Distinct and shared therapeutic neural mechanisms of mindfulness-based and social support stress reduction groups in adults with autism spectrum disorder.
Broc A. Pagni, Ethan Hill, Melissa J M Walsh, Shanna Delaney, Destiny Ogbeama, Leanna Monahan, James R Cook, Nicolas Guerithault, Maria V Dixon, Lisa Ballard, B Blair Braden
Journal of Psychiatry and Neuroscience 2023 DOI: 10.1503/jpn.220159 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 78 |
| Population | Adults with autism spectrum disorder |
| Interventions | Mindfulness-based stress reduction Social support/education |
| Topics | Meditation |
| Citations | 20 |
| Registration | NCT04017793 |
| Key findings | MBSR and SE both reduced depression, anxiety, and autistic traits, but MBSR additionally improved executive functioning and mindfulness traits, with distinct neural connectivity changes. |
Abstract
Mindfulness-based stress reduction (MBSR) alleviates depression and anxiety in adults with autism spectrum disorder (ASD); however, underlying therapeutic neural mechanisms and mindfulness-specific effects have yet to be elucidated. We randomly assigned adults with ASD to MBSR or social support/education (SE). They completed questionnaires that assessed depression, anxiety, mindfulness traits, autistic traits and executive functioning abilities as well as a self-reflection functional MRI task. We used repeated-measures analysis of covariance (ANCOVA) to evaluate behavioural changes. To identify task-specific connectivity changes, we performed a generalized psychophysiological interactions (gPPI) functional connectivity (FC) analysis on regions of interest (ROIs; insula, amygdala, cingulum and prefrontal cortex [PFC]). We used Pearson correlations to explore brain-behaviour relationships. Our final sample included 78 adults with ASD - 39 who received MBSR and 39 who received SE. Mindfulness-based stress reduction uniquely improved executive functioning abilities and increased mindfulness traits, whereas both MBSR and SE groups showed reductions in depression, anxiety and autistic traits. Decreases specific to MBSR in insula-thalamus FC were associated with anxiety reduction and increased mindfulness traits, including the trait "nonjudgment;" MBSR-specific decreases in PFC-posterior cingulate connectivity correlated with improved working memory. Both groups showed decreased amygdala-sensorimotor and medial-lateral PFC connectivity, which corresponded with reduced depression. Larger sample sizes and neuropsychological evaluations are needed to replicate and extend these findings. Together, our findings suggest that MBSR and SE are similarly efficacious for depression, anxiety and autistic traits, whereas MBSR produced additional salutary effects related to executive functioning and mindfulness traits. Findings from gPPI identified shared and distinct therapeutic neural mechanisms, implicating the default mode and salience networks. Our results mark an early step toward the development of personalized medicine for psychiatric symptoms in ASD and offer novel neural targets for future neurostimulation research. ClinicalTrials.gov identifier NCT04017793.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 9
- Mindfulness-Based Interventions for People with Autism Spectrum Disorder: A Systematic Literature Review. Brain Sciences September 30, 2024
- App-based meditation habits maintain reductions in depression symptoms among autistic adults. Autism June 1, 2024
- Smartphone Mindfulness Intervention Reduces Anxiety Symptoms and Perceived Stress in Autistic Adults: A Randomized Controlled Trial Mindfulness April 8, 2025
- Pilot randomized controlled trial of MINDful TIME, a novel telehealth mindfulness-based intervention for autistic adolescents and their caregivers. Autism July 1, 2025
- The impact of mindfulness-based stress reduction therapy on individuals with autism spectrum disorder and their caregivers: A systematic review. Journal of Psychiatric Research January 29, 2026
and 4 more in the library
Cites 16
- Meditation experience is associated with differences in default mode network activity and connectivity Proceedings of the National Academy of Sciences November 23, 2011
- Mindfulness meditation training alters cortical representations of interoceptive attention Social Cognitive and Affective Neuroscience June 11, 2012
- Changes in global and thalamic brain connectivity in LSD-induced altered states of consciousness are attributable to the 5-HT2A receptor Elife October 25, 2018
- Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials Frontiers in Psychiatry January 21, 2020
- Common and Dissociable Neural Activity After Mindfulness-Based Stress Reduction and Relaxation Response Programs Psychosomatic Medicine April 11, 2018
and 11 more in the library