Mind and health: developing a neural marker for mindfulness, a pathway to health

心灵与健康：开发正念神经标记，这是通往健康的途径

• 批准号: 8849088
• 负责人: Carl Fulwiler
• 金额: $ 2.52万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-01 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8849088
• 关键词: Accounting; Address; Affect; Amygdaloid structure; Anger; Anxiety; Attention; Awareness; Behavior; Behavior Therapy; Behavioral; Biological Markers; Body Weight decreased; Brain; Cessation of life; Clinical Research; Clinical Trials; Communities; Data; Dose; Eating; Education; Educational process of instructing; Effectiveness; Emotional; Emotional Stress; Emotions; Ensure; Evaluation; Exercise; Expectancy; Experimental Designs; Food; Fostering; Foundations; Functional Imaging; Functional Magnetic Resonance Imaging; Future; Goals; Health; Health Care Costs; Health behavior; Health behavior change; Individual; Individual Differences; Informal Social Control; Intervention; Knowledge; Magnetic Resonance Imaging; Maintenance; Measurement; Measures; Mediation; Meditation; Mental Depression; Mental Health; Mind; Monitor; Morbidity - disease rate; National Center for Complementary and Alternative Medicine; Neurosciences; Obesity; Outcome; Participant; Pathway interactions; Patient Self-Report; Patients; Personal Satisfaction; Physical activity; Psychological Factors; Qualifying; Randomized; Relapse; Reliance; Research; Research Personnel; Rest; Role; Sampling; Science; Sleep; Solid; Strategic Planning; Stress; Symptoms; Testing; Time; Training; Training Programs; Validation; Work; base; behavior change; biological adaptation to stress; comparison group; depressive symptoms; design; effective intervention; effectiveness trial; experience; follow-up; group intervention; holistic approach; imaging modality; improved; innovation; intervention effect; member; mindfulness; mindfulness-based stress reduction; multi-component intervention; multidisciplinary; neuroimaging; premature; psychologic; psychological outcomes; public health priorities; public health relevance; randomized trial; relating to nervous system; response; trait

DESCRIPTION (provided by applicant): A recent review commissioned by NCCAM concluded that the research on meditation practices is characterized by poor methodological quality and that more rigorous science is needed before firm conclusions can be drawn on the effectiveness of these practices for improving health and well-being. The best studied form of meditation is mindfulness, which is most commonly taught by the Mindfulness-Based Stress Reduction (MBSR) training developed by members of our research team at UMass. The immediate goal of the proposed R34 is to validate a proposed biomarker for the effects of MBSR. Based on our preliminary data, we propose that resting-state fMRI measurement of functional connectivity (FC) in the limbic stress response network will be a valuable biomarker for the effect of MBSR on emotional and stress reactivity and will predict sustained improvements in health behaviors. This biomarker will enable future large-scale randomized trials that focus on the effectiveness of MBSR for long-term health behavior change, such as maintenance of weight loss. The proposed biomarker will allow future studies to refine MBSR interventions based on improved understanding of the effective components and individual differences, reduce reliance on self-reported measures, and provide an objective measure for identifying patients most likely to benefit and those who may need a tailored intervention. Our Specific Aims are to: (1) Validate functional connectivity as a biomarker for responsiveness to MBSR; (2) Investigate the association of functional connectivity change with changes in health behaviors at 6 month follow-up. Our preliminary data demonstrate that FC in the amygdala-orbitofrontal circuit is 1) strongly correlated with trait mindfulness and inversely correlated with emotional reactivity, and 2) enhanced by just 8 weeks of MBSR training Moreover, MBSR produces quantifiable changes in this circuit that correspond to improvements in psychological traits shown to impact health behaviors. We will randomize 100 community participants to MBSR or an attention control. Endpoints include changes in FC, health behavior (sleep quality, physical activity, healthy eating), and related psychological constructs (perceived stress, depression, trait anxiety, and trait anger, and positive affect). Endpoints will be measured at baseline, 8 weeks and 12 weeks, with an additional measurement at 6 months for health behavior and psychological outcomes. We hypothesize that the intervention group will experience a greater increase in FC than the comparison group and that changes in FC will correlate with health behavior and psychological constructs. We will also account for intervention engagement and expectancy. The ability to objectively and quantitatively measure the effects of MBSR/mindfulness on the brain is highly innovative. Our inter-disciplinary research team includes the developer of MBSR, experienced clinical trials / behavioral therapy researchers, and experts in functional imaging methods.

描述（由申请人提供）：NCCAM 最近委托进行的一项审查得出的结论是，冥想练习的研究的特点是方法质量较差，需要更严格的科学才能对这些练习改善健康和福祉的有效性得出明确的结论。研究得最好的冥想形式是正念，最常见的是由我们麻省大学研究团队成员开发的基于正念的减压（MBSR）培训。拟议 R34 的直接目标是验证拟议的 MBSR 效果的生物标志物。 根据我们的初步数据，我们提出，边缘应激反应网络中功能连接（FC）的静息态 fMRI 测量将成为 MBSR 对情绪和压力反应性影响的有价值的生物标志物，并将预测健康行为的持续改善。该生物标志物将使未来的大规模随机试验成为可能，这些试验重点关注 MBSR 对长期健康行为改变（例如维持体重减轻）的有效性。拟议的生物标志物将使未来的研究能够在提高对有效成分和个体差异的理解的基础上完善MBSR干预措施，减少对自我报告措施的依赖，并提供客观的衡量标准来识别最有可能受益的患者和可能需要量身定制干预措施的患者。我们的具体目标是：(1) 验证功能连接作为 MBSR 反应性的生物标志物； (2) 调查 6 个月随访时功能连接变化与健康行为变化的关联。 Our preliminary data demonstrate that FC in the amygdala-orbitofrontal circuit is 1) strongly correlated with trait mindfulness and inversely correlated with emotional reactivity, and 2) enhanced by just 8 weeks of MBSR training Moreover, MBSR produces quantifiable changes in this circuit that correspond to improvements in psychological traits shown to impact health behaviors. 我们将随机分配 100 名社区参与者进行 MBSR 或注意力控制。终点包括 FC、健康行为（睡眠质量、体力活动、健康饮食）和相关心理结构（感知压力、抑郁、特质焦虑、特质愤怒和积极情绪）的变化。终点将在基线、8 周和 12 周时进行测量，并在 6 个月时进行额外的健康行为和心理结果测量。我们假设干预组的 FC 会比对照组有更大的增加，并且 FC 的变化将与健康行为和心理结构相关。我们还将考虑干预参与度和预期。 客观、定量地测量 MBSR/正念对大脑的影响的能力具有高度创新性。我们的跨学科研究团队包括MBSR的开发者、经验丰富的临床试验/行为治疗研究人员以及功能成像方法专家。