Mind over microglia: using mindfulness-based interventions to target stress-induced neuroinflammatory mediators to improve behavioral symptoms
Elizaveta Valovatsky, Zeel Patel, Pooja Jain
NeuroImmune Pharmacology and Therapeutics October 31, 2026 DOI: 10.1515/nipt-2026-0023 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Intervention | Mindfulness-based interventions (MBIs) |
| Topics | Meditation |
| Key findings | Argues that chronic stress-related neuroendocrine and immune dysregulation may contribute to symptom exacerbation in psychotic disorders, but that neuroinflammatory abnormalities are unlikely to represent a uniform mechanism across schizophrenia or bipolar disorder and may be most relevant to specific subgroups. Mindfulness-based interventions have been associated with reduced perceived stress and alterations in HPA-axis activity, inflammatory biomarkers, neurotrophic factors, and stress-responsive neural circuitry, and may improve clinical outcomes in schizophrenia-spectrum disorders, though findings are heterogeneous and direct evidence for microglial effects is lacking. |
Abstract
Abstract Chronic psychosocial stress is associated with dysregulation of neuroendocrine and immune pathways that may contribute to symptom exacerbation in individuals with psychotic disorders. Repeated activation of the hypothalamic–pituitary–adrenal (HPA) axis and sympathetic systems can alter glucocorticoid signaling, inflammatory mediators, blood–brain barrier function, and neuroimmune communication. Evidence implicates stress-responsive inflammatory pathways and heterogeneous microglial states in neural circuits involved in cognition, emotional regulation, and stress responsivity. Psychotic disorders are multifactorial and biologically heterogeneous, and neuroinflammatory abnormalities are unlikely to represent a uniform mechanism across schizophrenia or bipolar disorder. Stress-related immune dysregulation may instead be particularly relevant to subgroups defined by inflammatory status, disease stage, medication exposure, and metabolic factors. Mindfulness-based interventions (MBIs) have been associated with reduced perceived stress and alterations in HPA-axis activity, inflammatory biomarkers, neurotrophic factors, and stress-responsive neural circuitry. Mindfulness-based approaches may also improve clinical outcomes in schizophrenia-spectrum disorders, although findings remain heterogeneous and mechanistic studies in psychotic populations are limited. Direct evidence that MBIs modify microglial phenotype or activation state in psychotic disorders is lacking; proposed effects on neuroimmune function therefore remain inferential, supported primarily by peripheral biomarkers, neuroendocrine findings, and evidence from nonpsychotic and preclinical populations. This review evaluates evidence linking chronic stress and neuroendocrine and immune dysregulation with psychotic symptom expression, distinguishes established associations from proposed mechanisms, and considers the potential role of disease-adapted MBIs as adjunctive interventions.
Comparable studies
Other narrative reviews on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical populations | 2003 | Review | |
| Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects | 2007 | Review | |
| Mindfulness Interventions | 2016 | Review | |
| Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation | 2017 | Review | |
| Mindfulness and acceptance: expanding the cognitive-behavioral tradition | 2005 | Review |
Citations in the library
Cites 20
- Neural Correlates of Dispositional Mindfulness During Affect Labeling Psychosomatic Medicine July 1, 2007
- Effects of mindful-attention and compassion meditation training on amygdala response to emotional stimuli in an ordinary, non-meditative state Frontiers in Human Neuroscience 2012
- Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training NeuroImage: Clinical 2013
- Mindfulness meditation training alters stress-related amygdala resting state functional connectivity: a randomized controlled trial Social Cognitive and Affective Neuroscience June 5, 2015
- Neurobiological Changes Induced by Mindfulness and Meditation: A Systematic Review. Biomedicines November 15, 2024
and 15 more in the library