Neural mechanisms of mindfulness and meditation: Evidence from neuroimaging studies

Reductions in perceived stress following Transcendental Meditation practice are associated with increased brain regional connectivity at rest

Transcendental Meditation (TM) is defined as a mental process of transcending using a silent mantra. Previous work showed that relatively brief period of TM practice leads to decreases in stress and anxiety. However, whether these changes are subserved by specific morpho-functional brain modifications (as observed in other meditation techniques) is still unclear. Using a longitudinal design, we combined psychometric questionnaires, structural and resting-state functional magnetic resonance imaging (RS-fMRI) to investigate the potential brain modifications underlying the psychological effects of TM. The final sample included 19 naïve subjects instructed to complete two daily 20-min TM sessions, and 15 volunteers in the control group. Both groups were evaluated at recruitment (T0) and after 3 months (T1). At T1, only meditators showed a decrease in perceived anxiety and stress (t₍₁₈₎ = 2.53, p = 0.02), which correlated negatively with T1-T0 changes in functional connectivity among posterior cingulate cortex (PCC), precuneus and left superior parietal lobule. Additionally, TM practice was associated with increased connectivity between PCC and right insula, likely reflecting changes in interoceptive awareness. No structural changes were observed in meditators or control subjects. These preliminary findings indicate that beneficial effects of TM may be mediated by functional brain changes that take place after a short practice period of 3 months.

tDCS increases anxiety reactivity to intentional worry

While considerable experimental research has examined the impact of transcranial direct current stimulation (tDCS) on a range of cognitive processes associated with emotional pathology, the impact of tDCS on worry has been comparatively neglected. Given that anxiety pathology is characterised by motivated engagement in worry, and that frontal tDCS has the capacity to enhance goal-oriented cognition, it is important to examine whether tDCS would increase or ameliorate the cognitive and emotional effects of worry. In the current study we examined how tDCS influenced the anxiety response to worry, and the frequency of negative intrusive thoughts. We additionally examined whether stimulation delivered in isolation, or in combination with a mindful-focus task would augment the effects of tDCS. Ninety-seven (75 female) healthy participants received either active or sham anodal tDCS to the left dorsolateral prefrontal cortex, delivered either in isolation or concurrently with a mindful task (four conditions). The frequency of negative thought intrusions was assessed before and after a period of instructed worry, and state anxiety was assessed across the study. Active tDCS was associated with significantly greater elevation in anxiety in response to the worry induction. No effects were observed on the frequency of negative thought intrusions, and the combined delivery of tDCS with the concurrent mindful task did not alter the pattern of observed effects. While inviting replication in a high anxious sample, the present results highlight the possibility that tDCS may interact with motivated engagement in negative patterns of cognition, such as worry, to produce greater emotional reactivity.

The effects of Pythagorean Self-Awareness Intervention on breast cancer patients undergoing adjuvant therapy: A pilot randomized controlled trial

Introduction

Breast cancer patients undergo extended treatments that affect their psychological state and quality of life. There is a lack of studies examining the effects of holistic stress management interventions (that combine stress perception, cognitive and lifestyle interventions) on mental health and biological indices (e.g. cortisol concentrations) of breast cancer patients.

Materials and methods

This pilot randomized controlled trial provided the first assessment of the effects of a novel, cognitive-based intervention, the Pythagorean Self-Awareness Intervention (PSAI), on psychological symptoms, quality of life, sleep quality and lifestyle as well as on stress-related biological measures of breast cancer patients undergoing adjuvant therapy. Standardized questionnaires were administered at baseline and 8-weeksafter the intervention to evaluate quality of life, stress, depression, and anxiety (primary outcomes). Sleep quality, lifestyle and hair cortisol concentrations were also assessed (secondary outcomes).

Results

Forty-five breast cancer patients undergoing adjuvant therapy were randomly assigned to the PSAI group (n = 25) or the control group (n = 20).Women in the PSAI group reported significant improvements post-intervention in total Quality of Life, specific aspects of Quality of Life [Physical well-being, Social well-being, Emotional well-being, Functional well-being, Breast cancer concerns] as well as Perceived stress, depression, anxiety and stress. Improvements in secondary outcomes included increase in sleep quality, empowerment for healthy lifestyle and reduction of hair cortisol concentrations.

Conclusions

The PSAI was beneficial as complementary therapy in the women studied. Larger randomized controlled trials with longer follow-up are needed to ascertain these findings.

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Breast cancer patients face physical and psychological cancer-related stressors.

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Pythagorean self-awareness is a novel stress-management intervention (PSAI).

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Breast cancer patients were allocated to PSAI group and control group.

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Mental health, quality of life and sleep were ameliorated in PSAI group.

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Hair cortisol concentrations were reduced significantly in the PSAI group.

Modelling resilience in adolescence and adversity: a novel framework to inform research and practice

Recent conceptualisations of resilience have advanced the notion that it is a dynamic and multifaceted construct. However, its adaptive components, especially those forged by adversity, have not been fully realised, and its neurobiological and psychosocial underpinnings are yet to be meaningfully integrated. In part, this is because a developmental perspective is often neglected in the formulation of resilience. In this review, we consider the findings of resilience research, with a specific emphasis on the developmental period of adolescence. To bridge the gaps in our current understanding, we propose a model of resilience that is predicated on experiencing adversity. Specifically, our model provides a sophisticated insight into the components of resilience, which, together with intrinsic features, involves facilitation of, and skill acquisition via strengthening processes we term tempering and fortification. The model also points to the potential trajectories of adversity-driven resilience and forms the basis of a framework that allows for individual variance in resilience, and the identification of both neurobiological and psychosocial targets for prevention and therapeutic interventions.

The Effect of Brief Mindfulness Training on Brain Reactivity to Food Cues During Nicotine Withdrawal: A Pilot Functional Imaging Study

Objectives

Many individuals who smoke relapse due to weight gain. Mindfulness training has been shown to help smokers quit smoking, and, in other populations, has been used to help people lose weight. This study was designed to assess the effect of one week of mindfulness practice on food cravings in smokers during 12-hour smoking abstinence.

Methods

We assessed daily smokers with a history of smoking lapse after weight gain. Participants were provided with brief training in mindfulness meditation and mindful eating and were asked to practice each skill daily for one week. Before and after this week of mindfulness practice, participants completed surveys to rate their nicotine dependence and food cravings and underwent testing via functional magnetic resonance imaging.

Results

Study results included pre-post intervention reduction in brain activity in dorsomedial prefrontal cortex, visual areas, and pre-motor areas, regions potentially associated with response to food images.

Conclusions

The study was small; however, it suggests the possibility that mindfulness training might be used to decrease food cravings after smoking cessation.

A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence: A Randomized Clinical Trial

OBJECTIVE

Research has suggested that subanesthetic doses of ketamine may work to improve cocaine-related vulnerabilities and facilitate efforts at behavioral modification. The purpose of this trial was to test whether a single ketamine infusion improved treatment outcomes in cocaine-dependent adults engaged in mindfulness-based relapse prevention.

METHODS

Fifty-five cocaine-dependent individuals were randomly assigned to receive a 40-minute intravenous infusion of ketamine (0.5 mg/kg) or midazolam (the control condition) during a 5-day inpatient stay, during which they also initiated a 5-week course of mindfulness-based relapse prevention. Cocaine use was assessed through self-report and urine toxicology. The primary outcomes were end-of-study abstinence and time to relapse (defined as first use or dropout).

RESULTS

Overall, 48.2% of individuals in the ketamine group maintained abstinence over the last 2 weeks of the trial, compared with 10.7% in the midazolam group (intent-to-treat analysis). The ketamine group was 53% less likely (hazard ratio=0.47; 95% CI=0.24, 0.92) to relapse (dropout or use cocaine) compared with the midazolam group, and craving scores were 58.1% lower in the ketamine group throughout the trial (95% CI=18.6, 78.6); both differences were statistically significant. Infusions were well tolerated, and no participants were removed from the study as a result of adverse events.

CONCLUSIONS

A single ketamine infusion improved a range of important treatment outcomes in cocaine-dependent adults engaged in mindfulness-based behavioral modification, including promoting abstinence, diminishing craving, and reducing risk of relapse. Further research is needed to replicate these promising results in a larger sample.

Alterations in Brain Structure and Amplitude of Low-frequency after 8 weeks of Mindfulness Meditation Training in Meditation-Naïve Subjects

Increasing neuroimaging evidence suggests that mindfulness meditation expertise is related to different functional and structural configurations of the default mode network (DMN), the salience network (SN) and the executive network at rest. However, longitudinal studies observing resting network plasticity effects in brains of novices who started to practice meditation are scarce and generally related to one dimension, such as structural or functional effects. The purpose of this study was to investigate structural and functional brain network changes (e.g. DMN) after 40 days of mindfulness meditation training in novices and set these in the context of potentially altered depression symptomatology and anxiety. We found overlapping structural and functional effects in precuneus, a posterior DMN region, where cortical thickness increased and low-frequency amplitudes (ALFF) decreased, while decreased ALFF in left precuneus/posterior cingulate cortex correlates with the reduction of (CES-D) depression scores. In conclusion, regional overlapping of structural and functional changes in precuneus may capture different components of the complex changes of mindfulness meditation training.

Characterizing the Dynamical Complexity Underlying Meditation

Over the past 2,500 years, contemplative traditions have explored the nature of the mind using meditation. More recently, neuroimaging research on meditation has revealed differences in brain function and structure in meditators. Nevertheless, the underlying neural mechanisms are still unclear. In order to understand how meditation shapes global activity through the brain, we investigated the spatiotemporal dynamics across the whole-brain functional network using the Intrinsic Ignition Framework. Recent neuroimaging studies have demonstrated that different states of consciousness differ in their underlying dynamical complexity, i.e., how the broadness of communication is elicited and distributed through the brain over time and space. In this work, controls and experienced meditators were scanned using functional magnetic resonance imaging (fMRI) during resting-state and meditation (focused attention on breathing). Our results evidenced that the dynamical complexity underlying meditation shows less complexity than during resting-state in the meditator group but not in the control group. Furthermore, we report that during resting-state, the brain activity of experienced meditators showed higher metastability (i.e., a wider dynamical regime over time) than the one observed in the control group. Overall, these results indicate that the meditation state operates in a different dynamical regime compared to the resting-state.

Religious Belief at the Level of the Brain: Neural Correlates and Influence of Culture

This article summarizes key functional magnetic resonance imaging studies that correlate the neural substrate of religious belief and the influence of culture. I searched and updated PubMed (http://www.ncbi.nlm.nih.gov/pubmed) publications until March 2018 on religious belief and related topics. Belief, whether religious or nonreligious, is associated with greater signal in the ventromedial prefrontal cortex (vMPFC), a brain region important for self-representation, emotional associations, reward, and goal-driven behavior. However, religious belief, compared with nonreligious belief, registers greater signal in the precuneus, anterior insula, ventral striatum, anterior cingulate cortex, and posterior medial cortex-areas associated with governance of emotion, self-representation, and cognitive conflict. In contrast, nonreligious belief registers more signal in the left hemisphere memory networks (Harris et al. PLoS One 2009;4:e0007272). Moreover, cultural studies revealed self-judgment tasks in nonbelievers involved more the vMPFC, whereas Christians had significantly increased activation in the dorsomedial prefrontal cortex (Han et al. Soc Neurosci 2008;3:1-15). Consequently, the Christian belief of "surrendering to Christ" seemed to weaken neural coding of stimulus self-relatedness but enhanced neural activity underlying evaluative processes of self-referential stimuli. The findings suggest a transformation of the semantic autobiographical self to Christ's conceptual self.

Meditation-Induced States, Vagal Tone, and Breathing Activity Are Related to Changes in Auditory Temporal Integration

This study is based on the relationship between meditation, the present moment, and psychophysiology. We employed the metronome task to operationalize the extension of the present moment. A pre-post longitudinal study was conducted. The performance in the metronome task was compared before and after the interventions (meditation, story). The aim was to assess whether physiological changes (heart, breathing) during meditation influence the temporal-integration (TI) of metronome beats. Mindfulness meditators either meditated (n = 41) or listened to a story (n = 43). The heart and breathing activity were recorded during the intervention and compared to a resting-state condition. By applying path analyses we found that meditation led to an increase of the duration of integration intervals at the slowest metronome frequency (inter-stimulus interval, ISI = 3 s). After meditation, the higher the heart-rate variability (i.e., the root mean square of successive differences, RMSSD), the longer the duration of integration intervals at the fastest frequency (ISI = 0.33 s). Moreover, the higher the breathing rate during meditation, the greater the integration of intervals at ISI = 1 s. These findings add evidence to meditation-induced changes on the TI of metronome beats and the concept of the embodiment of mental functioning.

Differential Reduction of IP-10 and C-Reactive Protein via Aerobic Exercise or Mindfulness-Based Stress-Reduction Training in a Large Randomized Controlled Trial

Exercise and meditation improve health and well-being, potentially through decreasing systemic inflammation. In this study, healthy adults (N = 413) were randomized to 8 weeks of training in aerobic exercise, matched mindfulness-based stress reduction, or wait-list control. Three inflammation-related biomarkers (C-reactive protein, interleukin-6, and interferon-gamma-inducible protein-10) were assessed preintervention, directly postintervention, and 17 weeks later. Within-group analyses found that exercise participants had decreased serum interferon-gamma-inducible protein-10 postintervention and 17 weeks later, whereas C-reactive protein was lower in mindfulness-based stress-reduction participants 17 weeks postintervention only. Self-reported physical activity or amount of meditation practice did not predict biomarker changes. This study suggests that (a) training in aerobic exercise can lower interferon-gamma-inducible protein-10, a chemokine associated with interferon activity and illness, and (b) training in mindfulness meditation may have a delayed effect on C-reactive protein, an important inflammatory biomarker. The findings highlight the likelihood of multiple, distinct pathways underlying the health-promoting effects of these lifestyle interventions.

Concentrative (Sahaj Samadhi) meditation training and visual awareness: An fMRI study on color afterimages

All of us consciously experience the world around us through our sensory modalities. Empirical studies on the relationship between attention and awareness have shown that attention does influence perceptual experience or appearance in addition to better performance in perceptual tasks. The practice of meditation also changes perceptual experience in addition to better perceptual performance. For example, a study with Sahaj Samadhi meditators utilizing negative color afterimages had shown that concentrative meditation influences visual experience. However the brain regions that are modified by meditation practice leading to such changes in visual experience or awareness are still not known. Here using negative color afterimages in a functional MRI study, we investigated the brain mechanisms underlying the changes in visual awareness as a function of attentional enhancement achieved through long-term concentrative meditation practice. We found increased activity in right lateralized inferior occipital and inferior frontal cortex, which suggests the importance of attentional control in modulating visual awareness. The results of this study indicate that the link between attention and conscious experience is possibly changed by meditation practices.

The Emerging Empirical Science of Wisdom: Definition, Measurement, Neurobiology, Longevity, and Interventions

After participating in this activity, learners should be better able to:• Assess the empirical literature on wisdom• Evaluate a proposed model of wisdom development ABSTRACT: This article seeks to provide an overview of the empirical literature on wisdom in terms of its definitions and measurements, possible neurobiological basis, and evolutionary value, as well as changes with aging and potential clinical interventions to enhance components of wisdom. Wisdom may be defined as a complex human trait with several specific components: social decision making, emotion regulation, prosocial behaviors, self-reflection, acceptance of uncertainty, decisiveness, and spirituality. These components appear to be localized primarily to the prefrontal cortex and limbic striatum. Emerging research suggests that wisdom is linked to better overall health, well-being, happiness, life satisfaction, and resilience. Wisdom likely increases with age, facilitating a possible evolutionary role of wise grandparents in promoting the fitness of the species. Despite the loss of their own fertility and physical health, older adults help enhance their children's well-being, health, longevity, and fertility-the "Grandma Hypothesis" of wisdom. We propose a model of wisdom development that incorporates genetic, environmental, and evolutionary aspects. Wisdom has important implications at both individual and societal levels, and warrants further research as a major contributor to human thriving. There is a need for a greater emphasis on promoting wisdom through our educational systems from elementary to professional schools.

Does Emotional Intelligence Mediate the Relation Between Mindfulness and Anxiety and Depression in Adolescents?

High anxiety and depression are often observed in the Australian adolescent population, and if left untreated, can have long-term negative consequences impacting educational attainment and a range of important life outcomes. The utilization of mindfulness techniques has been associated with decreased anxiety and depression, but the underlying mechanisms for this is only beginning to be understood. Previous research with adult samples has suggested that the development of emotional intelligence (EI) may be one mechanism by which mindfulness confers its benefits on wellbeing. This study is the first to examine the relation between mindfulness, EI, anxiety, and depression in an adolescent population. It was hypothesized that EI would mediate the relationships between mindfulness and anxiety, as well as mindfulness and depression. The sample consisted of 108 adolescents from a public secondary school, aged between 13 and 15 years (M_age = 13.68, SD_age = 0.56, 51 males and 57 females). Participants completed an online self-report questionnaire which measured dispositional mindfulness, EI, anxiety, and depression. The results indicated that one subscale of EI – Emotional Recognition and Expression (ERE) mediated the relation between mindfulness and anxiety, while two subscales of EI – ERE and Emotional Management and Control (EMC) mediated the relation between mindfulness and depression. Future research utilizing a mindfulness intervention should be conducted to examine whether the use of mindfulness increases EI and decreases anxiety and depression in adolescents.

Yoga Practitioners Uniquely Activate the Superior Parietal Lobule and Supramarginal Gyrus During Emotion Regulation

Chronic stress contributes to both mental and physical illness. A high prevalence and cost of stress-related illnesses North America warrants investigation into alternative or complementary therapies which may help reduce adverse reactions to stressful stimuli. Emotion regulation is the process of monitoring and adjusting emotional responses to environmental stimuli and stressors. Individuals who participate in physical activity are less likely to have adverse responses to potentially stressful situations, potentially due to adaptions in emotion regulation. Yoga is a form of physical activity involving stretching exercises and meditation, that may lessen individuals’ levels of stress and anxiety and improve emotion regulation. High-frequency heart rate variability (HF-HRV) is considered a measure of parasympathetic nervous system (PNS) activity during the emotion regulation. Measuring HRV and brain activity using functional magnetic resonance imaging (fMRI) offers a useful, noninvasive approach to evaluating “neurovisceral” components of emotion regulation. We aimed to determine whether yoga practitioners (YP) exhibit different patterns of brain activation compared to recreational athletes (RA) without current yoga experience, while viewing emotionally arousing visual stimuli. Our secondary aim was to examine potential differences across groups in HRV throughout the presentation of these stimuli. Analysis of fMRI data during exposure to emotion-evoking (EE) stimuli revealed that the YP group activated two unique brain areas, namely the superior parietal lobule and the supramarginal gyrus. These areas have been associated with attentional awareness and reduced egocentric bias, processes that have been implicated in emotion regulation by others. The RA group activated the inferior middle frontal cortex, an area associated with cognitive reappraisal during emotion regulation. The YP group also demonstrated a trend towards a higher ratio of low- to high-frequency HRV compared to the RA group. The present findings support the presence of experience-dependent neurovisceral mechanisms associated with emotion regulation. Individuals who practice yoga regulate their neurovisceral responses to potentially stressful external stimuli in a different manner than recreational athletes who do not engage in yoga practice. The present study had a small sample size (RA: n = 12; YP: n = 19), which should be taken into account when interpreting the results.

Atypical Anxiety-Related Amygdala Reactivity and Functional Connectivity in Sant Mat Meditation

While meditation has drawn much attention in cognitive neuroscience, the neural mechanisms underlying its emotional processing remains elusive. Sant Mat meditators were recruited, who adopt a loving-kindness mode of meditation along with a vegetarian diet and an alcohol-restricted lifestyle and novices. We assessed their State-Trait Anxiety Inventory (STAI) and scanned their amygdala reactivity in response to an explicit and implicit (backward masked) perception of fearful and happy faces. In contrast with novices, meditators reported lower STAI scores. Meditators showed stronger amygdala reactivity to explicit happiness than to fear, whereas novices exhibited the opposite pattern. The amygdala reactivity was reduced in meditators regardless of implicit fear or happiness. Those who had more lifetime practice in meditation reported lower STAI and showed a weaker amygdala response to fear. Furthermore, the amygdala in meditators, relative to novices, had a stronger positive functional connectivity with the ventrolateral prefrontal cortex (PFC) to explicit happiness, but a more negative connectivity with the insula and medial orbitofrontal cortex (OFC) to explicit fear. Mediation analysis indicated the amygdala reactivity as the mediator for the linkage between meditation experience and trait anxiety. The findings demonstrate the neural correlates that underpin the beneficial effects of meditation in Sant Mat. Long-term meditation could be functionally coupled with the amygdala reactivity to explicit and implicit emotional processing, which would help reduce anxiety and potentially enhance well-being.

Mindfulness-based interventions and cognitive function among breast cancer survivors: a systematic review

Background

Breast cancer survivors have an elevated risk of cognitive impairment compared to age-matched women without cancer. Causes of this impairment are complex, including both treatment and psychological factors. Mindfulness-based interventions, which have been shown to improve cognitive function in the general population, may be one approach to mitigate cognitive impairment in this survivor population. Our objective was to conduct a systematic literature review of studies on the effect of mindfulness-based interventions on cognition among breast cancer survivors.

Methods

We conducted searches of three electronic databases (Scopus, PubMed and Cochrane Database of Systematic Reviews) in September 2017 for studies pertaining mindfulness and cognitive function among breast cancer survivors. Abstracts were manually searched by two reviewers and additional articles were identified through reference lists.

Results

A total of 226 articles were identified through our systematic search and six met inclusion criteria for this review. The reviewed studies lacked consistency in terms of the cognition domains studied (e.g. executive function, recent memory, etc) and in the measures used to assess cognition. Of the included studies, two found no association between mindfulness interventions and cognitive function, two found improvement that was not sustained at the follow-up, and another two found sustained improvement at 2- or 6-months.

Conclusions

Mindfulness-based interventions have shown some evidence for improving cognition among breast cancer survivors, but further research using validated and comprehensive cognitive assessments is needed. More research is also needed related to the timing, duration and content of mindfulness interventions.

Electronic supplementary material

The online version of this article (10.1186/s12885-018-5065-3) contains supplementary material, which is available to authorized users.

The Role of Attention in Therapy for Children and Adolescents Who Stutter: Cognitive Behavioral Therapy and Mindfulness-Based Interventions

METHOD

This clinical discussion paper will explore two aspects of attention in relation to young people who stutter and their parents: (a) what we attend to as human beings and (b) how we attend. It will draw on research and clinical practice informed by CBT and MBIs. Specifically, information-processing theory in CBT explains psychological well-being partly in terms of what individuals focus their attention on, whereas MBIs focus on the relationship between how individuals attend to their internal experiences and their psychological well-being.

CONCLUSIONS

Although a nascent field, MBIs may be useful as a part of therapy for children and adolescents who stutter. The concepts highlighted by MBIs may also help to resolve some clinical issues.

Current status of acceptance and commitment therapy for chronic pain: a narrative review

It is well known that chronic pain is prevalent, complex to manage, and associated with high costs, in health care and society in general. Thanks to advances in new forms of cognitive behavioral therapy (known as third-wave CBT), currently clinicians and researchers have an empirically validated psychological treatment with increasing research support for the treatment of chronic pain. This treatment is called acceptance and commitment therapy (ACT). The main aim of this paper is to provide a narrative review that summarizes and integrates the current state of knowledge of ACT in the management of chronic pain as well as discuss current challenges and opportunities for progress. Based on the psychological flexibility model, ACT extends previous forms of CBT and integrates many CBT-related variables into six core therapeutic processes. ACT is a process-based therapy that fosters openness, awareness, and engagement through a wide range of methods, including exposure-based and experiential methods, metaphors, and values clarification. To our knowledge, there are three published systematic reviews and meta-analyses that support the effectiveness of ACT for chronic pain and many studies focused on specific processes derived from the psychological flexibility model. There is also promising support for the cost-effectiveness of ACT; however, the current evidence is still insufficient to establish firm conclusions about cost-effectiveness and the most efficient means of delivery. Additional well-designed economic evaluations are needed. Other research aims include delineating the neurobiological underpinnings of ACT, refining available outcome and process measures or develop new ones for ACT trials, and meeting the challenge of wide dissemination and implementation in real-world clinical practice.

Extremely brief mindfulness interventions for women undergoing breast biopsies: a randomized controlled trial

PURPOSE

Mindfulness-based programs can reduce stress and help practitioners to have positive attitudes in their daily lives. This randomized controlled trial evaluated the impact of brief Mindfulness interventions on quantitative and qualitative stress parameters in patients undergoing imaging-guided breast biopsies.

METHODS

Eighty-two women undergoing percutaneous imaging-guided breast biopsy were randomized into two groups: MBI group or standard care group. One week before the biopsy procedure, on the waiting room and during the biopsy procedure, the MBI group was exposed to mindfulness techniques and the standard care group received supportive dialogue from the biopsy team. Participants completed questionnaires measuring depression, anxiety and stress, demographics, and medical history, besides evaluating their pain experience through a visual analogue scale for pain and had their systolic and diastolic blood pressure, initial and final temperate, heart rate, oxygen saturation, and salivary cortisol measured.

RESULTS

Participation in the mindfulness intervention group was associated with reduced levels of perceived stress, blood pressure, heart rate, and oxygen saturation compared to participation in the standard care group (P values < 0.05). No difference was observed regarding salivary cortisol levels, peripheral temperature, and pain perception between the two studied groups.

CONCLUSION

Results indicate that an extremely brief mindfulness intervention is a feasible intervention, suggesting that Mindfulness-based programs may be beneficial to reduce discomfort in acutely stressful settings.

A Systematic Review and Meta-analysis of the Effects of Meditation on Empathy, Compassion, and Prosocial Behaviors

Increased attention has focused on methods to increase empathy, compassion, and pro-social behavior. Meditation practices have traditionally been used to cultivate pro-social outcomes, and recently investigations have sought to evaluate their efficacy for these outcomes. We conducted a systematic review and meta-analysis of meditation for pro-social emotions and behavior. A literature search was conducted in PubMed, MEDLINE, PsycINFO, CINAHL, Embase, and Cochrane databases (inception-April 2016) using the search terms: mindfulness, meditation, mind-body therapies, tai chi, yoga, MBSR, MBCT, empathy, compassion, love, altruism, sympathy, or kindness. Randomized controlled trials in any population were included (26 studies with 1,714 subjects). Most were conducted among healthy adults (n=11) using compassion or loving kindness meditation (n=18) over 8-12weeks (n=12) in a group format (n=17). Most control groups were wait-list or no-treatment (n=15). Outcome measures included self-reported emotions (e.g., composite scores, validated measures) and observed behavioral outcomes (e.g., helping behavior in real-world and simulated settings). Many studies showed a low risk of bias. Results demonstrated small to medium effects of meditation on self-reported (SMD = .40, p < .001) and observable outcomes (SMD = .45, p < .001) and suggest psychosocial and neurophysiological mechanisms of action. Subgroup analyses also supported small to medium effects of meditation even when compared to active control groups. Clinicians and meditation teachers should be aware that meditation can improve positive pro-social emotions and behaviors.

Affective science and avoidant end-of-life communication: Can the science of emotion help physicians talk with their patients about the end of life?

Despite believing end-of-life (EOL) discussions with patients are important, doctors often do not have them. Multiple factors contribute to this shortfall, which interventions including reimbursement changes and communication skills training have not significantly improved to date. One commonly cited but under-researched reason for physician avoidance of EOL discussion is emotional difficulty. High occupational demand for frequent difficult discussions may overload physicians' normal emotional functioning, leading to avoidance or failure. We propose that cognitive, behavioral, and neuroscience evidence from affective science may offer helpful insights into this problem. Data from other populations show that strong emotion impairs cognitive performance and multiple demands can overload cognitive resources. We discuss several affective processes that may apply to physicians attempting EOL discussions. We then discuss selected interventions that have been shown to modify some of these processes and associated behavioral outcomes. Evidence for change in behavioral outcomes of interest includes performance and mood enhancement in healthy populations. We suggest that such mechanistically-targeted interventions may be hypothesized to help decrease physician avoidance of EOL discussion. Physicians may be motivated to adopt such interventions in order to enhance normal emotional functioning to meet supra-normal occupational demand. We propose this as a promising area of future study.

Ayahuasca: An ancient sacrament for treatment of contemporary psychiatric illness?

Ayahuasca is a traditional psychoactive sacrament that's been used in Amazonian shamanic rituals for hundreds of years. Ayahuasca is notorious for its psychedelic properties produced from the combination of monoamine oxidase inhibitors (MAOIs) found in the Banisteriopsis caapi vine and N-N-dimethyltryptamine from Psychotria viridis or Diplopterys cabrerana. Recently, ritual use of ayahuasca has increased and garnered attention for its potential in treating mental illnesses, such as substance use and depressive disorders. Due to its MAOI properties, there are serious drug interactions that may be of concern among patients who participate in ayahuasca use. The objectives of this paper are to describe ayahuasca's pharmacology, potential drug interactions, and clinical data for its treatment potential in psychiatric illness.

fMRI during Transcendental Meditation practice

This study used a within group design to investigate blood flow patterns (fMRI) in 16 long-term practitioners of Transcendental Meditation (mean practice: 34.3 years with each having over 36,000 h of meditation practice). During Transcendental Meditation practice, blood flow patterns were significantly higher in executive and attention areas (anterior cingulate and dorsolateral prefrontal cortices) and significantly lower in arousal areas (pons and cerebellum). This pattern supports the understanding that Transcendental Meditation practice requires minimal effort. During Transcendental Meditation, the attentional system was active (heightened blood flow in anterior cingulate and dorsolateral prefrontal cortices) in an automatic manner-decreased blood flow in the pons and cerebellum. This pattern of heightened blood flow in attentional areas and decreased blood flow in arousal areas has not been reported during other meditation practices. Future research should investigate blood flow patterns in different meditation practices in the same study.

Cultural aspects of anxiety disorders in India

Cultural factors have influenced the presentation, diagnoses, and treatment of anxiety disorders in India for several centuries. This review covers the antecedents, prevalence, phenomenology, and treatment modalities of anxiety disorders in the Indian cultural context. It covers the history of the depiction of anxiety in India and the concept of culture in the classification of anxiety disorders, and examines the cultural factors influencing anxiety disorders in India. We review the prevalence and phenomenology of various disorders, such as generalized anxiety disorder, panic disorder, social anxiety, and phobic disorder, as well as culture-specific syndromes such as dhat and koro in India. Finally, the review examines the wide range of therapeutic modalities practiced in India, such as faith healing, psychotherapy, ayurveda, psychopharmacology, Unani medicine, homeopathy, yoga, meditation, and mindfulness. We conclude by emphasizing the significance of cultural factors in making relevant diagnoses and offering effective and holistic treatments to individuals with anxiety disorders.

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence

Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, reveals low attrition with medium to large effect sizes. We review the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence

Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, reveals low attrition with medium to large effect sizes. We review the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.

Changes in Neural Connectivity and Memory Following a Yoga Intervention for Older Adults: A Pilot Study

Background: No study has explored the effect of yoga on cognitive decline and resting-state functional connectivity.

Objectives: This study explored the relationship between performance on memory tests and resting-state functional connectivity before and after a yoga intervention versus active control for subjects with mild cognitive impairment (MCI).

Methods: Participants ( ≥ 55 y) with MCI were randomized to receive a yoga intervention or active “gold-standard” control (i.e., memory enhancement training (MET)) for 12 weeks. Resting-state functional magnetic resonance imaging was used to map correlations between brain networks and memory performance changes over time. Default mode networks (DMN), language and superior parietal networks were chosen as networks of interest to analyze the association with changes in verbal and visuospatial memory performance.

Results: Fourteen yoga and 11 MET participants completed the study. The yoga group demonstrated a statistically significant improvement in depression and visuospatial memory. We observed improved verbal memory performance correlated with increased connectivity between the DMN and frontal medial cortex, pregenual anterior cingulate cortex, right middle frontal cortex, posterior cingulate cortex, and left lateral occipital cortex. Improved verbal memory performance positively correlated with increased connectivity between the language processing network and the left inferior frontal gyrus. Improved visuospatial memory performance correlated inversely with connectivity between the superior parietal network and the medial parietal cortex.

Conclusion:Yoga may be as effective as MET in improving functional connectivity in relation to verbal memory performance. These findings should be confirmed in larger prospective studies.

Cultural aspects of anxiety disorders in India

Cultural factors have influenced the presentation, diagnoses, and treatment of anxiety disorders in India for several centuries. This review covers the antecedents, prevalence, phenomenology, and treatment modalities of anxiety disorders in the Indian cultural context. It covers the history of the depiction of anxiety in India and the concept of culture in the classification of anxiety disorders, and examines the cultural factors influencing anxiety disorders in India. We review the prevalence and phenomenology of various disorders, such as generalized anxiety disorder, panic disorder, social anxiety, and phobic disorder, as well as culture-specific syndromes such as dhat and koro in India. Finally, the review examines the wide range of therapeutic modalities practiced in India, such as faith healing, psychotherapy, ayurveda, psychopharmacology, Unani medicine, homeopathy, yoga, meditation, and mindfulness. We conclude by emphasizing the significance of cultural factors in making relevant diagnoses and offering effective and holistic treatments to individuals with anxiety disorders.

Resting Brain Activity Related to Dispositional Mindfulness: a PET Study

Mindfulness denotes a state of consciousness characterized by receptive attention to and awareness of present events and experiences. As a personality trait, it constitutes the ability to become aware of mental activities such as sensations, images, feelings, and thoughts, and to disengage from judgment, conditioned emotions, and their cognitive processing or automatic inhibition. Default brain activity reflects the stream of consciousness and sense of self at rest. Analysis of brain activity at rest in persons with mindfulness propensity may help to elucidate the neurophysiological basis of this important mental trait. The sample consisted of 32 persons-23 with mental disorders and 9 healthy controls. Dispositional mindfulness (DM) was operationalized by Mindful Attention Awareness Scale (MAAS). Brain activity at rest with eyes closed was assessed by fluorodeoxyglucose positron emission tomography (F-18-FDG PET). After adjustment for depression, anxiety, age and years of education, resting glucose metabolism in superior parietal lobule and left precuneus/Brodmann area (BA) 7 was positively associated with DM. Activity of the left inferior frontal orbital gyrus (BA 47) and bilateral anterior thalamus were inversely associated with DM. DM appears to be associated with increased metabolic activity in some core area of the default mode network (DMN) and areas connected to the DMN, such as BA 7, hosting sense of self functions. Hypometabolism on the other hand was found in some nodes connected to the DMN, such as left inferior frontal orbital gyrus and bilateral thalamus, commonly related to functions of memory retrieval, decision making, or outward attention.

Mindfulness-Based Movement: A Polyvagal Perspective

Compelling evidence suggests that physical activity is an effective intervention for cancer survivors, including for those undergoing active cancer treatments. However, to date most evidence has emerged from interventions that have promoted moderate to vigorous physical activity. In this conceptual review, we argue that attention should be given to the entire continuum of physical activity from reducing sedentary behavior to increasing higher levels of physical activity when possible. In addition, considerable evidence in the cancer literature supports the value of mindfulness-based interventions as a means of helping patients and survivors cope with the variety of threats that accompany this disease. Based on the success of these two areas of research, we argue for conceptualizing and promoting physical activity as Mindfulness-Based Movement, using Polyvagal Theory as a theoretical framework to understand the role and value of Mindfulness-Based Movement as a potential intervention for cancer care and control.

The mindful eye: Smooth pursuit and saccadic eye movements in meditators and non-meditators

BACKGROUND

This study examined the effects of cultivated (i.e. developed through training) and dispositional (trait) mindfulness on smooth pursuit (SPEM) and antisaccade (AS) tasks known to engage the fronto-parietal network implicated in attentional and motion detection processes, and the fronto-striatal network implicated in cognitive control, respectively.

METHODS

Sixty healthy men (19-59years), of whom 30 were experienced mindfulness practitioners and 30 meditation-naïve, underwent infrared oculographic assessment of SPEM and AS performance. Trait mindfulness was assessed using the self-report Five Facet Mindfulness Questionnaire (FFMQ).

RESULTS

Meditators, relative to meditation-naïve individuals, made significantly fewer catch-up and anticipatory saccades during the SPEM task, and had significantly lower intra-individual variability in gain and spatial error during the AS task. No SPEM or AS measure correlated significantly with FFMQ scores in meditation-naïve individuals.

CONCLUSIONS

Cultivated, but not dispositional, mindfulness is associated with improved attention and sensorimotor control as indexed by SPEM and AS tasks.

Cost-utility and biological underpinnings of Mindfulness-Based Stress Reduction (MBSR) versus a psychoeducational programme (FibroQoL) for fibromyalgia: a 12-month randomised controlled trial (EUDAIMON study)

BACKGROUND

The EUDAIMON study focuses on fibromyalgia syndrome (FMS), a prevalent chronic condition characterized by pain, fatigue, cognitive problems and distress. According to recent reviews and meta-analyses, Mindfulness-Based Stress Reduction (MBSR) is a promising therapeutic approach for patients with FMS. The measurement of biomarkers as part of the analysis of MBSR effects would help to identify the neurobiological underpinnings of MBSR and increase our knowledge of FMS pathophysiology. The main objectives of this 12-month RCT are: firstly, to examine the effectiveness and cost-utility for FMS patients of MBSR as an add-on to treatment as usual (TAU) versus TAU + the psychoeducational programme FibroQoL, and versus TAU only; secondly, to examine pre-post differences in brain structure and function, as well as levels of specific inflammatory markers in the three study arms and; thirdly, to analyse the role of some psychological variables as mediators of 12-month clinical outcomes.

METHODS

Effectiveness, cost-utility, and neurobiological analyses performed alongside a 12-month RCT. The participants will be 180 adult patients with FMS recruited at the Sant Joan de Déu hospital (St. Boi de Llobregat, Spain), randomly allocated to one of the three study arms: TAU + MBSR vs. TAU + FibroQol vs. TAU. A comprehensive assessment to collect functional, quality of life, distress, costs, and psychological variables will be conducted pre-, post-intervention, and at 12-month post-intervention. Fifty per cent of study participants will be evaluated at pre- and post-treatment using Voxel-Based Morphometry, Diffusion Tensor Imaging, pseudo-continuous Arterial Spin Labeling, and resting state fMRI. A cytokine multiplex kit of high-sensitivity will be applied (cytokines IL-6, IL-8, IL-10 + high-sensitivity CRP test).

DISCUSSION

The findings obtained from this RCT will indicate whether MBSR is potentially cost-effective for FMS and contribute to knowledge of any brain and inflammatory changes associated with MBSR in FMS patients. Specifically, we will determine whether there are morphometric and functional changes associated with participation in MBSR in brain regions related to meta-awareness, body awareness, memory consolidation-reconsolidation, emotion regulation and in networks postulated to underpin the sensory-discriminative, cognitive-evaluative and affective-motivational aspects of the pain experience.

TRIAL REGISTRATION

NCT02561416 . Registered 23 September 2015.

Neural mechanisms of hypnosis and meditation

Hypnosis has been an elusive concept for science for a long time. However, the explosive advances in neuroscience in the last few decades have provided a "bridge of understanding" between classical neurophysiological studies and psychophysiological studies. These studies have shed new light on the neural basis of the hypnotic experience. Furthermore, an ambitious new area of research is focusing on mapping the core processes of psychotherapy and the neurobiology/underlying them. Hypnosis research offers powerful techniques to isolate psychological processes in ways that allow their neural bases to be mapped. The Hypnotic Brain can serve as a way to tap neurocognitive questions and our cognitive assays can in turn shed new light on the neural bases of hypnosis. This cross-talk should enhance research and clinical applications. An increasing body of evidence provides insight in the neural mechanisms of the Meditative Brain. Discrete meditative styles are likely to target different neurodynamic patterns. Recent findings emphasize increased attentional resources activating the attentional and salience networks with coherent perception. Cognitive and emotional equanimity gives rise to an eudaimonic state, made of calm, resilience and stability, readiness to express compassion and empathy, a main goal of Buddhist practices. Structural changes in gray matter of key areas of the brain involved in learning processes suggest that these skills can be learned through practice. Hypnosis and Meditation represent two important, historical and influential landmarks of Western and Eastern civilization and culture respectively. Neuroscience has beginning to provide a better understanding of the mechanisms of both Hypnotic and Meditative Brain, outlining similarities but also differences between the two states and processes. It is important not to view either the Eastern or the Western system as superior to the other. Cross-fertilization of the ancient Eastern meditation techniques presented with Western modern clinical hypnosis will hopefully result in each enriching the other.

The Association between Meditation Practice and Job Performance: A Cross-Sectional Study

Many previous studies have shown that meditation practice has a positive impact on cognitive and non-cognitive functioning, which are related to job performance. Thus, the aims of this study were to (1) estimate the prevalence of meditation practice, (2) identify the characteristics of individuals who practice meditation, and (3) examine the association between meditation practice and job performance. Two population-based, cross-sectional surveys were conducted. In study 1, we examined the prevalence of meditation practice and the characteristics of the persons practicing meditation; in Study 2, we examined the association between meditation practice and job performance. The outcome variables included work engagement, subjective job performance, and job satisfaction. The Utrecht Work Engagement Scale was used to assess work engagement, the World Health Organization Health and Work Performance Questionnaire (HPQ) was used to measure subjective job performance, and a scale developed by the Japanese government was used to assess job satisfaction. Hierarchical multiple regression analyses were used in Study 2. Demographic characteristics and behavioral risk factors were included as covariates in the analyses. The results of Study 1 indicated that 3.9% of persons surveyed (n = 30,665) practiced meditation; these individuals were younger and had a higher education, higher household income, higher stress level, and lower body mass index than those who did not practice meditation. The results of Study 2 (n = 1,470) indicated that meditation practice was significantly predictive of work engagement (β = 0.112, p < .001), subjective job performance (β = 0.116, p < .001), and job satisfaction (β = 0.079, p = .002), even after adjusting for covariates (β = 0.083, p < .001; β = 0.104, p < .001; β = 0.060, p = .015, respectively). The results indicate that meditation practice may positively influence job performance, including job satisfaction, subjective job performance, and work engagement.

Meditation has stronger relationships with mindfulness, kundalini, and mystical experiences than yoga or prayer

Contemplative practices can have profound effects on mindfulness and on physical and sensory and mystical experiences. Individuals who self-reported meditation, yoga, contemplative prayer, or a combination of practices and their patterns of practice were compared for mindfulness, kundalini effects, and mystical experiences. The results suggest that the amount of practice but not the pattern and social conditions of practice influences mindfulness and possibly mystical experiences. Meditation, yoga, contemplative prayer, or a combination of practices all were found to be associated with enhancements of mindfulness, kundalini effects, and mystical experiences, but meditation had particularly strong associations and may be the basis of the associations of yoga and prayer with these outcomes. The results further suggest that the primary association of contemplative practices is with the real time awareness and appreciation of sensory and perceptual experiences which may be the intermediary between disparate practices and mindfulness, kundalini effects, and mystical experiences.

Being present at school: implementing mindfulness in schools

Developmentally sensitive efforts to help students learn, practice, and regularly use mindfulness tactics easily and readily in and beyond the classroom are important to help them manage future stresses. Mindfulness emphasizes consciously focusing the mind in the present moment, purposefully, without judgment or attachment. Meditation extends this to setting aside time and places to practice mindfulness, and additionally, yoga includes physical postures and breathing techniques that enhance mindfulness and meditation. Several mindfulness programs and techniques have been applied in schools, with positive benefits reported. Some elements of these programs require modifications to be sensitive to the developmental state of the children receiving mindfulness training.

Meditation reduces pain-related neural activity in the anterior cingulate cortex, insula, secondary somatosensory cortex, and thalamus

Recent studies have shown that meditation inhibits or relieves pain perception. To clarify the underlying mechanisms for this phenomenon, neuroimaging methods, such as functional magnetic resonance imaging, and neurophysiological methods, such as magnetoencephalography and electroencephalography, have been used. However, it has been difficult to interpret the results, because there is some paradoxical evidence. For example, some studies reported increased neural responses to pain stimulation during meditation in the anterior cingulate cortex (ACC) and insula, whereas others showed a decrease in these regions. There have been inconsistent findings to date. Moreover, in general, since the activities of the ACC and insula are correlated with pain perception, the increase in neural activities during meditation would be related to the enhancement of pain perception rather than its reduction. These contradictions might directly contribute to the ‘mystery of meditation.’ In this review, we presented previous findings for brain regions during meditation and the anatomical changes that occurred in the brain with long-term meditation training. We then discussed the findings of previous studies that examined pain-related neural activity during meditation. We also described the brain mechanisms responsible for pain relief during meditation, and possible reasons for paradoxical evidence among previous studies. By thoroughly overviewing previous findings, we hypothesized that meditation reduces pain-related neural activity in the ACC, insula, secondary somatosensory cortex, and thalamus. We suggest that the characteristics of the modulation of this activity may depend on the kind of meditation and/or number of years of experience of meditation, which were associated with paradoxical findings among previous studies that investigated pain-related neural activities during meditation.

Mindfulness-based therapies in the treatment of functional gastrointestinal disorders: a meta-analysis

Background. Functional gastrointestinal disorders are highly prevalent and standard treatments are often unsatisfactory. Mindfulness-based therapy has shown benefit in conditions including chronic pain, mood, and somatization disorders. Objectives. To assess the quality and effectiveness reported in existing literature, we conducted a meta-analysis of mindfulness-based therapy in functional gastrointestinal disorders. Methods. Pubmed, EBSCO, and Cochrane databases were searched from inception to May 2014. Study inclusion criteria included randomized, controlled studies of adults using mindfulness-based therapy in the treatment of functional gastrointestinal disorders. Study quality was evaluated using the Cochrane risk of bias. Effect sizes were calculated and pooled to achieve a summary effect for the intervention on symptom severity and quality of life. Results. Of 119 records, eight articles, describing seven studies, met inclusion criteria. In six studies, significant improvements were achieved or maintained at the end of intervention or follow-up time points. The studies had an unclear or high risk of bias. Pooled effects were statistically significant for IBS severity (0.59, 95% CI 0.33 to 0.86) and quality of life (0.56, 95% CI 0.47 to 0.79). Conclusion. Studies suggest that mindfulness based interventions may provide benefit in functional gastrointestinal disorders; however, substantial improvements in methodological quality and reporting are needed.