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Biological Psychology 92 (2013) 275–281

Contents lists available at SciVerse ScienceDirect

Biological Psychology
journal homepage: www.elsevier.com/locate/biopsycho

Cortical thickness, mental absorption and meditative practice: Possible

implications for disorders of attention
Joshua A. Grant a,b,c,d,∗ , Emma G. Duerden a,b,c,d , Jérôme Courtemanche c,d,e , Mariya Cherkasova f ,
Gary H. Duncan b,g,h , Pierre Rainville b,c,d,g
a
Département de Physiologie, Université de Montréal, Montréal, QC, Canada
b
Le Groupe de Recherche sur le Système Nerveux Central (GRSNC), Montréal, QC, Canada
c
Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Montréal, QC, Canada
d
Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
e
Département de Psychologie, Université de Montréal, Montréal, QC, Canada
f
Research Institute of the McGill University Health Centre, Montréal, QC, Canada
g
Département de Stomatologie, Université de Montréal, Montréal, QC, Canada
h
Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada

a r t i c l e i n f o a b s t r a c t

Article history: Mental training techniques rooted in meditation are associated with attention improvement, increased
Received 11 May 2012 activation and cortical thickening of attention/executive-related brain areas. Interestingly, attention-
Accepted 12 September 2012 deficit/hyperactivity disorder (ADHD) is associated with behavioural deficits, hypo-activation and cortical
Available online xxx
thinning of similar networks. This study assessed the relationship between prior meditative training,
attentional absorption, and cortical thickness. Grey matter thickness was measured in 18 meditators
Keywords:
and 18 controls. Subjective reports of attentional absorption were modestly higher in meditators and
Cortical thickness
across the entire sample correlated positively with cortical thickness in several regions corresponding
Attentional absorption
Meditation
to cingulo-fronto-parietal attention networks. Within these regions the meditation group had greater
Attention deficit hyperactivity disorder cortical thickness which was positively related to the extent of prior training. Evidence suggesting that
Mindfulness meditative practice activates these cortical areas, improves attention and may ameliorate symptoms of
Mental training ADHD by targeting vulnerable brain regions is discussed.
© 2012 Elsevier B.V. All rights reserved.

1. Introduction
The term meditation refers to a family of mental exercises
aimed at enhancing the practitioner’s ability to attain and main-
tain a target state, often attentional or affective in nature (e.g.
sustained attention or a state of compassion) (Lutz et al., 2008).
Although often viewed as spiritual, many such techniques are,
for the most part, completely secular and are gaining recogni-
tion as clinically relevant (Chiesa and Serretti, 2010). Functional
imaging studies have reported that meditating in an MRI scanner
activates attention-related cortices such as the anterior cingulate
cortex (ACC) and frontoparietal networks (Brefczynski-Lewis et al.,
2007; Manna et al., 2010). A number of studies have also reported
regional grey matter differences between individuals who medi-
tate and those who do not (Pagnoni and Cekic, 2007; Grant et al.,
∗ Corresponding author. Present address: Department of Social Neuroscience,
Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstrasse 1a,
04103 Leipzig, Germany. Tel.: +49 341 9940 2653; fax: +49 341 9940 2356.
E-mail address: grant@cbs.mpg.de (J.A. Grant).
2010; Holzel et al., 2008, 2010; Lazar et al., 2005; Luders et al.,
2009; Vestergaard-Poulsen et al., 2009). In all cases meditators have
been found to have more grey matter, in specific regions, than non-
meditators. Further, several of these effects have involved regions
implicated in attention/executive processing (e.g. ACC, superior
and middle frontal gyri and orbitofrontal regions) (Grant et al.,
2010; Holzel et al., 2008; Lazar et al., 2005; Luders et al., 2009;
Vestergaard-Poulsen et al., 2009). Behaviourally, practitioners of
meditation have been shown to perform significantly better on
attention and executive function tasks such as the Attention Net-
work Task (ANT), the Stroop Task, attentional blink, Symbol Digit
Modalities Test, verbal fluency, and the n-back task (Prakash et al.,
2010; Zeidan et al., 2010; Tang et al., 2007; van Leeuwen et al.,
2009). While it is certainly possible that there are pre-existing
differences in meditators, there is now evidence from longitu-
dinal studies that improvement in attention performance (Lutz
et al., 2009; Tang et al., 2007; Zeidan et al., 2010) and increases
in grey matter (Holzel et al., 2010, 2011) occur over the course
of meditative training. Importantly, preliminary evidence suggests
that meditative training may be an effective adjunct treatment
for patients suffering from attention-deficit/hyperactivity disorder

0301-0511/$ – see front matter © 2012 Elsevier B.V. All rights reserved.
http://dx.doi.org/10.1016/j.biopsycho.2012.09.007
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276 J.A. Grant et al. / Biological Psychology 92 (2013) 275–281
(ADHD). Following an 8 week meditation program, improvements
were observed on the ANT, the Stroop Task and the Trail Making
Test, as well as in self-reported ADHD symptoms (Zylowska et al.,
2008).
In the literature there are parallels between meditative practice
and ADHD at several levels. ADHD is characterized by inatten-
tion, impulsiveness and hyperactivity. Neuroimaging studies have
strongly implicated the fronto-striato-thalamic circuitry in the
pathophysiology of this disorder (Bush et al., 2005; Seidman et al.,
2005). Functional MRI studies of ADHD have repeatedly shown
hypo-activation of the anterior cingulate, dorsolateral and inferior
prefrontal cortices as well as the basal ganglia, thalamus, and pari-
etal cortices (Dickstein et al., 2006). Morphometric brain imaging
studies have likewise found structural differences, such as corti-
cal thinning, in many of these same areas, in populations of both
adults and children with ADHD (Shaw and Rabin, 2009; Seidman
et al., 2005). Furthermore, cortical thinning of a subset of these
regions has been associated with poor clinical outcome 5 years later
(Shaw et al., 2006). While ADHD and cortical thickness have sub-
stantial heritability (Durston et al., 2004; Forero et al., 2009; Rimol
et al., 2010), morphometric longitudinal studies suggest regional
grey matter may also vary as a function of training and perfor-
mance (Draganski and May, 2008). One particularly notable study
found that training naïve participants to juggle resulted in grey
matter density increases, concomitant with performance gains, in
brain regions previously implicated in processing visual motion
(Draganski et al., 2004). Findings such as these suggest that, despite
the high likelihood of a genetic predisposition, it may be possible to
combat the functional deficits of a disorder like ADHD by targeting
the vulnerable cortices with a suitable training intervention. As dis-
cussed above, one potential candidate to bolster both grey matter
thickness and attention/executive function is meditative practice.
The present study provides initial evidence that cortical,
attention-related brain regions, that appear to be sensitive to thin-
ning in ADHD, are related to an experiential measure of attention
and are thicker in practitioners of meditation. The analysis took
place over two phases. We were first interested in testing the
hypothesis that an experiential measure of attention would (a)
differ between meditators and controls and (b) relate to grey mat-
ter thickness in attention-related brain regions. With evidence to
support these hypotheses a post hoc analysis was performed exam-
ining the physical overlap between the present results and a report
of grey matter thinning observed in a study of ADHD (Shaw et al.,
2006).
2. Materials and methods
2.1. Participants
Eighteen Zen meditators (14 male/4 female) were recruited, that had been
practicing between 2 and 30 years and had accumulated a minimum of 1000 h of life-
time practice (mean = 6406, SD = 1955, min = 1010, max = 39,439). Eighteen age- and
gender-matched control subjects (14 males/4 female) were subsequently recruited.
All participants provided informed written consent, approved by a local Ethics Com-
mittee (CMER-RNQ 05-06-020). Meditators were recruited from meditation centres
in the Montréal area and had an average age of 37.1 yrs (SD = 10.9, range 22–57) and
did not differ from controls (average age 37.9 yrs, SD = 10.5, range = 21–55). With the
exception of one monk and one nun, all participants were lay practitioners. Control
subjects were also from Montreal and had no previous experience with meditation
or yoga.
2.2. Self report measures
Participants’ trait attentional absorption was measured with the 34-item
Tellegen Absorption Scale (TAS), a True/False subscale of the Multidimensional
Personality Questionnaire (Tellegen and Atkinson, 1974). The TAS measures one’s
tendency for “episodes of ‘total’ attention that fully engage one’s representational
(i.e. perceptual, enactive, imaginative and ideational) resources” (Tellegen and
Atkinson, 1974). Two previous studies have reported higher absorption scores for
meditators using this scale (Davidson et al., 1976; Holzel and Ott, 2006), the later also
finding correlations between absorption and meditation depth and mindfulness. To
further examine this connection we also administered the Five Facet Mindfulness
Questionnaire (FFMQ) (Baer et al., 2008). The FFMQ measures skills associated with
the construct of mindfulness, namely, the tendencies to be observant (OBS), non-
judgmental (NJ) and nonreactive (NR) toward one’s experiences as well as aware in
the present moment (AWARE). A meditation experience questionnaire was admin-
istered sampling years, hours and frequency (days per week) of lifetime practice.
2.3. MRI acquisition and cortical thickness measurement
A single high-resolution (voxel size = 1 mm3 ) T-1 weighted structural MRI image
(MP-RAGE) was acquired for each participant on a 3 Tesla Siemens Trio MR scanner
(Siemens, Erlangen, Germany). An automated cortical thickness analysis pipeline
was employed (Montréal Neurological Institute (MNI)) (Lerch and Evans, 2005).
Images were linearly registered, transformed into MNI space and corrected for
non-uniformity artifacts (Collins et al., 1994; Sled et al., 1998). Images were then
segmented into grey and white matter and cerebrospinal fluid (Zijdenbos et al.,
2002). Grey and white matter surfaces were produced using constrained Laplacian
anatomic segmentation using proximities (Kim et al., 2005). A surface deforma-
tion algorithm (MacDonald et al., 2000) then expanded the white matter surfaces
to the surface boundary between grey matter and cerebrospinal fluid, allowing the
calculation of cortical thickness. Thickness data were smoothed following surface
curvature using a blurring kernel of 20 mm.
2.4. Statistical analyses
Questionnaires were analysed with independent sample t-tests and correlated
with cortical thickness estimates using Pearson correlations in SPSS. Cortical thick-
ness data were analysed with the general linear model (GLM), controlling for age and
gender, in SurfStat (www.stat.uchicago.edu/∼worsley/surfstat) and with additional
multiple linear regressions in SPSS. Given our explicitly unidirectional hypotheses,
1-tailed tests were used for all analyses.
Estimates of cortical thickness at 81,924 vertices covering the entire cortical
mantle were regressed on attentional absorption scores across the whole sample.
For this full brain analysis the significance threshold was set to p < 0.05, corrected for
multiple comparisons using the random-field theory (Worsley et al., 1996) to strictly
control type I error. Regions meeting this strict criterion (i.e. showing a relation
between absorption and cortical thickness) were then defined as absorption-ROIs.
Mean thickness within each ROI was computed. These values were compared
between groups and correlated with meditation experience in SPSS. To examine
the proximity of the present results with respect to previously reported structural
findings in ADHD, MNI coordinates were acquired from Shaw et al. (2006). In the
original study these regions exhibited cortical thinning in patients with ADHD and
included the right superior medial PFC, temporal pole, left superior medial PFC, pre-
central gyrus and left medial PFC/cingulate. Circular ROIs with a 15 mm radius were
created using SurfStat and compared visually by overlaying the respective maps.
Euclidian distance between the peak coordinates from the two studies was also
computed.
Finally, we performed a full brain exploratory search for each of the FFMQ sub-
scales as well as regressions with mean cortical thickness within absorption-ROIs.
The main effects of group and meditation experience, at the full brain level, have
been reported as part of the original study from which this data was acquired,
investigating the structural correlates of pain sensitivity (Grant et al., 2010).
3. Results
3.1. Self report measures
Scores for all questionnaires were normally distributed based on
the Shapiro–Wilk test. Meditators scored slightly higher than con-
trols on the TAS (t(34) = 1.91, p < 0.05, d = 0.64) indicating a tendency
to be more absorbed in their experience. Meditators also scored
higher than controls on three of the subscales of the FFMQ (OBS:
t(34) = 3.30, p < 0.01, d = 1.09, NR: t(34) = 3.64, p < 0.001, d = 1.20 and
AWARE: t(34) = 2.03, p < 0.05, d = 0.67) indicating a greater tendency
to be mindful. Across the entire sample TAS scores were positively
correlated with OBS scores (r(34) = 0.39, p < 0.01) and NR scores
(r(34) = 0.32, p < 0.05) suggesting that absorption and mindfulness
may have shared experiential dimensions. Absorption scores in the
meditation group were predicted by the number of days of practice
per week (r(16) = 0.41, p < 0.05) while years of practice predicted NR
scores (r(16) = 0.47, p < 0.05) with more experience being associated
with less reactivity.
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J.A. Grant et al. / Biological Psychology 92 (2013) 275–281 277

Fig. 1. Cortical thickness correlations with self-reported absorption. Areas in orange-red (t-threshold = 3.6) are Bonferonni-corrected for multiple comparison over the cortical
surface. Regions where thinner grey matter was associated with more absorption (blue-green clusters) did not reach significance. (Right) Relationship between thickness
and absorption within specific regions. R-values correspond to the partial correlations after controlling for age and gender. S.R. = standardized residuals. (For interpretation
of the references to colour in this figure legend, the reader is referred to the web version of the article.)

3.2. Cortical thickness: whole brain analysis of absorption
For the whole brain analysis, higher absorption was associated
with thicker grey matter in nodes of the cingulo-fronto-parietal
(CFP) attention networks (Fig. 1 and Table 1). A large and highly sig-
nificant cluster of absorption-related cortical thickness was found
in the left superior frontal gyrus extending into supra-callosal parts
of the medial frontal and cingulate gyri. Additional significant clus-
ters were found in the middle frontal gyri and superior parietal
lobule bilaterally, the left supramarginal gyrus as well as the right
precuneus. These regions were defined as absorption-ROIs. No sig-
nificant negative correlations between TAS scores and thickness
were observed.
3.3. Cortical thickness: group and meditation-related effects
within absorption-ROIs
The large cluster spanning left SFG, medial frontal and cingulate
gyri in the absorption analysis was split into three components
(SFG, ACC and PCC), based on clearly visible borders, for the
remainder of the analyses with the absorption-ROIs. Within these
ROIs, meditators had greater cortical thickness than controls in
left SFG (t(32) = 1.90, p < 0.05), SMG (t(32) = 2.37, p < 0.05) and SPL
(t(32) = 1.85, p < 0.05) (Fig. 2 and Table 1). It must be noted that this
analysis is not independent of the procedure used to derive the
absorption ROIs. With knowledge that the meditators scored higher
on the absorption questionnaire the analysis becomes circular and

Table 1
Full brain thickness/absorption correlations and effects of group and meditation in absorption-ROIs.

Location Vertices (#) Cluster (t, p) Peak-MNI (x, y, z) Meditation training (r/p) Group dif (t/p) Closest ADHD-peak
(mm-structure)

Frontal
SFG-Cing L 1220 4.60, <0.001*
SFG −7, 9, 69 0.42, <0.05 (yr) 1.95, <0.05 6.2 SFG/Med-PFC L
ACC −7, 16, 40 0.49, <0.05 (yr) ns 8.8 Med-PFC/ACC L
PCC −12, −24, 43 ns ns 38.2 Med-PFC/ACC L
MFG R 132 4.60, <0.05* 35, 31, 38 0.43, <0.05 (yr) ns 24.1 SFG/Med-PFC R
MFG L 446 4.51, =0.01* −25, 40, 39 0.53, <0.05 (yr) ns 41.0 SFG/Med-PFC L
Parietal
SMG L 533 4.64, <0.001* −45, −35, 26 ns 2.35, <0.05 >50
SPL R 369 4.55, <0.001* 32, −50, 53 ns ns >50
SPL L 211 4.26, <0.05* −4, −53, 55 0.44, <0.05 (yr) 1.95, <0.05 49.3 PreCG L
PrCun R 240 4.21, =0.01* 18, −83, 45 0.55, <0.05 (h) ns >50

Data are from 18 meditators and 18 controls. SFG-Cing refers to a large contiguous region which was divided into superior frontal, anterior and posterior cingulate regions.
Reported r-values are partial correlation coefficients, that is, representing unique variance after accounting for age and gender in the regression model. ACC, anterior cingulate
cortex; med-PFC, medial prefrontal cortex; MFG, middle frontal gyrus; MNI, Montreal Neurological Institute; PCC, posterior cingulate cortex; PreCG, precentral gyrus; PrCun,
precuneus; MFG, left medial frontal gyrus; SFG-Cing, superior frontal gyrus-cingulate; SPL, superior parietal lobule; SMG, supramarginal gyrus.
*
Indicates p-values Bonferonni-corrected for multiple comparison over the entire cortical surface based on the random-field theory.
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278 J.A. Grant et al. / Biological Psychology 92 (2013) 275–281

Fig. 2. Group differences and meditation experience correlations within the absorption-ROIs. (Upper panels) Meditators had significantly thicker grey matter in the superior
frontal gyrus (SFG), superior parietal lobule (SPL) and supramarginal gyrus (SMG) all of the left side. M = meditators, C = controls. (Lower panels) Partial regression plots show
the standardized residuals (S.R.) of cortical thickness and years of practice after accounting for age, separately for each variable. The R-value is the partial coefficient and the
best fit line maintains the true relationship between the variables. More years of experience was associated with greater thickness of left SFG, SPL, anterior cingulate cortex
(ACC) and middle frontal gyrus (MFG). For additional regions see Table 1.

should be interpreted with some caution. Within the meditation
group, years of training (after accounting for age) was positively
associated with thickness of the left SFG (r(13) = 0.42, p < 0.05), ACC
(r(13) = 0.49, p < 0.05), SPL (r(13) = 0.44, p < 0.05) and MFG bilater-
ally (left: r(13) = 0.53, p < 0.05; right: r(13) = 0.43, p < 0.05) (Fig. 2
and Table 1). Hours of experience was associated with thickness of
the right precuneus (r(13) = 0.50, p < 0.05). There were no group dif-
ferences or correlations with total hemispheric grey matter volume
reinforcing the focal nature of the effects. Significant overlap was
observed between the main effect of absorption and ADHD-related
cortical thinning observed previously by another group (Shaw et al.,
2006) (Fig. 3). The physical distance between the peaks observed
in the present study and those observed by Shaw et al. (2006) are
listed in Table 1.
To examine possible relations between absorption and mindful-
ness, mean cortical thickness of the absorption-ROIs was regressed
on the FFMQ revealing positive associations between OBS scores
and left SFG (r(33) = 0.46, p < 0.01), MFG (r(33) = 0.34, p < 0.05), SPL
(r(33) = 0.48, p < 0.01) and SMG (r(33) = 0.37, p < 0.05). NR scores
were associated with mean thickness in the same regions with
the exception of the SMG (left SFG: r(33) = 0.37, p < 0.05; MFG:
r(33) = 0.31, p < 0.05; SPL: r(33) = 0.34, p < 0.05). In each of these
cases, greater thickness was associated with higher self-reported
mindfulness. The AWARE and NJ subscales were not associated
with mean thickness in any of the absorption network ROIs. Subse-
quent full brain searches revealed a correlation between NR scores
and cortical thickness in the right fusiform gyrus but no additional
regions were found for OBS, NJ or AWARE scores. As reported in
Grant et al. (2010) a global search contrasting meditators and con-
trols revealed that the right dorsal ACC was significantly thicker in
meditators and a single region on the right precentral gyrus was
found to be related to hours of meditation experience.

4. Discussion

Attentional absorption has been described as one’s tendency

Fig. 3. Overlap between absorption and ADHD. Red: regions where absorption cor-
related with grey matter thickness across the entire sample of the present report.
Yellow: ROIs derived from Shaw et al. (2006) where attention-deficit hyperactivity
disorder (ADHD) was associated with thinner cortex and worse outcome. Orange:
overlap between the main effect of absorption and cortical thinning in ADHD. (For
interpretation of the references to colour in this figure legend, the reader is referred
to the web version of the article.)
for “episodes of ‘total’ attention that fully engage one’s represen-
tational resources” (Tellegen and Atkinson, 1974). Consistent with
previous reports (Davidson et al., 1976; Holzel and Ott, 2006), medi-
tators had a greater, albeit modest, tendency to become absorbed in
their experiences than control subjects. Further, absorption scores
of meditators were related to the frequency of their practice sug-
gesting the trait may be malleable and sensitive to training. Across
the entire sample of meditators and controls, absorption positively
correlated with grey matter thickness, at multiple nodes of cingulo-
fronto-parietal (CFP) attention/executive networks. Within these
regions meditators had thicker cortex which was also related to
the extent of training. We suggest below, based on these and
other structural, functional and behavioural results, that there is
 Author's personal copy
J.A. Grant et al. / Biological Psychology 92 (2013) 275–281
substantial evidence indicating that meditative training has a pos-
itive impact on attention. We further describe the remarkable
correspondence, albeit in opposing directions, between meditation
and ADHD and speculate about the use of this form of mental train-
ing to bolstering grey matter thickness in highly susceptible cortical
regions implicated in the disorder.
Structurally, the present report shows that individuals’ propen-
sity for attentional absorption is related to the grey matter
thickness of left ACC, SFG, SMG and bilateral MFG and SPL. These
regions are all parts of attention and executive control networks
known under various formulations as the dorsal attention network
(Bush et al., 2000; Cabeza and Nyberg, 2000; Corbetta and Shulman,
2002), the frontoparietal control system (Vincent et al., 2008) or the
executive control network (Seeley et al., 2007). These systems have
been postulated to coordinate attention under competing condi-
tions. In absolute terms, meditators had thicker grey matter than
controls in each of the above-mentioned regions, significantly so in
the left SFG, SMG and SPL. Further, the years of practice of individ-
ual meditators, after controlling for age, predicted the thickness of
left SFG, ACC, SPL and MFG bilaterally. One possible interpretation
of these results is that repeatedly engaging in meditative practice
leads, overtime, to increases in grey matter thickness in brain
regions important for the control and maintenance of attention
(an alternative is discussed below). This interpretation is consis-
tent with a growing body of work, including a longitudinal training
study, reporting thicker or more dense grey matter for meditators
compared to controls (Grant et al., 2010; Holzel et al., 2008, 2010,
2011; Lazar et al., 2005; Luders et al., 2009; Vestergaard-Poulsen
et al., 2009). Indeed, several of these studies have reported effects
of meditation in attention/executive regions such as ACC, superior,
middle and orbito-frontal regions. Importantly, functional imag-
ing studies have also shown that engaging in meditative practice
activates these same networks.
The main effect of absorption and cortical thickness in left ACC,
SFG, SMG and bilateral MFG and SPL corresponds well with atten-
tion and executive control networks. Functional MRI studies of
meditation have reported engagement of these networks during
practice (Lutz et al., 2008). Brefczynski-Lewis et al. (2007) found
greater activation of left MFG, DLPFC, SMG, right SFG and SPL
bilaterally during sustained attention in advanced Tibetan medi-
tators compared to novices. Similarly, Manna et al. (2010) reported
stronger cingulate and medial PFC activation during meditation
for Theravadin monks compared to controls. Interestingly, a brain-
imaging study from our group examining attentional absorption
stemming from hypnotic induction reported absorption-specific
increases in regional cerebral blood flow in the ACC as well as bilat-
erally in the SFG, MFG, IFG and IPL (Rainville et al., 2002). Thus,
networks functionally activated during both absorption and medi-
tative practice, appear to overlap substantially with those observed
in the present study to relate, structurally, to attentional absorp-
tion. This lends further support to the idea that meditation is a
trainable skill that is reflected in anatomical and functional brain
changes.
The idea that repeated practice or skill learning can result in
functional and structural changes in the brain is certainly not new
(Buonomano and Merzenich, 1998). However it has only been in
the past decade that MRI technology and analyses have become
advanced enough to show, in living humans, that skills such as
juggling (Draganski et al., 2004), mirror reading (Ilg et al., 2008)
or playing a musical instrument (Gaser and Schlaug, 2003) can
influence the amount of grey matter in functionally relevant brain
regions. In a similar manner, learning the skills associated with
meditation, such as being mindful or sustaining one’s focus, may
increase grey matter in regions implicated in attention/executive
processing. Fittingly, we also observed correlations between cor-
tical thickness and facets of mindfulness, which were stronger
279
in meditators, within regions where absorption correlated with
grey matter thickness. This suggests that absorption and aspects
of mindfulness, such as the tendency to be observant and non-
reactive, may share common neural substrates. Similar to other
skills, changes in brain function and structure resulting from train-
ing in meditation should have a corresponding behavioural effect.
Evidence also suggests meditative practice is associated with per-
formance improvements on attention and executive control tasks.
Behaviourally, substantial evidence now exists, from both lon-
gitudinal and cross-sectional studies, that meditative training can
enhance performance on attention/executive tasks such the ANT,
Stroop, attentional blink, a cued-response task, the Symbol Digit
Modalities Test, verbal fluency, and the n-back task (Prakash et al.,
2010; Zeidan et al., 2010; Hodgins and Adair, 2010; Tang et al.,
2007; van Leeuwen et al., 2009). Taken as a whole, the existent lit-
erature suggests meditative practice functionally and structurally
alters attention and executive control networks and improves per-
formance on tasks which engage these regions. Interestingly, in all
three domains the story is the reverse for ADHD.
In the present report, the thickness of cortical regions asso-
ciated with absorption and mindfulness overlapped with regions
reported to undergo cortical thinning in ADHD populations, specif-
ically the cingulate, prefrontal and parietal cortices (Shaw et al.,
2006) (Fig. 3). Of particular interest, cortical thinning of the cingu-
late cortex, measured longitudinally, has been found to be related to
worse outcome in patients (Shaw et al., 2006). In the present report
we created a region of interest centred on the peak from that study
and found direct overlap with the main effect of absorption. In the
same ACC cluster, a positive relationship was observed between
thickness and the extent of meditators’ training. Additional reports
of cortical thinning in adults with ADHD (Makris et al., 2007) have
implicated the ACC, DLFPC and parietal lobules where again, in the
present report, absorption was associated with thicker grey matter
and meditation experience.
It is within these same networks that the majority of functional
abnormalities have been observed in children, adolescents, and
adults with ADHD while performing cognitive tasks tapping atten-
tion and executive function (Bush et al., 2010). A meta-analysis of 16
functional imaging studies of ADHD reported significant patterns
of hypo-activity of anterior cingulate, dorsolateral and inferior pre-
frontal cortices as well as basal ganglia, thalamus, and the parietal
cortex in sufferers of the disorder (Dickstein et al., 2006). As dis-
cussed above, activation of many of these regions is enhanced in
meditators (Brefczynski-Lewis et al., 2007; Manna et al., 2010).
Finally, preliminary behavioural results suggest that an 8 week, sec-
ular, meditation-based program can improve symptoms of ADHD
and scores on measures of attention and executive control such as
the ANT, Stroop and the Trail Making Test in adults and adolescents
(Zylowska et al., 2008).
Taken as a whole, existing behavioural, functional and structural
imaging studies provide a link between meditation and ADHD; the
former being associated with performance enhancement, increased
activation and thicker cortex while the later is associated with per-
formance decrement, hypoactivation and cortical thinning. This
could potentially indicate that the cognitive processes engaged
and strengthened by meditation, possibly reflected by cortical
thickening, are similar to those impaired in ADHD and associated
with functional and structural abnormalities. The contribution of
the present results is that of a potential mechanism by which
meditative practice may act; via changes in cortical thickness,
itself potentially induced from repeated functional activation of
the relevant circuits. While this interpretation admittedly exceeds
what is reasonable for the results presented here, it highlights the
remarkable consistency across studies and measures. Further sup-
port for this link can be found in other domains as well. Seeley
et al. (2007) used resting-state MRI under task-free conditions
 Author's personal copy
280 J.A. Grant et al. / Biological Psychology 92 (2013) 275–281
to link the executive-control network (considerably overlapping
with the present results) to prior performance of the Trail Mak-
ing Test (TMT). The TMT is an executive task requiring one to
switch between competing attentional sets and has been shown
to improve in ADHD populations following meditation training.
Finally, there is evidence that stimulant treatment for ADHD acts
partly by staving off cortical thinning (Shaw et al., 2009). This
suggests that it may be the engagement of specific brain regions,
enabled via the treatment and verified by positive changes in
behaviour, which prevents grey matter loss.
5. Limitations
Thus far we have argued that our results combined with
the existent literature point to meditation as a plausible causal
agent, positively influencing cortical thickness and potentially
modulating behaviour in turn. However, such causality cannot be
determined from a cross sectional study and indeed a case can be
made for alternative interpretations. For example, it may be, and
is perhaps even likely, that there is a substantial genetic contribu-
tion to one’s tendency for absorption (Ott et al., 2005; Ott, 2007), as
there is for both regional cortical thickness (Rimol et al., 2010) and
ADHD (Durston et al., 2004; Forero et al., 2009). It may be that, due
to such factors, a phenotype characterized by high absorption is
attracted to, and perseveres in, the practice of meditation. Indeed,
Holzel and Ott (2006) suggest it may be one’s propensity for absorp-
tion that influences the depth of the meditative state. Nonetheless,
contributions to complex mental phenomenon will likely never be
purely genetic or environmental and the existing longitudinal evi-
dence suggests a significant contribution of meditative training to
changes in attention performance (Prakash et al., 2010; Zeidan et al.,
2010; Hodgins and Adair, 2010; Tang et al., 2007; van Leeuwen
et al., 2009) and grey matter (Holzel et al., 2010) over time.
An unfortunate limitation of the present study is the lack of
a performance-based measure of attention. This stems from the
fact that these data were collected for a study designed to assess
the structural correlates of pain perception (Grant et al., 2010).
Such a measure would have certainly been helpful. Nonetheless,
the strong correlation between absorption and cortical thickness,
nearly exclusively in attention/executive networks, suggests that
the scale may indeed tap these processes. It is interesting to note
that the measure of absorption employed in the present report
depends on participants’ access to the quality or stability of their
mental experience. This suggests that there is a definite relation-
ship between brain structure and the experience one has of their
mental state, and further, that this is consistent across a modest
sample size. While an experiential-based construct like absorption
is not likely to be useful diagnostically for attention-related dis-
orders, it does seem relevant. After all, whether highly focused or
inattentive, our mental experience encompasses all that we can
ever consciously know, making the quality of that experience a
motivating factor for treatment.
It should also be noted that other disorders such as Alzheimer’s
Disease involve similar networks and effects observed here may
more generally reflect a maintenance of cortical thickness in med-
itation as suggested previously (Pagnoni and Cekic, 2007; Lazar
et al., 2005) and resulting from any number of factors associated
with the practice or lifestyle. Nonetheless, given the prelimi-
nary evidence for the effectiveness of meditation as an adjunct
treatment for ADHD (Zylowska et al., 2008), there seems to be
adequate justification for larger longitudinal studies combining
mental training via meditation with performance measures of
attention/executive control and MRI morphometry. Importantly,
clinical studies could also directly test the hypothesis that medita-
tive training will increase cortical thickness in sufferers of ADHD
and ultimately, link those changes with behavioural improvement.
The substantial financial burden that this and related disorders
place on health care systems (Guevara et al., 2001), raises the incen-
tive, both socially and economically, for such a complementary
treatment option.
To conclude, the current study provides evidence that grey mat-
ter thickness, overlapping with regions of the brain susceptible to
thinning in disorders of attention, is associated with an individual’s
experience of mental absorption or engagement in their experi-
ence. Individuals who practice meditation had thicker cortex in
several of these regions which was also related to the extent of their
training. We suggest that these results and the existent literature
provide ample justification for further inquiry into the potential
use of meditative practice as an adjunct treatment for ADHD.
Financial disclosures
None of the authors have any financial or other relationship that
might lead to a conflict of interest.
Acknowledgments
This research was supported jointly by a Canadian Institutes
of Health Research (CIHR) operating grant (P.R.) and a Mind and
Life Institute Varela Grant (J.A.G.). J.A.G has also been supported
by a fellowship from CIHR. We would like to thank L’Unité de
Neuroimagerie Fonctionnelle du Centre de recherche de l’Institut
universitaire de gériatrie de Montréal for technical help with scan-
ning and members of the Duncan-Rainville labs.
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