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Sara W. Lazar

Massachusetts General Hospital, Harvard University

47 papers in the library · 9,847 citations · publishing 2000-2026

Papers

Attenuation of Anxiety-Potentiated Startle After Treatment With Escitalopram or Mindfulness Meditation in Anxiety Disorders.

Biological Psychiatry January 1, 2024 Elizabeth A Hoge, Caroline H Armstrong, Mihriye Mete et al. 10 citations

Anxiety disorders are linked to heightened startle responses during unpredictable threat, a physiological marker called anxiety-potentiated startle (APS). In a study of 93 individuals with anxiety disorders and 66 healthy controls, APS was higher in the anxious group at baseline. After eight weeks of treatment with either escitalopram or mindfulness-based stress reduction, both treatment groups showed significantly greater reductions in APS compared to controls, with patients' APS levels falling into the range of healthy individuals. Fear-potentiated startle (FPS), a response to predictable threat, did not differ between groups at baseline nor change with treatment. These results validate APS as a biological correlate of pathological anxiety and provide evidence that mindfulness-based stress reduction can alter anxiety-related neurocircuitry similarly to medication.

How does mindfulness training improve moral cognition: A theoretical and experimental framework for the study of embodied ethics

November 12, 2018 Gunes Sevinc, Sara W. Lazar 8 citations

Mindfulness meditation, often studied for its benefits to individual well-being and cognitive skills like attention and memory, may also enhance moral behavior. In Buddhist tradition, mindfulness cultivates wholesome actions and prosocial qualities. This article proposes that increased awareness of physiological and mental states after mindfulness training could change how morally relevant information is processed, promoting moral action. It summarizes neuroscientific research on moral cognition and offers a theoretical and experimental framework for studying the link between mindfulness and ethical behavior.

ENIGMA-Meditation: Worldwide Consortium for Neuroscientific Investigations of Meditation Practices.

Biological psychiatry. Cognitive neuroscience and neuroimaging April 1, 2025 Saampras Ganesan, Fernando A Barrios, Ishaan Batta et al. 6 citations

Meditation practices, which have shown therapeutic benefits for conditions like depression, pain, addiction, and anxiety, have been studied with neuroimaging over the past decade. However, existing neuroscientific models are based on small, heterogeneous datasets, limiting generalizability and replicability. The ENIGMA-Meditation consortium is the first worldwide collaborative effort to conduct systematic meta- and mega-analyses of globally distributed neuroimaging data using standardized methods. This framework aims to improve statistical power and address multidomain heterogeneity in meditation practice types, experience, and experimental design. The consortium will generate rigorous neuroscientific insights into the mechanisms underlying meditation's therapeutic effects on psychological and cognitive attributes.

The effect of mindfulness‐based programs on cognitive performance across the lifespan: A systematic review and meta‐analysis

Alzheimer s & Dementia December 1, 2020 Tim Whitfield, Thorsten Barnhofer, Rebecca L. Acabchuk et al. 6 citations

A systematic review and meta-analysis of 46 studies examined whether mindfulness-based programs improve cognitive performance across the adult lifespan. When combining healthy and clinical studies of working-age adults (18–65 years), there was no significant effect of mindfulness training on cognitive performance compared to control conditions. However, a small but significant positive effect was observed for older adults (over 65), including those with subjective or objective cognitive impairment. The cognitive domains most frequently measured were executive function and attention. The findings suggest that mindfulness-based programs may confer cognitive benefits primarily for older adults, with no evidence of benefit for younger populations.

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.

Neural correlates of reduction in self-judgment after mindful self-compassion training: A pilot study with resting state fMRI.

Journal of Mood and Anxiety Disorders March 1, 2025 Diane Joss, Michael Datko, Charisma I Washington et al. 5 citations

Self-judgment, a symptom common to many psychological disorders, often follows childhood maltreatment and can make standard treatments less effective. In a pilot study of 24 adults with anxiety or depressive disorders (83% had multiple diagnoses), an eight-week mindful self-compassion program significantly reduced self-judgment and increased self-compassion. Participants who reported more childhood trauma improved more than those with less trauma. Brain scans showed that reduced self-judgment was linked to stronger connections between the posterior cingulate cortex and frontal regions involved in regulation and language, and weaker connections with the amygdala-hippocampal complex, suggesting the training lessens fear-related influences on self-referential thinking while boosting executive control.

The Mindful Scientist: How Meditation Could Support Ethical Scientific Practice

Mindfulness September 2, 2025 Kevin Berryman, Yanli Lin, Sara W. Lazar et al. 4 citations

Personal virtues such as conscience, harmlessness, and equanimity may help scientists adhere to ethical principles like accountability and objectivity, but this connection is underexplored. Cultivating mindful ethical virtues through meditation could strengthen these personal traits, bridging the gap between external ethical frameworks and internal motivations for scientific conduct. A framework mapping this conceptual alignment is outlined, and Mindfulness-Based Ethical Development Interventions (MBED) are proposed as a non-sectarian approach to training ethical behaviors in the scientific community. The paper calls for meta-scientific initiatives that prioritize developing undeveloped ethical virtues among scientists.

How Does Mindfulness Affect Cognition? A Reflection on Confounding Issues Surrounding Mindfulness-based Intervention Research Targeting Cognitive Outcomes

November 2, 2018 David R. Vago, Resh S Gupta, Sara W. Lazar 3 citations

A systematic review of randomized controlled trials examined whether mindfulness-based interventions improve cognitive functioning. The authors identify three confounding issues in the existing evidence: unclear criteria for what qualifies as a mindfulness-based intervention, limitations of the cognitive tests used, and variable methodological quality of trials. These problems can distort interpretations of data. The review offers recommendations for improving research on mindfulness and cognition, rather than reporting a definitive finding about cognitive effects.

ENIGMA-Meditation: Worldwide consortium for neuroscientific investigations of meditation practices

April 8, 2024 Saampras Ganesan, Aki Tsuchiyagaito, Greg J Siegle et al. 2 citations preprint

Meditation practices, which have been adapted into manualized interventions for conditions like depression, pain, addiction, and anxiety, show therapeutic promise, but their neuroscientific basis remains unclear. Current neuroimaging studies rely on small, heterogeneous datasets that vary in practice types, participant experience, clinical targets, and imaging methods, limiting generalizability and replicability. To address this, the ENIGMA-Meditation consortium was formed as a global collaboration to conduct systematic meta- and mega-analyses of distributed neuroimaging data using standardized methods. This framework aims to improve statistical power and rigorously characterize the neural mechanisms underlying meditation's effects on psychological and cognitive attributes, advancing the field of contemplative neuroscience.

PCC-hippocampal functional connectivity associated with stress biomarker changes after meditation training for healthy adults.

Neuroscience Letters May 23, 2025 Diane Joss, Gunes Sevinc, John W. Denninger et al. 1 citation

Among 94 chronically stressed but otherwise healthy adults randomized to eight weeks of meditation, yoga, or stress education, only the meditation group showed a significant reduction in resting-state functional connectivity between the posterior cingulate cortex and the left hippocampus. Changes in this brain connectivity were correlated with improvements in perceived stress, allostatic load, and anti-inflammatory gene expression, suggesting that meditation's neural effects are closely linked to physical wellness biomarkers. No such changes occurred in the yoga or stress education groups, indicating this neurobiological mechanism may be unique to meditation training.

Complex harmonic manifolds in mindfulness-based cognitive therapy for major depressive disorder

medRxiv July 8, 2026 Paulina Clara Dagnino, Anne Maj van der Velden, Yonatan Sanz Perl et al.

In people with major depressive disorder, mindfulness-based cognitive therapy (MBCT) plus treatment as usual, compared to treatment as usual alone, alters whole-brain dynamics in ways that may reduce rumination. Using a novel method called complex harmonics decomposition on fMRI data from 80 patients, the study identified low-dimensional spatiotemporal manifolds that capture both local and long-range brain interactions. After MBCT, during rumination, brain regions involved in bodily and interoceptive processing became more consistently integrated across these manifolds. The latent configurations shifted with clinical and behavioral improvements, and the brain showed greater flexibility within the reduced space. These changes may reflect reduced 'stickiness' of ruminative thinking patterns following mindfulness training.

P01.46. Assessment of autonomic tone at rest and during meditation in a longitudinal study of an eight-week meditation intervention

BMC Complementary and Alternative Medicine June 1, 2012 Gaelle Desbordes, Riccardo Barbieri, Luca Citi et al.

Electrocardiogram recordings from eight healthy adults without prior meditation experience, collected as part of a larger randomized controlled trial, showed that an eight-week mindful-attention meditation intervention increased heart rate variability (HRV) and decreased the LF/HF ratio, indicating improved autonomic function and more predominant vagal tone. These changes were not seen in the control group. A marked increase in respiratory sinus arrhythmia (RSA) occurred during meditation compared to rest. The authors suggest RSA may be a useful marker of the meditative state and encourage further research on HRV measures as indicators of autonomic health after meditation.

Beneficial effects of mindfulness-based intervention on hippocampal volumes and episodic memory for childhood adversity survivors

Journal of Affective Disorders Reports March 30, 2024 Diane Joss, Martin H. Teicher, Sara W. Lazar

An 8-week mindfulness-based intervention (MBI) led to increases in right hippocampus and right subiculum volumes among adults with adverse childhood experiences, while an active control condition (stress management education) did not. Only the MBI group improved pattern separation, a measure of episodic memory, and this improvement was linked to stress reduction and right subiculum volume changes. The findings indicate that mindfulness training may counteract some negative neural effects of early-life stress, with the subiculum playing a key role in reducing stress reactivity.

Mindfulness Training Changes Brain Dynamics During Depressive Rumination: A Randomized Controlled Trial.

Biological Psychiatry February 1, 2023 Anne Maj van der Velden, Jacqueline Scholl, Else-Marie Elmholdt et al.

Mindfulness-based cognitive therapy for recurrent depression alters brain connectivity during rumination. In a randomized controlled trial with 80 participants, those who received the therapy (n=50) showed decreased connectivity between the salience network and the lingual gyrus while ruminating, compared with treatment as usual (n=30). This change in brain connectivity mediated improvements in sustaining and controlling attention to body sensations. The findings indicate that a clinically effective mindfulness intervention modulates neurocognitive functioning during depressive rumination and enhances the ability to sustain attention to the body.

Attention and Default Mode Network Assessments of Meditation Experience during Active Cognition and Rest.

Brain Sciences April 29, 2021 Kathryn J Devaney, Emily J Levin, Vaibhav Tripathi et al.

Experienced Vipassana meditators show stronger anticorrelation between the dorsal attention network and the default mode network during both sustained attention tasks and at rest, compared to matched controls and a larger reference dataset. This pattern, previously linked to better brain health, indicates more stable sustained attention without increased distractibility. No differences were observed between meditators and controls in an attentional reorienting task. The findings, based on functional MRI, suggest that long-term meditation practice may enhance the brain's ability to maintain focused attention by strengthening the separation between attention and default mode networks.

Brain network topology predicts participant adherence to mental training programs.

Network neuroscience (Cambridge, Mass.) January 1, 2020 Marzie Saghayi, Jonathan Greenberg, Christopher O'Grady et al.

Greater system segregation and clustering of brain connections measured in resting-state fMRI scans predict adherence to both meditation and creative writing programs. At a local level, regions in subcortical circuitry such as striatum and accumbens predicted adherence in all subjects. Adherence to meditation was predicted by connectivity within the local network of the anterior insula and default mode network; in the writing program, adherence was predicted by network neighborhood of frontal and temporal regions. Four machine learning methods classified individual capacity for adherence with reasonable accuracy. These findings indicate that adherence to mental training programs is associated with organizational patterns of brain connectivity.

Measuring cognitive outcomes in mindfulness-based intervention research: a reflection on confounding factors and methodological limitations.

Current Opinion in Psychology August 1, 2019 David R. Vago, Resh S Gupta, Sara W. Lazar

A review of three systematic reviews on mindfulness-based meditation and cognitive outcomes identifies methodological limitations and confounding factors that hinder interpretation of results. The analysis covers what is known about how mindfulness affects cognition, variable criteria defining mindfulness-based interventions, limitations of cognitive measurement tools, and methodological quality of trials. Constructive recommendations are offered for advancing research on mindfulness and cognition.

Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl.

Perspectives on psychological science : a journal of the Association for Psychological Science January 1, 2018 Nicholas T. van Dam, Marieke K. van Vugt, David R. Vago et al.

The authors reply to a commentary by Davidson and Dahl, agreeing with many suggestions but emphasizing that their original concerns remain especially relevant to mindfulness and meditation research. They highlight the vulnerability of this relatively young field compared to more mature scientific disciplines, discuss special characteristics of research participants, and stress the serious consequences of adverse experiences that a significant subset of individuals suffer during mindfulness and other contemplative practices. They also scrutinize common applications of mindfulness and meditation to illness and introduce caveats regarding mobile technologies for guiding contemplative practices.

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.

Stress reduction correlates with structural changes in the amygdala.

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.