Effect of app-based mindfulness on extinction recall - a 7T-fMRI study.
Johannes Björkstrand, Emil Olsson, Oisín Hugh Clancy, Stefan Möller, Isabella M Björkman-Burtscher, Nishika Raheja, David Sjöström, Marino Persiani, Walter Staiano, Ulrich Kirk
Scientific Reports March 25, 2026 DOI: 10.1038/s41598-026-45569-z (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 55 |
| Population | Healthy participants |
| Intervention | Mindfulness meditation |
| Duration | 4-week intervention |
| Topics | Meditation |
| Key findings | Mindfulness training enhanced extinction recall by reducing threat responses to extinguished cues via reduced subcortical threat-processing activation, consistent with direct modulation of fear circuits. |
Abstract
Fear-based disorders affect millions worldwide, yet current treatments show limited effectiveness for many patients. While mindfulness is increasingly used clinically for anxiety and trauma disorders, the neural mechanisms underlying its effects on fear processing remain unclear. We conducted a randomized controlled trial using 7T fMRI to test whether mindfulness training enhances fear extinction recall-a process critical for recovery from these disorders. Healthy participants received four weeks of app-based mindfulness meditation (n = 27) or served as waitlist controls (n = 28), then underwent fear conditioning and extinction recall testing. Mindfulness training specifically enhanced extinction recall, reducing threat responses to extinguished cues by both physiological (skin conductance, p=.028) and neural measures. Critically, our findings reveal a candidate mechanism: mindfulness reduced activation in subcortical threat-processing regions (amygdala, striatum, supplementary motor area) without enhancing cognitive control areas, a pattern consistent with direct modulation of fear circuits rather than top-down inhibition, though top-down contributions cannot be excluded. This pattern is consistent with mindfulness enhancing safety memory retrieval through implicit rather than explicit emotion regulation, providing preliminary neurobiological evidence relevant to optimizing mindfulness-based treatments. Our findings suggest that mindfulness training, whether administered before or alongside exposure therapy, could potentially enhance therapeutic outcomes by improving the consolidation and retrieval of safety memories, although replication in larger clinical samples is needed.
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
Cites 22
- The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology 2003
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Mindfulness Meditation and Psychopathology Annual Review of Clinical Psychology December 11, 2018
- MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology September 1, 2019
- The Mindfulness-to-Meaning Theory: Extensions, Applications, and Challenges at the Attention–Appraisal–Emotion Interface Psychological Inquiry October 2, 2015
and 17 more in the library