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Jonathan Downar

2 papers in the library · 71 citations · publishing 2014-2025

Papers

Adaptive neural reward processing during anticipation and receipt of monetary rewards in mindfulness meditators

Social Cognitive and Affective Neuroscience September 4, 2014 Ulrich Kirk, Kirk Warren Brown, Jonathan Downar 66 citations

Reward seeking is common and adaptive, but excessive pursuit of monetary rewards can reduce well-being. People trained in mindfulness meditation show lower brain reactivity to monetary incentives. In a functional MRI study, 34 meditators and 44 matched controls performed a monetary incentive delay task equally well, but meditators had lower activation in the caudate nucleus during reward anticipation and higher activation in the bilateral posterior insula. During reward receipt, meditators showed reduced activation in the ventromedial prefrontal cortex. Connectivity between the right caudate and bilateral anterior insula was weaker in meditators during anticipation. These findings indicate that mindfulness meditators are less susceptible to monetary rewards at a neural level.

Efficacy of intranasal esketamine versus rTMS for treatment-resistant depression: analysis of individual participant data from two clinical trials.

EClinicalMedicine December 1, 2025 Tyler S Kaster, Yi Dai, Fidel Vila-Rodriguez et al. 5 citations

Both repetitive transcranial magnetic stimulation (rTMS) and intranasal esketamine are more effective than starting a new antidepressant medication for treatment-resistant depression. In a secondary analysis of individual patient data from two clinical trials involving 282 matched participants, rTMS reduced depression severity scores by 5.35 points and esketamine by 2.89 points more than medication alone. The difference between rTMS and esketamine was not statistically significant, but the results suggest rTMS may be at least as effective as esketamine. The analysis highlights the need for direct head-to-head trials comparing these two interventions.