility of relapse. Despite decades of research, SUD relapse rates remain high, underscoring the need for more effective treatments. Scientific findings indicate that SUDs are driven by dysregulation of neural processes underlying reward learning and executive functioning. Emerging evidence suggests that mindfulness training can target these neurocognitive mechanisms to produce significant therapeutic effects on SUDs and prevent relapse. The purpose of this manuscript is to review the cognitive, affective, and neural mechanisms underlying the effects of mindfulness-based interventions (MBIs) on SUDs. We discuss the etiology of addiction and neurocognitive processes related to the development and maintenance of SUDs. We then explore evidence supporting use of MBIs for intervening in SUDs and preventing relapse. Finally, we provide clinical recommendations about how these therapeutic mechanisms might be applied to intervening in SUDs and preventing relapse.

Behavioral interventions in health neuroscience

Many chronic health concerns (obesity, addiction, stress, chronic pain, and depression) have garnered recent attention for their increasing frequency, intractability, and serious health consequences. Because they are often difficult to treat and there are not always effective pharmacological treatments, many patients are pursuing behavioral interventions for these conditions. Experimental behavioral intervention studies have shown some efficacy for health, but the mechanisms for these treatments are not well understood. Health neuroscience is a burgeoning field that seeks to link neural function and structure with physical and mental health. Through this lens, initial studies have begun to investigate how behavioral interventions modulate neural function in ways that lead to improvements in health markers and outcomes. Here, we provide a review of these studies in terms of how they modulate key neurobiological systems, and how modulation of these systems relates to physical health and disease outcomes. We conclude with discussion of opportunities for future research in this promising area of study.