The Impact of App-Delivered Mindfulness Meditation on Functional Connectivity and Self-Reported Mindfulness Among Health Profession Trainees

Jeremy L Smith, Jason W Allen, Carla Haack, Kathryn Wehrmeyer, Kayley Alden, Maha B Lund, Jennifer S Mascaro, Jeremy L Smith, Jason W Allen, Carla Haack, Kathryn Wehrmeyer, Kayley Alden, Maha B Lund, Jennifer S Mascaro

Abstract

Objectives: Previous research indicates that mindfulness meditation reduces anxiety and depression and enhances well-being. We examined the impact of app-delivered mindfulness meditation on resting state functional MRI (fMRI) connectivity among physician assistant (PA) students and surgery residents.

Methods: PA students and residents were randomized to receive a popular meditation app or to wait-list control group. Before and after the 8-week meditation period, we acquired fMRI scans of participants' resting state, and participants completed a self-report measure of mindfulness. We used a 2 × 2, within- and between-group factorial design and leveraged a whole-brain connectome approach to examine changes in within- and between-network connectivity across the entire brain, and to examine whether changes in connectivity were associated with app use or to changes in self-reported mindfulness.

Results: Meditation practitioners exhibited significantly stronger connectivity between the frontoparietal network and the left and right nucleus accumbens and between the default mode (DMN) and salience networks, among other regions. Mindfulness practice time was correlated with increased connectivity between the lateral parietal cortex and the supramarginal gyrus, which were also positively correlated with increased scores on the "Describing" subscale of the Five Facet Mindfulness Questionnaire between baseline and post-meditation. These findings are consistent with previous research indicating that mindfulness-based interventions alter functional connectivity within the DMN and between the DMN and other networks both during meditation and at rest, as well as increased connectivity in systems important for emotion and reward.

Conclusions: Recent commentaries call for healthcare provider and trainee wellness programs that are sustainable and preventive in nature rather than reactive; these data indicate that even brief sessions of app-delivered mindfulness practice are associated with functional connectivity changes in a dose-dependent manner.

Keywords: Connectivity; Meditation; Mindfulness; Resting state; fMRI.

Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflict of interest.

© Springer Science+Business Media, LLC, part of Springer Nature 2020.

Figures

Fig. 1
Fig. 1
a Comparison of the effect of treatment (practitioners versus controls) at + 8 week-follow-up visit. Warm colors represent stronger connectivity (higher ROI-ROI correlations) in practitioners than controls at + 8 weeks; cool colors, weaker connectivity (lower ROI-ROI correlations) in practitioners than controls at + 8 weeks. The effect of treatment on the connectivity of right lateral parietal and left posterior parietal cortices is presented below the carousel plot. t test; FDR correction by Benjamini-Hochberg method. b Effect of ΔFFMQ(Des) on connectivity at + 8 weeks over all subjects (practitioners and controls). Warm colors indicate increased connectivity (ROI-ROI correlations) with greater increases in FFMQ(Des) from baseline to + 8 weeks. The connection in gray was not significant for the treatment effect shown in Fig. 1a. The effect of ΔFFMQ(Des) on right lateral parietal connectivity is shown below the carousel plot. FDR correction by Benjamini-Hochberg method
Fig. 2
Fig. 2
a Effect of practice time on connectivity at + 8 weeks in practitioners only. Warm colors indicate stronger connectivity (ROI-ROI correlations) with greater practice time over the 8-week experiment. b Connectivity of right lateral parietal cortex as effect of practice time in practitioners. FDR correction by Benjamini-Hochberg method
Fig. 3
Fig. 3
Changes in connectivity between the default-mode (right hemisphere lateral parietal cortex) and salience networks (supramarginal gyri) as a function of either a difference FFMQ(Des) scores between visit 2 and visit 1 (left column) or time spent practicing with the meditation application (right column). Regression line is in dark orange; thin lines represent 95% confidence intervals. Overall significance of regression line fits is shown in the table
Fig. 4
Fig. 4
a Comparison of regional changes in connectivity with the right hemisphere lateral parietal cortex (left column) and changes in spectral power (middle and right columns). Practitioners and controls are represented with amber and blue, respectively. pFDR ≤ 0.05. b Cross-spectral density (shared spectral power) between right lateral parietal cortex and left supramarginal (left column) and right supramarginal gyrus (right column) in controls (blue) and practitioners (amber) at + 8 weeks. Baseline cross-spectral densities are presented as dotted lines

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Source: PubMed

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