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

描述（由申请人提供）：NCCAM最近委托进行的一项审查得出结论，关于冥想练习的研究的特点是方法质量差，在得出这些练习对改善健康和福祉的有效性的确切结论之前，需要更严格的科学。研究得最好的冥想形式是正念，这是最常见的正念减压（MBSR）训练，由我们在马萨诸塞大学的研究团队成员开发。建议的R34的直接目标是验证MBSR效应的建议生物标志物。 基于我们的初步数据，我们建议，静息状态功能磁共振成像测量功能连接（FC）在边缘应激反应网络将是一个有价值的生物标志物的影响MBSR的情绪和压力反应，并将预测持续改善健康行为。这种生物标志物将使未来的大规模随机试验能够集中在MBSR对长期健康行为改变的有效性上，例如维持体重减轻。拟议的生物标志物将允许未来的研究，以完善MBSR干预措施的基础上，提高对有效成分和个体差异的理解，减少对自我报告的措施的依赖，并提供一个客观的措施，以确定最有可能受益的患者和那些可能需要量身定制的干预措施。我们的具体目标是：（1）将功能连接作为MBSR反应性的生物标志物;（2）在6个月随访时调查功能连接变化与健康行为变化的相关性。 我们的初步数据表明，杏仁核-眶额回路中的FC 1）与特质正念密切相关，与情绪反应呈负相关，2）仅通过8周的MBSR训练就得到增强。此外，MBSR在该回路中产生了可量化的变化，这些变化与影响健康行为的心理特质的改善相对应。 我们将随机抽取100名社区参与者进行正念减压疗法或注意力控制。终点包括FC、健康行为（睡眠质量、身体活动、健康饮食）和相关心理结构（感知压力、抑郁、特质焦虑、特质愤怒和积极情感）的变化。将在基线、8周和12周时测量终点，并在6个月时额外测量健康行为和心理结局。我们假设，干预组将经历一个更大的增加FC比对照组和FC的变化将与健康行为和心理结构。我们还将考虑干预参与和期望。 客观和定量地测量正念减压疗法/正念对大脑的影响的能力是高度创新的。我们的跨学科研究团队包括正念减压疗法的开发者、经验丰富的临床试验/行为疗法研究人员和功能成像方法专家。

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.