Author: Michael Datko1, Jacqueline Lutz2, Richa Gawande3, Alexandra Comeau2, My Ngoc To2, Tenzin Desel4, Jenny Gan2, Gaelle Desbordes5, Vitaly Napadow6, Zev Schuman-Olivier3
Affiliation: <sup>1</sup> Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, United States of America; Harvard Medical School, Boston, MA, United States of America; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States of America. Electronic address: mdatko@cha.harvard.edu.
<sup>2</sup> Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, United States of America.
<sup>3</sup> Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
<sup>4</sup> Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States of America.
<sup>5</sup> Mind and Life Institute, Charlottesville, VA, United States of America.
<sup>6</sup> Harvard Medical School, Boston, MA, United States of America; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States of America; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States of America.
Conference/Journal: Psychiatry Res Neuroimaging
Date published: 2022 Oct 22
Other:
Volume ID: 327 , Pages: 111559 , Special Notes: doi: 10.1016/j.pscychresns.2022.111559. , Word Count: 240
Interoceptive dysfunction is often present in anxiety and depression. We investigated the effects of an 8-week intervention, Mindfulness Training for Primary Care (MTPC), on brain mechanisms of interoceptive attention among patients with anxiety and/or depression. We hypothesized that fMRI brain response to interoception in the insula, a region known for interoceptive processing, would increase following the MTPC intervention, and that such increases would be associated with post-intervention changes in self-reported measures of interoceptive awareness. Adults (n = 28) with anxiety and/or depression completed baseline and post-intervention fMRI visits, including a task in which they alternated between focusing on their heartbeat (interoception (INT)) and a control visual attention task (exteroception (EXT)). Following MTPC, we observed increased evoked fMRI response (relative to baseline) in left anterior insula during the INT-EXT task contrast (z > 3.1, p < 0.001 corrected). In patients with moderate-to-severe depression as defined by the Patient Reported Outcomes Measurement Information System (PROMIS), increased post-intervention insula response was associated with increased Body Trusting, a subscale of the Multidimensional Assessment of Interoceptive Awareness (z > 3.1, p = 0.007 corrected). This study demonstrates that patients with mood disorders may respond differentially to mindfulness-based treatment depending on depression severity, and that among those who are more depressed, increased trusting in one's own body sensations and experiencing the body as a safe place to attend to may be necessary components of positive responses to mindfulness-based interventions.
Keywords: Anxiety; Interoception; Intervention; Meditation; Mood disorders; fMRI.
PMID: 36308976 DOI: 10.1016/j.pscychresns.2022.111559