Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training
Britta K. Hölzel, Elizabeth A Hoge, Douglas N. Greve, Tim Gard, J. David Creswell, Kirk Warren Brown, Lisa Feldman Barrett, C. Schwartz, Dieter Vaitl, Sara W. Lazar
NeuroImage: Clinical 2013 DOI: 10.1016/j.nicl.2013.03.011 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 26 |
| Population | Patients with current DSM-IV generalized anxiety disorder |
| Interventions | Mindfulness-Based Stress Reduction Stress Management Education |
| Duration | 8-week intervention |
| Topics | Anxiety Meditation |
| Keywords | Mindfulness-based stress reduction Amygdala Beck anxiety inventory Clinical psychology Psychological intervention Prefrontal cortex Beck depression inventory Cognition |
| Citations | 285 |
| Key findings | Mindfulness training (MBSR) increased ventrolateral prefrontal cortex activation and amygdala-prefrontal functional connectivity in GAD patients, and these changes correlated with reduced anxiety symptoms. |
Abstract
Mindfulness training aims to impact emotion regulation. Generalized anxiety disorder (GAD) symptoms can be successfully addressed through mindfulness-based interventions. This preliminary study is the first to investigate neural mechanisms of symptom improvements in GAD following mindfulness training. Furthermore, we compared brain activation between GAD patients and healthy participants at baseline. 26 patients with a current DSM-IV GAD diagnosis were randomized to an 8-week Mindfulness Based Stress Reduction (MBSR, N = 15) or a stress management education (SME, N = 11) active control program. 26 healthy participants were included for baseline comparisons. BOLD response was assessed with fMRI during affect labeling of angry and neutral facial expressions. At baseline, GAD patients showed higher amygdala activation than healthy participants in response to neutral, but not angry faces, suggesting that ambiguous stimuli reveal stronger reactivity in GAD patients. In patients, amygdala activation in response to neutral faces decreased following both interventions. BOLD response in ventrolateral prefrontal regions (VLPFC) showed greater increase in MBSR than SME participants. Functional connectivity between amygdala and PFC regions increased significantly pre- to post-intervention within the MBSR, but not SME group. Both, change in VLPFC activation and amygdala-prefrontal connectivity were correlated with change in Beck Anxiety Inventory (BAI) scores, suggesting clinical relevance of these changes. Amygdala-prefrontal connectivity turned from negative coupling (typically seen in down-regulation of emotions), to positive coupling; potentially suggesting a unique mechanism of mindfulness. Findings suggest that in GAD, mindfulness training leads to changes in fronto-limbic areas crucial for the regulation of emotion; these changes correspond with reported symptom improvements.
Comparable studies
Other randomized controlled trials on anxiety, most cited first.
Citations in the library
Cited by 105
- Mindfulness Interventions Annual Review of Psychology September 30, 2016
- How Does Mindfulness Training Affect Health? A Mindfulness Stress Buffering Account Current Directions in Psychological Science December 1, 2014
- Mindfulness Meditation and Psychopathology Annual Review of Clinical Psychology December 11, 2018
- State and Training Effects of Mindfulness Meditation on Brain Networks Reflect Neuronal Mechanisms of Its Antidepressant Effect Neural Plasticity 2016
- Mindfulness meditation training alters stress-related amygdala resting state functional connectivity: a randomized controlled trial Social Cognitive and Affective Neuroscience June 5, 2015
and 100 more in the library
Cites 14
- Mindfulness: A proposed operational definition. Clinical Psychology Science and Practice 2004
- Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology Science and Practice 2003
- Alterations in Brain and Immune Function Produced by Mindfulness Meditation Psychosomatic Medicine July 1, 2003
- Neural Correlates of Dispositional Mindfulness During Affect Labeling Psychosomatic Medicine July 1, 2007
- Minding one’s emotions: Mindfulness training alters the neural expression of sadness. Emotion February 1, 2010
and 9 more in the library