Mindfulness-based intervention to decrease mood lability in at-risk youth: Preliminary evidence for changes in resting state functional connectivity

Abstract

Background: In youth at familial risk for bipolar disorder (BD), mood lability is an important precursor to BD onset. Previous work in adults indicates that mindfulness-based interventions (MBI) may improve emotion regulation, in part by increasing resting-state functional connectivity (rsFC) between posterior cingulate cortex (PCC) and executive control network (ECN). In this pilot study, we assessed effects of an MBI on PCC-ECN rsFC and mood lability in at-risk youth.

Methods: We recruited 35 youth (10-14 years old) with a first-degree family history of BD and mood lability, and 21 age-matched healthy controls. Eligible at-risk youth were scanned pre/post an 8-week MBI and assessed three months later. Healthy controls were scanned at matched timepoints but did not participate in the MBI. The MBI used age-appropriate strategies to promote non-judgmental, present-moment awareness. We assessed pre/post changes in PCC-ECN rsFC and how rsFC changes were related to mood outcomes.

Results: Twenty at-risk youth were scanned pre/post MBI; 16 had high-quality rsFC data. Following MBI, at-risk youth showed increased rsFC between PCC and left dorsolateral prefrontal cortex (DLPFC) (BA 9; k = 28; corrected p=.006); healthy controls did not show this increase. Following MBI, at-risk youth reported more mindfulness (F = 7.15, p=.003), less mood lability (F = 7.2, p=.002), and less suppression of negative emotions (F = 5.05, p=.01). PCC-DLPFC rsFC increases predicted less mood lability (t=-2.25, p=.04) and less emotion suppression (t=-2.75, p=.02) at follow-up.

Limitations: Small sample and lack of a control intervention.

Conclusions: PCC-DLPFC rsFC may be a clinically meaningful neural target of an MBI in at-risk youth, related to improvements in mood lability.

Keywords: Bipolar disorder; Emotion regulation; Mindfulness; Mood lability; Neuroimaging; Resting-state functional connectivity.

Copyright © 2020 Elsevier B.V. All rights reserved.

Figures

Figure 1:

Diagram for completers vs. non-completers (at-risk only)

Figure 2a.

Left DLPFC region showing increased PCC rsFC following MBI in the at-risk youth

Figure 2b.

Group × Time interaction within extracted cluster (p=.10). Compared to all other scans (Healthy Controls; At-Risk Scan 1), At-Risk Scan 2 showed increased PCC-DLPFC rsFC (p=.006); this pattern is consistent with a “spreading interaction” model.