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Network-level functional topological changes after mindfulness-based cognitive therapy in mood dysregulated adolescents at familial risk for bipolar disorder: a pilot study

Kun Qin, Du Lei, Jing Yang, Wenbin Li, Maxwell J. Tallman, Luis Rodrigo Patino Duran, Thomas J. Blom, Kaitlyn M. Bruns, Sian Cotton, John A. Sweeney, Qiyong Gong, Melissa P. DelBello

BMC Psychiatry May 2, 2021 DOI: 10.1186/s12888-021-03211-4 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Pre-post intervention study Randomized Pilot study Peer reviewed
Sample size 10
Population Mood dysregulated adolescents at familial risk for bipolar disorder
Intervention Mindfulness-Based Cognitive Therapy for Children (MBCT-C)
Duration 12-week intervention
Topics Meditation
Keywords Graph theory Emotion regulation Psychoradiology Bipolar disorder Familial risk
Key points MBCT-C increased global efficiency and decreased characteristic path length within the fronto-parietal and cingulo-opercular networks, and reduced characteristic path length in the cingulo-opercular network was associated with improved emotion regulation.

Abstract

Abstract Background Given that psychopharmacological approaches routinely used to treat mood-related problems may result in adverse outcomes in mood dysregulated adolescents at familial risk for bipolar disorder (BD), Mindfulness-Based Cognitive Therapy for Children (MBCT-C) provides an alternative effective and safe option. However, little is known about the brain mechanisms of beneficial outcomes from this intervention. Herein, we aimed to investigate the network-level neurofunctional effects of MBCT-C in mood dysregulated adolescents.

Methods: Ten mood dysregulated adolescents at familial risk for BD underwent a 12-week MBCT-C intervention. Resting-state functional magnetic resonance imaging (fMRI) was performed prior to and following MBCT-C. Topological metrics of three intrinsic functional networks (default mode network (DMN), fronto-parietal network (FPN) and cingulo-opercular network (CON)) were investigated respectively using graph theory analysis.

Results: Following MBCT-C, mood dysregulated adolescents showed increased global efficiency and decreased characteristic path length within both CON and FPN. Enhanced functional connectivity strength of frontal and limbic areas were identified within the DMN and CON. Moreover, change in characteristic path length within the CON was suggested to be significantly related to change in the Emotion Regulation Checklist score.

Conclusions: 12-week MBCT-C treatment in mood dysregulated adolescents at familial risk for BD yield network-level neurofunctional effects within the FPN and CON, suggesting enhanced functional integration of the dual-network. Decreased characteristic path length of the CON may be associated with the improvement of emotion regulation following mindfulness training. However, current findings derived from small sample size should be interpreted with caution. Future randomized controlled trials including larger samples are critical to validate our findings.