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Tim Gard

Massachusetts General Hospital, Harvard University

13 papers in the library · 5,067 citations · publishing 2007-2020

Papers

How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective

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.

Interoception, contemplative practice, and health

Frontiers in Psychology June 9, 2015 Norman A. S. Farb, Jennifer Daubenmier, Cynthia Price et al. 630 citations

Interoception, the sense of internal bodily signals, is essential for embodiment, motivation, and well-being but remains poorly understood. This review integrates perspectives from neuroscience, clinical practice, and contemplative studies, introducing an expanded taxonomy of interoceptive processes. It argues that many of these processes can be explained by a predictive coding model of mind-body integration, which describes tension between expected and felt body sensations. This model parallels contemplative theories and links interoception to affective and psychosomatic disorders. Maladaptive interpretation of bodily sensations may underlie many contemporary maladies, and contemplative practices may reduce these biases, restoring a sense of presence and agency.

Investigation of mindfulness meditation practitioners with voxel-based morphometry

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.

Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training

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.

Pain Attenuation through Mindfulness is Associated with Decreased Cognitive Control and Increased Sensory Processing in the Brain

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.

Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression

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.

Fluid intelligence and brain functional organization in aging yoga and meditation practitioners

DOAJ (DOAJ: Directory of Open Access Journals) April 1, 2014 Tim Gard, Tim eGard, Maxime eTaquet et al. 104 citations

Fluid intelligence declines slower in middle-aged yoga and meditation practitioners than in matched controls. Resting state functional brain networks of practitioners are more integrated and resilient to damage. Mindfulness correlates positively with fluid intelligence, network resilience, and global network efficiency. The findings suggest that mindfulness may play a mechanistic role in preserving cognitive and brain function during aging.

Hippocampal circuits underlie improvements in self‐reported anxiety following mindfulness training

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.

Moving beyond mindfulness: Defining equanimity as an outcome measure in meditation and contemplative research

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.

The neural and psychological mechanisms of yoga and mindfulness meditation

January 1, 2015 Tim Gard 2 citations

Pain can be modulated by mindfulness through a unique brain mechanism involving increased sensory processing and decreased cognitive control, opposite to typical pain modulation techniques. Mindfulness practitioners, but not controls, reduced pain unpleasantness by 22% and anticipatory anxiety by 29% during a mindful state. 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, plus increased rostral anterior cingulate cortex activation during pain anticipation.

Mindfulness-Based Stress Reduction, Fear Conditioning, and The Uncinate Fasciculus: A Pilot Study.

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.

Greater widespread functional connectivity of the caudate in older adults who practice kripalu yoga and vipassana meditation than in controls.

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.

Potential self-regulatory mechanisms of yoga for psychological health.

Frontiers in Human Neuroscience January 1, 2014 Tim Gard, Jessica J Noggle, Crystal L Park et al.

A theoretical framework and systems-based network model proposes that yoga integrates top-down and bottom-up forms of self-regulation to improve psychological health. The model emphasizes how specific components of yoga practice affect cognitive, emotional, behavioral, and autonomic output under stress through interoception and bottom-up input, resulting in bidirectional feedback between high- and low-level brain networks and afferent input from interoceptive processes. From a predictive coding perspective, yoga shifts perceptual inference for stress modulation and optimal self-regulation. Over time and practice, self-regulatory processes become more automatized and efficient, requiring less effort to initiate and terminating more rapidly when no longer needed. The paper synthesizes evidence from behavior theory and cognitive neuroscience with emerging yoga and meditation research to guide future research on stress-mediated psychological disorders.