Neural mechanisms of mindfulness-based stress reduction in asthma.

Mindfulness-based stress reduction (MBSR) training in adults with asthma reduced brain responses in the lateral prefrontal and orbitofrontal cortex when viewing emotional cues, and this reduction was linked to increased mindfulness. Decreased activity in the salience network after training was associated with lower psychological distress and less airway inflammation. Some of these brain and clinical changes persisted at a 6-month follow-up, while others did not. The findings indicate that MBSR promotes more efficient emotional processing and reduces reactivity, helping explain how mindfulness improves asthma control and inflammation through mind-brain-immune interactions.

Study at a glance

Abstract

Mindfulness-based stress reduction (MBSR) can improve symptoms of chronic inflammation; in asthma, improving asthma control and reducing airway inflammation. Understanding the neural mechanisms underlying these salubrious outcomes could help identify neuroimmune phenotypes and personalize interventions. Adults with asthma were randomized to 8 weeks of MBSR (n = 38) or a wait-list group (n = 34). Clinically relevant asthma-related and psychological outcomes were measured, and task-based fMRI data were acquired during exposure to emotional cues at baseline, post-intervention, and 6mo follow-up. Whole-brain group x time interactions and voxelwise regressions were used to evaluate changes in neural responses to emotion cues from baseline and their relationship to psychological and biological outcomes. Post-intervention, MBSR participants showed decreased lateral prefrontal/orbitofrontal cortex responses to aversive cues relative to controls, which was associated with increased mindfulness. Across participants, decreased salience network reactivity at post-intervention was associated with reduced psychological distress and airway inflammation. At 6 months, some relationships persisted while others did not. Results suggest that mindfulness training reduced effortful regulation of cognitive and affective responses to emotional cues, instead promoting more efficient processing strategies and reduced affective reactivity. Our findings clarify neural mechanisms underlying MBSR's clinical benefits for asthma, underscoring mind-brain-immune relationships as a critical target for asthma treatment.