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

MBCT 对 MDD 内感受意识和沉思大脑机制的影响

• 批准号: 9273477
• 负责人: Gaelle Desbordes
• 金额: $ 13.72万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9273477
• 关键词: Address; Amygdaloid structure; Anxiety; Area; Arousal; Attention; Autonomic nervous system; Awareness; Brain; Brain imaging; Brain region; Clinical; Clinical Trials; Cognitive; Control Groups; Cross-Sectional Studies; Development; Development Plans; Disease; Emotional; Emotions; Engineering; Feeling; Functional Magnetic Resonance Imaging; Health; Individual; Insula of Reil; Intercept; Intervention; Investigation; Knowledge; Learning; Light; Link; Major Depressive Disorder; Measurable; Measures; Meditation; Mental Health; Mentored Research Scientist Development Award; Mentors; Mind; Mind-Body Intervention; Modeling; National Center for Complementary and Alternative Medicine; Neurosciences; Outcome; Participant; Patients; Physiological; Public Health; Randomized; Regulation; Relapse; Research; Research Personnel; Scientist; Standardization; Structure; Testing; Training; Training Support; Work; base; burden of illness; career development; cingulate cortex; clinical application; depressive symptoms; design; disability; effective therapy; experience; flexibility; group intervention; heart rate variability; improved; mindfulness; mindfulness based cognitive therapy; mindfulness intervention; mortality; negative mood; neuroimaging; prevent; public health relevance; reduce symptoms; relating to nervous system

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.

该指导研究科学家发展（K 01）奖将支持在神经科学和工程方面接受过培训的初级研究员的培训和职业发展，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措施的培训。拟议的研究重点是基于正念的认知疗法（MBCT）的神经和生理机制，这是一种有效的抑郁症（MDD）群体干预。MDD的特征是适应不良的沉思--一种持续的消极的、自我关注的心理状态。正念认知疗法框架认为，沉思倾向可以通过正念练习来纠正，以促进对通常引发沉思的不愉快心理状态和内部感受的早期识别，从而使其能够从随后的恶性循环中解脱出来，进入典型的MDD消极情绪。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具有可测量的影响，特别是在已知在MDD中功能失调的大脑区域中，并且冥想训练可以改善心肺功能的自主调节，如通过心率变异性（HRV）的测量所评估的。然而，MBCT在MDD中的具体作用机制目前尚不清楚。在这项研究中，我们将使用功能性磁共振成像（fMRI）和自主神经（HRV）评估（i）调查MBCT对涉及拦截意识和反刍的大脑网络以及自主神经系统的纵向影响，以及（ii）测试MBCT后增加拦截大脑激活的机制，提高参与者脱离反刍大脑活动的能力，从而减轻抑郁症状。从拟议的研究结果将揭示MBCT在重性抑郁症的神经和生理机制的行动。