Rethinking Mental Health: Spirituality, Healing and Culture

Lecture:
Neuroscience and Meditation

Gaelle Desbordes, PhD

Boston University
Feb 12, 2011
Scientificstudyofmeditation:Exchanges
betweenscientistsandcontemplatives
 Aquickhistoryofthescientificstudyof
meditation:theearlystages

TranscendentalMeditation(TM)

HerbertBenson(1975):Meditation(andothercontemplativepractices)
induceaRelaxationResponse,whichistheoppositetothestress
response
 Bodychangesduringstress

Imagesource:
http://www.atomicmeme.com/_imgs/learninghub/stressbiol/body_fight_flight2.png
 H.Benson(1975):theRelaxationResponse
[iswhatmeditationdoes]

From:http://hubpages.com/hub/RXforStressTheRelaxationResponse
SympatheticNervousSystem: ParasympatheticNervous
Fightorflight System:Restanddigest

Imagesource:www.medicalook.com
 butrecentresearchsuggeststhatthereismoretomeditationthanthe
relaxationresponse.
 Aquicktourofthebrain

FromRickHanson(2009)Buddha'sBrainp.54
 Prefrontalcortex(PFC):setsgoals,makesplans,directsaction;shapes
emotions,inpartbyguidingandsometimesinhibitingthelimbic system
Anteriorcingulate cortex(ACC):steadiesattentionandmonitorsplans;helps
integratethinkingandfeeling
Insula:interoception (sensestheinternalstateofthebody),includinggut
feelings;linkedtoempathy
Thalamus:majorrelaystationforsensoryinformation
Corpuscallosum:bundleoffiberspassinginformationbetweenthetwobrain
hemispheres
Limbicsystem:includesthebasalganglia,hippocampus,amygdala,
hypothalamus,andpituitarygland;centraltoemotionandregulation
Basalganglia:involvedwithrewards,stimulationseeking,andmovement
Hippocampus:formsmemories,detectsthreats,
Amygdala:respondsveryquicklytoemotionallychargedstimuli(especially
negativeones);actslikeanalarmbell todetectdangerintheenvironment
Hypothalamus:regulatesprimaldrivessuchashungerandsex;produces
oxytocin;activatespituitarygland
Pituitarygland:makesendorphins(i.e.internalopiate);triggerssex
hormones;storesandreleasesoxytocin.
Pleasenote:theabovelistisanoversimplification!Eachofthesebrainareasis
involvedinmanyotherfunctionsaswell.Neuroscienceisstillaveryyoung
science,andweareonlybeginningtounderstandhowthebrainworks.

FromRickHanson(2009)Buddha'sBrainpp.5355
 Recentfindingsinneuroscience
aboutmeditation
Longtermchangesinbrainanatomy:
Meditationpractitionersmayhavethickercortexinbrainregionsassociated
withattention,interoception andsensoryprocessing,includingthe
prefrontalcortexandrightanteriorinsula.Meditationmightoffsetage
relatedcorticalthinning.

Insula Prefrontal cortex

From Lazar et al., 2005, Neuroreport

 Recentfindingsinneuroscience
aboutmeditation:MBSR
TheeightweekMindfulnessBasedStressReduction(MBSR)Programhas
manybeneficialeffectsonmentalhealth,demonstratedinrandomized
controlledstudies
Forexample,ithelpswithchronicpain,autoimmunediseases(psoriasis),
anxiety,depression
[SeeupcominglectureonMindfulnessandDepression]
However,themechanisms bywhichMBSRworksarestilllargelyunknown
andunderinvestigation.
Forexample,arecentstudyfoundsmallchangesinthebrainafter8
weeksofMBSR(seenextslide)
 Hlzel etal.,2011:Mindfulnesspracticeleadsto
increasesinregionalbraingraymatterdensity

Participantswhomeditatedfor
about30minutesadayforeight
weekshadmeasurablechangesin
graymatterdensityinpartsofthe
brainassociatedwithmemory,sense
ofself,empathyandstress.
M.R.I.brainscanstakenbeforeand
aftertheparticipants meditation
regimenfoundincreasedgraymatter
inthehippocampus,anarea
importantforlearningandmemory.
Theimagesalsoshowedareduction
ofgraymatterintheamygdala,a
regionconnectedtoanxietyand
stress.Acontrolgroupthatdidnot
practicemeditationshowednosuch
changes.
From:http://well.blogs.nytimes.com/2011/01/28/howmeditationmaychangethebrain/
From Hlzel et al., 2011, Psychiatry Research: Neuroimaging
Recentfindingsinneuroscience:lovingkindness
andcompassionmeditation
Mostmeditationresearchhasfocusedonpracticesthatemphasize calming
themind(e.g.TM),improvingfocusedattention,ordeveloping
mindfulness(e.g.MBSR).

Morerecently,neuroscienceresearchhasturnedtocompassionandloving
kindnessmeditation.
Inlovingkindnesscompassionmeditation,expertpractitioners (comparedto
novices)showmore,notless,emotionalreactivitytosoundsofpeoplein
distress:fasterheartbeat,andstrongerresponseintheinsula (linkedto
interoception andempathy),whichcannotbeexplainedbytherelaxation
responsehypothesis.

experts
novices

From Lutz et al., 2008, PLoS ONE, Regulation of the Neural Circuitry of
Emotion by Compassion Meditation: Effects of Meditative Expertise
PureCompassion meditationcaninducestrongEEGpatternspreviously
associatedwithpositiveemotionalityandenhancedadaptiveimmune
functioning:
(Lutzetal.,2004,ProceedingsoftheNationalAcademyofSciences,Long
termmeditators selfinducehighamplitudegammasynchronyduring
mentalpractice)
 EEGbrainwavesduringcompassionmeditation

EEG Gamma power

These high-amplitude gamma-

band oscillations and phase-
synchrony are off-the-chart
from the normal range.
Lutz et al., 2004 PNAS Start Compassion meditation
 Phenomenology
vs.
hypothesisdrivenresearch

Atthispointintime,meditationneuroscienceisstillatthestageof
observinganddescribingwhathappensphenomenologically.Thereisno
scientifictheoryquiteyet,butthisisthetopicofactiveresearch.
 OngoingresearchatEmoryUniversity

Physiologicalmechanismslinkedwith
meditation:
Meditationmayimproveemotional
andphysicalhealthbyreducing
inflammatoryreactivitytostressand
illness Dr. Chuck Raison, MD,
Department of Psychiatry
and Behavioral Sciences
Depression itselfischaracterizedby
increasedinflammation(Raisonetal.,
TrendsinImmunology, 2006)

Alsoinflammatory:fibromyalgia,
neuropathicpain,heartdisease,
stroke,Alzheimersdisease,etc. Geshe Lobsang Tenzin Negi, PhD,
Department of Religious Studies
 Benefitsofcompassionmeditation:
pilotstudyoncollegestudents

Compassionmeditation
effectsonreductionsin
inflammationandemotional
distressinresponseto
psychologicalstress

Pace et al., Effect of compassion meditation on neuroendocrine, innate

immune and behavioral responses to psychosocial stress,
Psychoneuroendocrinology, 2009

Pace et al., Innate immune, neuroendocrine and behavioral responses to

psychosocial stress do not predict subsequent compassion meditation
practice time, Psychoneuroendocrinology, 2010
 TrierSocialStressTest(TSST)

publicspeakinginamockjobinterview formatinfrontofapanelof
expertsinbehavioralanalysis andvideocamera
mentalarithmetic
anticipatorystress/anxiety
HeartRateVariabilityandSkinConductanceLevel
Intravenouslinetotestseveralbloodmarkers(IL6,cortisol,NE,E,NPY,VIP,
NFNB,PBMC)at15minintervals,before,duringandafterthestressor
 TrierSocialStressTesteffects
onimmuneandinflammatorymarkers
 Inflammationmarkers(thelower,thebetter)beforeandafter
compassionmeditationtraining

Pace et al., 2010, Psychoneuroendocrinology

 Doseresponserelationshipforimmune
responseafterstressor

Pace et al., 2009, Psychoneuroendocrinology

 Doseresponserelationship
foremotionaldistressafterstressor

Pace et al., 2009

Basedontheabovepilotstudies,alargescalerandomizedclinicaltrialtotest
thephysiologicaleffectsofmeditationiscurrentlyunderwayat Emory
UniversityandBostonUniversity(incollaborationwithHarvardandthe
MassachusettsGeneralHospital):

TheCompassionandAttentionLongitudinalMeditationstudy
 TheCompassionAttentionLongitudinal
Meditation(CALM)study

Compassionmeditationanditseffectoninflammatoryresponsestoacute
andchronicstress

NIH(R01)fundedstudyatEmoryUniversity,Atlanta,GA
PrincipalInvestigator:Dr.CharlesRaison
Compassionvs.MindfulnessAttentionvs.Controls
Targetedenrollment:N=360adultsover5years
 Studyparticipants

Healthy,age2555
Targetedenrollment:N=360peopleover5years:
120MindfulnessAttention
120Compassion
120controls
Racial/ethnicdiversityrepresentativeofthelargerpopulation
 Whatdoesthestudyconsistof?

Iterativetrainingover8weeks
Twiceaweekonehourmeetings/teachings
Meditationsubjectsareaskedtomeditate2030mineveryday(Practice
timeistrackedbyaportablemeditationlog device)
Controlsubjectsareaskedtokeepadailyjournalofhealthdiscussions
ThereisNOphysicalexercise(e.g.,yoga)ordietarychangeinvolved;
peoplekeeptheirhabituallifestyle.
 Meditationtraininginthefirstgroup:
MindfulnessAttentionTraining(MAT)
Protocoloutlineoverthecourseof8weeks:

Settlingthebodyandrespirationintheirnaturalstate
Mindfulnessofbreathingwithrelaxationandstabilityofattention
Mindfulnessofbreathingwithrelaxation,stabilityandvividness
Settlingthemindinitsnaturalstate
Awarenessofawareness

TheMATprotocolwasdesignedbyAlanWallace(SantaBarbaraInstitute
forConsciousness)andGeshe Lobsang Tenzin Negi (EmoryUniversity)
basedonTibetanBuddhism,butcompletelysecularincontent
 Meditationtraininginthesecondgroup:
lovingkindnessandcompassionmeditation
Protocoloutlineoverthecourseof8weeks:

Developingattentionandstabilityofmind,asinMAT(includedinall
subsequentsteps)
Developingcompassionforoneselfthroughmindfulnessofsensations,
feelingsandemotions
Cultivatingequanimityandappreciationforothers
Developingaffectionandempathy
Wishingandaspirational compassion
Activecompassionforothers

TheCompassionmeditationprotocolwasdesignedbyGeshe Lobsang
Tenzin Negi (EmoryUniversity)
basedontraditionalTibetanlojong =mindtraining techniques,but
completelysecularincontent
 Control:Healthdiscussiongroup

Protocoloutlineoverthecourseof8weeks:

Onehourtalkonahealthrelatedtopicbyalocalexpert
Onehouractiveparticipationinsmallgroupdiscussions,roleplaying,and
friendlydebatesdesignedtomakethehealthtopicscoveredpersonally
relevant
Asasubstitutefordailymeditationpractice,thesecontrolsubjectsare
keepingadailylogoftheirreflectionsonhowtoincorporatethecurrent
healthtopicintodailylife
(Logswillnotbecollected,butaveragetimespentonitperdaywillbe
recorded)
 Pre andpostinterventionassessments
TrierSocialStressTest(TSST):
publicspeakinginamockjobinterview formatinfrontofapanelof
expertsinbehavioralanalysis andvideocamera
mentalarithmetic
anticipatorystress/anxiety
HeartRateVariabilityandSkinConductanceLevel
IntravenouslinetotestIL6,cortisol,NE,E,NPY,VIP,NFNB,PBMC
at15minintervals,before,during,andafterthestressor
Neuropsychiatric,psychosocialandlifestyleassessments
12differentselfreportandclinicianbasedassessments
Brainimaging(atMGH):structural,diffusionbased,andfunctionalMRI
Onasubsetofthesubjects(targetN=48,or16pergroup)
FundedseparatelybyanNIHResearchChallengegrant(ARRA)toProfessor
EricSchwartzatBostonUniversity
 Recapofpreviousneuroimaging studies

SaraLazar,MGH:
corticalthicknesslargerinmeditators in
regionsassociatedwithattention,
interoception andsensoryprocessing,
includingprefrontalcortexandright
anteriorinsula
Longitudinalstudy:Stressreduction
(followingMBSRintervention)correlates
withdecreaseinamygdala greymatter
density
AntoineLutz,RichieDavidson(U.of
WisconsinMadison):compassionmeditation
inexperts
Highamplitudegammasynchrony(EEG)
enhancedactivationofinsula,cingulate
cortices,amygdala,etc.(fMRI)
andothers
 Motivationsforbrainimaging

Changesinstressresponseinvolvethebrain,esp.limbicandsubcortical
structures(e.g.Hypothalamicpituitaryadrenal(HPA)axis)
Thewhere question:Whichneuralregionsandcircuitsareinvolved?
Neuroplasticity:Useitorloseit;canwetrainthebraintobemore
Attentive?Mindful?
Compassionate?
Differentreactionstoemotionalstimuli,linkedtobetterqualityoflife
(changeintrait)
Neuralcorrelatesofmeditativestates asalteredstatesofconsciousness
 Hypothesesonlongitudinaleffectsof
meditationtraining
Structuralchanges:corticalthickness,greymatterdensity
Changesinanatomicalconnectivity
Changesinfunctionalconnectivity(indefaultmodenetwork+other
networks)
Physiologicaltrait changesintherestingstate
longitudinaldifferencesinbaselinebrainactivation
Changesinautonomicphysiology
Changesinresponsetoemotionalstimuli
longitudinaldifferencesinbrainresponsetostimuli
Changesinautonomicphysiology
Neuralcorrelatesofmeditation:mindfulnessvs.compassionvs.rest
probablyactivatedifferentregionsofthebrain(state changes)
 Brainimagingexperimentaldesign

Siemens3Twith32channelheadcoil
Simultaneousrecordingsofautonomicphysiologicaldata:
ECG,breathingbelt,pulseoxymeter,GSR
Anatomical(structuralanddiffusionbased)scans:
corticalthickness,greymatterdensity,whitematterconnectivity
fMRI inrestingstatetomeasurefunctionalconnectivity
fMRI task:passiveviewingofemotionalvisualstimuli
Photographsofhumanbeingsinvarioussituations(fromIAPS
database)
3emotionalvalences:positive,negative,neutral,presentedinrandom
order
 Thanksto:
BostonUniversity:
EricSchwartz
EmoryUniversity:
ChuckRaison
Geshe Lobsang Tenzin Negi
Harvard/MGH:
LamaWillaMiller
TedKaptchuk
BruceFischl
LarryWald
Vitaly Napadow
SaraLazar
andmanyothersforinspirationandfeedback!

Funding:NIH:NCCAMRC1AT005728(E.Schwartz)
andNCCAMR01AT004698(C.Raison)
MindandLifeInstituteVarelaAward(G.Desbordes)
 Thankyou!

Pleasefeelfreetocontactmeifyouhaveanyquestions:gdesbord@bu.edu