Meditation and Neuroplasticity

Transcription

1 Meditation and Neuroplasticity Sara Lazar, Ph.D. Department of Psychiatry, Massachusetts General Hospital Supported by NIH/NCCAM, the CDC, and Kripalu Center for Yoga and Health

2 Mindfulness Purposefully paying attention to experiences in the present moment in a non-judgmental way (Kabat-Zinn 1990)

3 Mindfulness meditation No mantra! Primary focus is breath, bodily sensations, and sensory stimuli (sounds etc). Conscious awareness of present moment (not lost in thought, spaced out or in a trance state). Non-judgmental attitude a.k.a. MINDFULNESS

4 Lets try it!

5 Mindfulness Based Stress Reduction 8 week manualized group intervention Weekly class with stress education and meditation practice 40 minutes mindful meditation daily (sitting, yoga, bodyscan) Anytime mindfulness exercises

6 Scientifically Validated Benefits Decreased stress (self report, cortisol, etc.) Reduced symptoms associated with: Depression Anxiety disorders Pain Insomnia Increased self-reported quality of life (satisfaction with work, family, health, etc.)

7 Monty

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10 Yoga and meditation completely changed my life

11 Suggests Neuroplasticity! Change in the nature of connections between neurons

12 Behavior Brain Activity Brain Structure

13 Can yoga and meditation change brain activity or structure?

14 Behavior Brain Activity

15 Brain activity during meditation Insula and temporal pole/superior temporal gyrus Anterior cingulate Lazar et al

16 Amygdala less active Consistent with decreased arousal and sense of well-being

17 Behavior Brain Activity Brain Structure

18 MRI- versatile images of the brain Functional Structural

19 Group differences in neural volume Taxi drivers - Hippocampus Maguire, E.A. et al (2000) PNAS. Bilinguals - Intraparietal sulcus Mechelli, A., et al (2004) Nature. Musicians - Multiple cortical areas Gaser, C. & Schlaug, G. (2003) J. Neurosci.. Brain volume correlates with experience or proficiency

20 Percent change in gray matter Practice dependent neural plasticity Draganski, B., Gaser, C., Busch, V., Schuierer, G., Bogdahn, U., & May, A. (2004) Nature, 427(6972), Reprinted with permission from Macmillan Publishers Ltd:

21 Areas thicker in meditators Lazar et al NeuroReport November 2005

22 Insula functional roles Integration of thoughts, senses, and emotions Awareness of visceral processes (heart and breathing rate, hunger, etc) Recognition of facial emotions (particularly disgust) Smaller in schizophrenic and bipolar patients

23 Prefrontal Cortex functional roles Working memory and selective attention Fluid intelligence

24 Thickness Prevent/slow normal aging? Meditators Controls Age

25 Impact on Fluid Intelligence Gard et al 2014

26 Other interpretations? Meditators are just different and their brains were like that before they started Its just because they take 40 minutes a day to rest Diet or other lifestyle effects?

27 Does gray matter increase with training?

28 Methods Recruit participants from the Center for Mindfulness MRI images pre and post MBSR Wait-list control group

29 Increase in gray matter concentration Posterior Cingulate Temporo-parietal Junction Hippocampus P = P = P = Self-related processes Perspective Memory taking Hӧlzel, Lazar et al. (2011)

30 Correlation between changes in brain stem and well-being p=0.024 Singleton et al 2014

31 Change in perceived stress is correlated with change in amygdala gray matter r=0.53; p = 0.049; 2-tailed Hölzel et al., 2009

32 Normal density High density High density MBSR Higher density Lower density Reflects Relationship to Stress Mitra et al., 2005

33 Types of plasticity New neurons Molecular events Synaptic branching Glia and astrocytes Blood vessels Nerve cells Astrocytes (helper cells) Blood vessels

34 Types of plasticity New neurons Molecular events Synaptic branching Glia and astrocytes Blood vessels Nerve cells Astrocytes (helper cells) Blood vessels

35 Types of plasticity New neurons Molecular events Synaptic branching Glia and astrocytes Blood vessels Nerve cells Astrocytes (helper cells) Blood vessels

36 Behavior Brain Activity Brain Structure

37 Sadness reactivity following MBSR Compared to wait-list, MBSR participants had less selfreferential activity and more lateralized sensory activity. Farb et al 2010

38 Insula - BDI negative correlation p< Farb et al 2010

39 Self-compassion moderates the effects of mind wandering on depression at baseline * Greenberg et al 2018

40 Self-compassion moderates the effects of mind wandering on depression over time * Greenberg et al 2018

41 Social Anxiety Disorder Decreases amygdala reactivity to social anxietyrelated negative self-beliefs following MBSR Goldin and Gross 2010

42 Changes in state anxiety Brain activity during meditation (compared to rest) that correlate with changes in state anxiety (pre/post MRI session) vmpfc subgenual ACC anterior insula posterior insula Zeidan et al 2014

43 Impact on MDs N=70 primary care physicians (no control group) 8-week CME program including mindfulness meditation, self-awareness exercises, didactic material, and discussion. Improvements in mindfulness, burnout, empathy, physician belief scale, total mood disturbance, conscientiousness, and emotional stability. Improvements in mindfulness correlated with improvements in mood disturbance, perspective taking, burnout, conscientiousness and emotional stability. Most changes maintained at 15 month follow-up Krasner et al 2009

44 Grepmair et al 2007 Impact on Others DOUBLE BLIND STUDY 18 therapists-in-training randomly assigned to learn Zen or waitlist control. Continued giving standard treatment. Patients of therapists trained in Zen had better outcome than patients of control therapists. p < 0.01 for 7/9 scales of the SCL-90-R n = ~60 in each group

45 Meditation can literally change your brain!