Perspectives on Psychological Science
October 14, 2011
Britta K. Hölzel, Sara W. Lazar, Tim Gard et al.
2,997 citations
Mindfulness meditation, the nonjudgmental awareness of present-moment experiences, improves well-being and reduces psychiatric and stress-related symptoms, leading to its integration into psychotherapeutic interventions. Despite a surge in publications, few theoretical reviews synthesize the literature into a comprehensive framework. This article explores four components through which mindfulness exerts its effects: attention regulation, body awareness, emotion regulation (including reappraisal, exposure, extinction, and reconsolidation), and a change in perspective on the self. Empirical research, including self-reports and experimental data, supports these mechanisms. Neuroimaging studies show mindfulness practice is associated with neuroplastic changes in the anterior cingulate cortex, insula, temporo-parietal junction, fronto-limbic network, and default mode network. The authors suggest these components work synergistically to enhance self-regulation, guiding future research and treatment development.
Social Cognitive and Affective Neuroscience
December 3, 2007
Britta K. Hölzel, Ulrich Ott, Tim Gard et al.
544 citations
Long-term mindfulness meditators show greater gray matter concentration in brain regions linked to interoceptive awareness and meditation, including the right anterior insula, left inferior temporal gyrus, and right hippocampus. In a comparison of 20 Vipassana meditators (averaging 8.6 years of practice, 2 hours daily) with matched non-meditators, the amount of meditation training predicted gray matter concentration in the left inferior temporal gyrus, suggesting a causal impact of practice. The findings indicate that meditation practice is associated with structural brain differences in areas typically activated during meditation and relevant to the task.
NeuroImage Clinical
January 1, 2013
Britta K. Hölzel, Elizabeth A Hoge, Douglas N. Greve et al.
285 citations
Mindfulness training alters brain activity in regions involved in emotion regulation among people with generalized anxiety disorder (GAD). In a preliminary study, 26 GAD patients were randomly assigned to either an 8-week Mindfulness-Based Stress Reduction (MBSR) program or a stress management education control. At baseline, GAD patients showed higher amygdala activation than healthy participants when viewing neutral faces, indicating heightened reactivity to ambiguous stimuli. After both interventions, amygdala activation to neutral faces decreased. MBSR, but not the control, led to greater increases in ventrolateral prefrontal cortex (VLPFC) activity and strengthened amygdala-prefrontal functional connectivity. These brain changes correlated with reductions in anxiety scores, suggesting clinical relevance. The shift from negative to positive amygdala-prefrontal coupling may represent a unique mechanism of mindfulness.
Cerebral Cortex
December 15, 2011
Tim Gard, Britta K. Hölzel, Alexander T. Sack et al.
275 citations
Pain can be modulated by mindfulness, but the underlying brain mechanisms differ from those of other cognitive techniques. Mindfulness practitioners reduced pain unpleasantness by 22% and anticipatory anxiety by 29% during a mindful state, while controls did not. In the brain, this reduction was associated with decreased activation in the lateral prefrontal cortex and increased activation in the right posterior insula during stimulation, and increased rostral anterior cingulate cortex activation during pain anticipation. These findings indicate a unique mechanism of pain modulation involving increased sensory processing and decreased cognitive control, contrasting with established mechanisms.
Frontiers in Psychology
June 30, 2016
Marasha De Jong, Sara W. Lazar, Kiran Hug et al.
200 citations
Chronic pain and depression are linked to reduced body awareness. Mindfulness-Based Cognitive Therapy (MBCT) increased certain aspects of body awareness—specifically self-regulation and not distracting from bodily sensations—more than treatment as usual in 31 patients with chronic pain and active depression. The improvement in depression severity was partly explained by the increased ability to not distract from bodily sensations. These results offer preliminary support for the idea that mindfulness interventions can enhance body awareness in this population and highlight its clinical importance.
Frontiers in Human Neuroscience
August 25, 2015
Anselm Doll, Britta K. Hölzel, Christine C. Boucard et al.
174 citations
Mindfulness, defined as nonjudgmental attention to the present moment, is linked to synchronized ongoing activity between the default mode and salience networks in the brain. After two weeks of daily 20-minute attention-to-breath training, healthy participants completed mindfulness questionnaires and resting-state functional MRI. Analysis revealed that intrinsic functional connectivity between subnetworks of the default mode and salience networks—and at a trend level between the salience and left central executive networks—correlated with mindfulness scores. Additional control analyses supported the specificity of these findings. The results suggest that ongoing interactions among core brain networks relate to the ability to attend to current experience without judgment.
CNS Neuroscience & Therapeutics
April 2, 2011
Thilo Deckersbach, Britta K. Hölzel, Lori Eisner et al.
130 citations
A mindfulness-based cognitive therapy (MBCT) program tailored for bipolar disorder was tested in 12 individuals. After 12 group sessions and at a 3-month follow-up, participants showed increased mindfulness, reduced residual depressive mood symptoms, fewer attentional difficulties, and improvements in emotion regulation, psychological well-being, positive affect, and psychosocial functioning. The findings suggest MBCT may help manage residual mood symptoms and improve overall functioning in people with bipolar disorder.
Scientific Reports
August 2, 2022
Benno Bremer, Qiong Wu, María Guadalupe Mora Álvarez et al.
125 citations
One month of mindfulness meditation training increases functional connectivity between major large-scale brain networks, particularly the default mode network, salience network, and central executive network. In a study of 46 healthy, meditation-naïve adults, resting-state fMRI scans before and after 31 days of mindfulness training or an active control intervention revealed that mindfulness training strengthened connections between nodes of the default mode and salience networks, and between the salience network and key regions of the central executive network. These connectivity changes may represent a neural mechanism underlying the beneficial effects of mindfulness meditation on health and cognition.
Frontiers in Human Neuroscience
January 1, 2014
Omar Singleton, Britta K. Hölzel, Mark Vangel et al.
116 citations
Participation in an 8-week mindfulness-based stress reduction (MBSR) course led to increases in psychological well-being (PWB) scores, which were positively correlated with increases in gray matter concentration in two bilateral clusters in the brainstem, including the pontine tegmentum, locus coeruleus, nucleus raphe pontis, and sensory trigeminal nucleus. These brain areas are sites of norepinephrine and serotonin synthesis and release, which modulate arousal and mood. No brain regions showed a negative correlation with PWB change. This preliminary finding suggests a neural basis for enhanced well-being through mindfulness training.
Journal of Psychiatric Practice
November 1, 2011
Jonathan P. Stange, Lori Eisner, Britta K. Hölzel et al.
83 citations
People with bipolar disorder often experience cognitive difficulties such as problems with executive functioning, even when their mood is stable. In an open pilot trial of mindfulness-based cognitive therapy (MBCT), participants reported significant improvements in executive functioning, memory, and the ability to start and complete tasks, as measured by the Behavior Rating Inventory of Executive Function and the Frontal Systems Behavior Scale. These cognitive improvements were linked to increases in mindful, nonjudgmental awareness of thoughts and feelings, but not to reductions in depression. Gains tended to fade after treatment ended, though some improvements in executive functioning persisted for three months. MBCT may serve as an adjunct to medication for improving cognition in bipolar disorder.
Psychosomatic Medicine
April 11, 2018
Gunes Sevinc, Britta K. Hölzel, Javeria A. Hashmi et al.
65 citations
Two meditation-based stress reduction programs—Relaxation Response (RR) and Mindfulness-Based Stress Reduction (MBSR)—both reduced stress, with MBSR showing a larger effect (Cohen's d = 1.02) than RR (Cohen's d = 0.50). Both programs activated shared neural pathways between ventromedial prefrontal regions and supplementary motor areas. However, the RR bodyscan meditation, which emphasizes physical relaxation, showed stronger connectivity between the right inferior frontal gyrus (involved in inhibition and control) and supplementary motor areas. The MBSR program, which emphasizes mindful awareness without explicit relaxation, uniquely improved self-compassion and rumination and showed connectivity between the right anterior insula (sensory awareness and salience) and pregenual anterior cingulate during meditation. These distinct neural patterns align with each program's theoretical focus.
Psychosomatic Medicine
May 5, 2021
Thorsten Barnhofer, Tim Jonas Reeß, Maria Fißler et al.
24 citations
Mindfulness-based interventions reduce activation in the right dorsolateral prefrontal cortex when depressed patients view angry faces, a change linked to improved ability to decenter from negative thoughts, reduced brooding, and fewer depressive symptoms. In a randomized trial, patients with recurrent depression received either a two-week mindfulness-based intervention or psychoeducation and rest. After the mindfulness intervention, decreased right dlPFC activation correlated with greater decentering, less brooding, and lower symptom scores. The psychoeducation group showed decreased amygdala response to happy faces. The findings suggest mindfulness may help patients avoid elaborating or suppressing negative emotions, a potential mechanism for preventing mood escalation.
Brain and Behavior
September 18, 2020
Gunes Sevinc, Jonathan Greenberg, Britta K. Hölzel et al.
24 citations
Mindfulness meditation training is linked to structural changes in the hippocampus, specifically the subiculum, which are associated with reduced connectivity between the hippocampus and lateral occipital regions during the retrieval of extinguished fear memories. This reduced connectivity correlates with decreases in self-reported anxiety after mindfulness training. The findings suggest that the subiculum plays a key role in regulating interactions with contextual cues during memory retrieval, and that mindfulness training may foster resilience by altering these brain circuits.
October 3, 2019
Gaelle Desbordes, Tim Gard, Elizabeth A Hoge et al.
6 citations
Equanimity, an even-minded mental state toward all experiences regardless of their pleasantness, is proposed as a key outcome measure for contemplative research. While mindfulness has been used as a measurable outcome of meditation, it encompasses multiple components, some better characterized as equanimity. The article defines and discusses the inter-relationship between mindfulness and equanimity from classical Buddhist and modern psychology perspectives, reviews meditation techniques for cultivating equanimity, and examines psychological, physiological, and neuroimaging methods for assessing it. Equanimity captures potentially the most important psychological element in improving well-being and should be a focus in future research.
Neuroimage
July 1, 2016
Anselm Doll, Britta K. Hölzel, Satja Mulej Bratec et al.
After two weeks of training in attention-to-breath (ATB) meditation, healthy participants viewed aversive pictures during fMRI. ATB, compared with passive viewing, reduced amygdala activation and increased coupling between the amygdala and dorsomedial prefrontal cortex. This increased integration was associated with mindfulness ability. A fronto-parietal network was also recruited during emotional stimulation. The findings suggest that amygdala–dorsal prefrontal cortex integration may be a neural pathway through which mindfulness practice regulates emotion.
Frontiers in Behavioral Neuroscience
January 1, 2016
Britta K. Hölzel, Vincent Brunsch, Tim Gard et al.
Mindfulness training helped maintain sensitivity to learned emotional cues, while controls lost that response. In a pilot study, 46 healthy participants were quasi-randomized to an 8-week Mindfulness-Based Stress Reduction (MBSR) course or a waitlist control group. Before and after the course, they underwent a two-day fear conditioning, extinction learning, and extinction memory protocol. Skin conductance response showed that after MBSR, participants maintained a differential response to conditioned versus non-conditioned stimuli, whereas controls did not. MBSR participants also showed increased fractional anisotropy in the uncinate fasciculus, a white matter tract linked to emotional learning, though the group-by-time interaction was not significant. Changes in this tract correlated with changes in emotional response, suggesting neural plasticity from mindfulness practice.
Frontiers in Human Neuroscience
January 1, 2015
Tim Gard, Maxime Taquet, Rohan Dixit et al.
Yoga and meditation practitioners show stronger functional connectivity within basal ganglia-thalamocortical circuits than non-practitioners, with the right caudate emerging as a central node. Analyses using Network-Based Statistics revealed difference components for yoga practitioners versus controls and meditators versus controls, with significantly greater degree centrality in the caudate for both practitioner groups. This greater connectivity was not due to single connections but to broader connectivity between the caudate and numerous brain regions. The finding of greater caudate connectivity in meditators was replicated in an independent dataset. This enhanced connectivity may relate to reported effects of these practices on behavioral flexibility, mental health, and well-being, though its mechanistic role remains unestablished.
Psychiatry Research
November 10, 2010
Britta K. Hölzel, J. Carmody, M. Vangel et al.
Participation in an eight-week Mindfulness-Based Stress Reduction (MBSR) program is associated with increases in gray matter concentration in several brain regions. Sixteen healthy, meditation-naïve adults underwent MRI scans before and after the program, and their brain changes were compared to a wait-list control group of 17 individuals. Increases were found in the left hippocampus, posterior cingulate cortex, temporo-parietal junction, and cerebellum. These regions are involved in learning, memory, emotion regulation, self-referential processing, and perspective taking. The findings suggest that MBSR can produce structural brain changes.
Social Cognitive and Affective Neuroscience
March 1, 2010
Britta K. Hölzel, James Carmody, Karleyton C Evans et al.
Reductions in perceived stress after an 8-week mindfulness-based stress reduction intervention correlate with decreases in gray matter density in the right basolateral amygdala. Stressed but otherwise healthy individuals (N = 26) reported significantly less perceived stress after the intervention. The study demonstrates that neuroplastic changes are associated with improvements in a psychological state variable, not just with learning abstract information or motor and language skills.
Neuroscience Letters
June 21, 2007
Britta K. Hölzel, Ulrich Ott, Hannes Hempel et al.
During mindfulness of breathing, experienced Vipassana meditators show stronger brain activation in the rostral anterior cingulate cortex and dorsal medial prefrontal cortex compared to non-meditators. The rostral anterior cingulate cortex activation may reflect enhanced processing of distracting events, while medial prefrontal cortex activation suggests stronger engagement in emotional processing. Fifteen meditators with an average of 7.9 years of daily two-hour practice and fifteen matched non-meditators participated in an fMRI study comparing meditation to mental arithmetic.