MBCT effects on brain mechanisms of interoceptive awareness and rumination in MDD

描述（由申请人提供）：本导师研究科学家发展（K01）奖将支持在神经科学和工程方面受过培训的初级研究者的培训和职业发展，过渡到冥想脑成像研究领域。拟议的职业发展计划包括身心医学、临床试验、心理健康、神经成像和基于冥想的临床应用干预方面的培训。正念认知疗法（MBCT）是治疗重度抑郁症（MDD）的一种有效的群体干预手段。重度抑郁症的特点是不适应的反刍——一种持续的消极的、自我关注的精神状态。MBCT框架认为，反刍倾向可以通过使用正念练习来纠正，以促进对通常引发反刍的不愉快的精神状态和内部感觉的早期认识，从而使其脱离随后的恶性循环，进入典型的重度抑郁症的负面情绪。先前的研究（包括申请人最近的工作）表明，基于正念的干预对大脑结构和功能有可测量的影响，特别是在已知的MDD中功能失调的大脑区域，并且冥想训练可以改善心肺功能的自主调节，通过心率变异性（HRV）的测量来评估。然而，MBCT在MDD中的具体作用机制目前尚不清楚。在本研究中，我们将使用功能性磁共振成像（fMRI）和自主神经（HRV）评估(i)来研究MBCT对与拦截意识和反刍有关的大脑网络以及自主神经系统的纵向影响，（ii）来测试所提出的机制，即MBCT后增加的拦截性大脑激活可以提高参与者从反刍大脑活动中解脱出来的能力，从而减轻抑郁症状。本研究结果将揭示MBCT治疗重度抑郁症的神经和生理机制。

DESCRIPTION (provided by applicant): This Mentored Research Scientist Development (K01) Award will support the training and career development of a junior investigator with prior training in neuroscience and engineering, transitioning into the field of meditation brain imaging research. The proposed career development plan includes training in mind-body medicine, clinical trials, mental health, neuroimaging, and meditation-based interventions for clinical applications. The proposed research focuses on the neural and physiological mechanisms of mindfulness-based cognitive therapy (MBCT), an effective group intervention for major depressive disorder (MDD). MDD is characterized by maladaptive rumination-a persistence of negative, self-focused mind states. The MBCT framework holds that ruminative tendencies can be remediated by using mindfulness practice to facilitate an earlier recognition of unpleasant mind states and internal feelings that usually trigger rumination, thereby enabling disengagement from the subsequent downward spiral into negative moods typical of MDD. Previous studies (including recent work by the Applicant) suggest that mindfulness-based interventions have measurable effects on brain structure and function, especially in brain regions known to be dysfunctional in MDD, and that meditation training may improve autonomic regulation of cardiorespiratory function, as assessed with measures of heart rate variability (HRV). However, the specific mechanisms of action of MBCT in MDD are currently unknown. In this study we will use functional magnetic resonance imaging (fMRI) and autonomic (HRV) assessments (i) to investigate the longitudinal effects of MBCT on the brain networks involved with interceptive awareness and rumination and on the autonomic nervous system, and (ii) to test the proposed mechanism that increased interceptive brain activation after MBCT improves participant ability to disengage from ruminative brain activity, thereby reducing depressive symptoms. The findings from the proposed research will shed light on the neural and physiological mechanisms of action of MBCT in major depression.