From default-mode to action-mode: biphasic network reconfiguration with meditation in schizophrenia
Qing Wang, Lizhao Du, Jialing Sheng, Qiao Wang, Yuan Shi, Ting Xue, Zhong Sun, Yingying Tang, Donghong Cui
medRxiv November 20, 2025 preprint DOI: 10.1101/2025.11.20.25340575 (opens in new tab) via Semantic Scholar
Summary
AI-generated from the abstractAn eight-month randomized clinical trial of male inpatients with schizophrenia found that daily clinician-guided meditation plus rehabilitation improved symptoms by 11.8% at 3 months and 20.8% at 8 months, and improved cognition by 7.6% at 3 months, which then plateaued. Early cognition improvement predicted but did not mediate later symptom relief. Brain imaging revealed a biphasic pattern: baseline default-mode-cerebellar complexity predicted 3-month benefit, while 3-month action-mode/sensorimotor-executive complexity predicted 8-month gains. These findings support a biphasic network reconfiguration model for meditation in schizophrenia and suggest phase-specific markers for personalized treatment.
Study at a glance
| Characteristics | Randomized controlled trial Longitudinal |
|---|---|
| Sample size | 64 |
| Population | Male inpatients with schizophrenia |
| Intervention | clinician-guided meditation plus rehabilitation |
| Duration | 8-month intervention |
| Keywords | Medicine Psychology |
| Key finding | Daily clinician-guided meditation plus rehabilitation improved symptoms by 20.8% at 8 months and cognition by 7.6% at 3 months, with a biphasic brain network reconfiguration pattern. |
Abstract
Whether and how meditation benefits severe psychosis over clinically meaningful timescales remains unclear. We embedded longitudinal neuroimaging in an eight-month, parallel group randomized clinical trial (ChiCTR1800014913) of male inpatients (n=64) with schizophrenia receiving daily clinician-guided meditation plus rehabilitation versus rehabilitation alone. Meditation improved the symptoms by 11.8% at 3 months and 20.8% at 8 months (average treatment effects of PANSS decrease rates) and increase the cognition (RBANS) by 7.6% at 3 months that plateaued. Early cognition improvement predicts but not mediates later symptom relief. Resting-state fMRI revealed a biphasic pattern related to symptom improvement: baseline default-mode-cerebellar complexity predicted 3-month benefit, whereas 3-month action-mode/sensorimotor-executive complexity predicted 8-month gains, which was mirrored by functional connectivity prediction models. These findings support a biphasic network reconfiguration model for meditation: early default-mode-cerebellar involvement followed by later action-mode engagement, and provide phase-specific, information-based markers for personalized meditation in schizophrenia.