Rethinking Mental Health: Spirituality, Healing and Culture

Lecture:
Neuroscience and Meditation

Gaelle Desbordes, PhD

Boston University
Feb 12, 2011
Scientificstudyofmeditation:Exchanges
betweenscientistsandcontemplatives
 Aquickhistoryofthescientificstudyof
meditation:theearlystages

• TranscendentalMeditation(TM)

• HerbertBenson(1975):Meditation(andothercontemplativepractices)
inducea““RelaxationResponse””,whichistheoppositetothe““stress
response””
 Bodychangesduringstress

Imagesource:
http://www.atomicmeme.com/_imgs/learninghub/stressbiol/body_fight_flight2.png
 H.Benson(1975):theRelaxationResponse
[iswhatmeditationdoes]

From:http://hubpages.com/hub/RXͲforͲStressͲTheͲRelaxationͲResponse
SympatheticNervousSystem: ParasympatheticNervous
FightͲorͲflight System:RestͲandͲdigest

Imagesource:www.medicalook.com
…… butrecentresearchsuggeststhatthereismoretomeditationthanthe
relaxationresponse.
 Aquicktourofthebrain

FromRickHanson(2009)Buddha'sBrainp.54
 • Prefrontalcortex(PFC):setsgoals,makesplans,directsaction;shapes
emotions,inpartbyguidingandsometimesinhibitingthelimbic system
• Anteriorcingulate cortex(ACC):steadiesattentionandmonitorsplans;helps
integratethinkingandfeeling
• Insula:interoception (sensestheinternalstateofthebody),including““gut
feelings””;linkedtoempathy
• Thalamus:majorrelaystationforsensoryinformation
• Corpuscallosum:bundleoffiberspassinginformationbetweenthetwobrain
hemispheres
• Limbicsystem:includesthebasalganglia,hippocampus,amygdala,
hypothalamus,andpituitarygland;centraltoemotionandregulation
• Basalganglia:involvedwithrewards,stimulationseeking,andmovement
• Hippocampus:formsmemories,detectsthreats,……
• Amygdala:respondsveryquicklytoemotionallychargedstimuli(especially
negativeones);actslikean““alarmbell”” todetectdangerintheenvironment
• Hypothalamus:regulatesprimaldrivessuchashungerandsex;produces
oxytocin;activatespituitarygland
• Pituitarygland:makesendorphins(i.e.internal““opiate””);triggerssex
hormones;storesandreleasesoxytocin.
Pleasenote:theabovelistisanoversimplification!Eachofthesebrainareasis
involvedinmanyotherfunctionsaswell.Neuroscienceisstillaveryyoung
science,andweareonlybeginningtounderstandhowthebrainworks.

FromRickHanson(2009)Buddha'sBrainpp.53Ͳ55
 Recentfindingsinneuroscience
aboutmeditation
LongͲtermchangesinbrainanatomy:
Meditationpractitionersmayhavethickercortexinbrainregionsassociated
withattention,interoception andsensoryprocessing,includingthe
prefrontalcortexandrightanteriorinsula.MeditationmightoffsetageͲ
relatedcorticalthinning.

Insula Prefrontal cortex

From Lazar et al., 2005, Neuroreport

 Recentfindingsinneuroscience
aboutmeditation:MBSR
• TheeightͲweekMindfulnessͲBasedStressReduction(MBSR)Programhas
manybeneficialeffectsonmentalhealth,demonstratedinrandomized
controlledstudies
• Forexample,ithelpswithchronicpain,autoimmunediseases(psoriasis),
anxiety,depression……
• [SeeupcominglectureonMindfulnessandDepression]
• However,themechanisms bywhichMBSRworksarestilllargelyunknown
andunderinvestigation.
• Forexample,arecentstudyfoundsmallchangesinthebrainafter8
weeksofMBSR(seenextslide)
 Hölzel etal.,2011:Mindfulnesspracticeleadsto
increasesinregionalbraingraymatterdensity

““Participantswhomeditatedfor
about30minutesadayforeight
weekshadmeasurablechangesin
grayͲmatterdensityinpartsofthe
brainassociatedwithmemory,sense
ofself,empathyandstress.
M.R.I.brainscanstakenbeforeand
aftertheparticipants’’ meditation
regimenfoundincreasedgraymatter
inthehippocampus,anarea
importantforlearningandmemory.
Theimagesalsoshowedareduction
ofgraymatterintheamygdala,a
regionconnectedtoanxietyand
stress.Acontrolgroupthatdidnot
practicemeditationshowednosuch
changes.””
From:http://well.blogs.nytimes.com/2011/01/28/howͲmeditationͲmayͲchangeͲtheͲbrain/
From Hölzel et al., 2011, Psychiatry Research: Neuroimaging
Recentfindingsinneuroscience:lovingͲkindness
andcompassionmeditation
Mostmeditationresearchhasfocusedonpracticesthatemphasize calming
themind(e.g.TM),improvingfocusedattention,ordeveloping
mindfulness(e.g.MBSR).

Morerecently,neuroscienceresearchhasturnedtocompassionandlovingͲ
kindnessmeditation.
InlovingkindnessͲcompassionmeditation,expertpractitioners (comparedto
novices)showmore,notless,emotionalreactivitytosoundsofpeoplein
distress:fasterheartbeat,andstrongerresponseintheinsula (linkedto
interoception andempathy),whichcannotbeexplainedbytherelaxation
responsehypothesis.

experts
novices

From Lutz et al., 2008, PLoS ONE, Regulation of the Neural Circuitry of
Emotion by Compassion Meditation: Effects of Meditative Expertise
““PureCompassion”” meditationcaninducestrongEEGpatternspreviously
associatedwithpositiveemotionalityandenhancedadaptiveimmune
functioning:
(Lutzetal.,2004,ProceedingsoftheNationalAcademyofSciences,LongͲ
termmeditators selfͲinducehighͲamplitudegammasynchronyduring
mentalpractice)
 EEGbrainwavesduringcompassionmeditation

EEG Gamma power

These high-amplitude gamma-

band oscillations and phase-
synchrony are “off-the-chart”
from the normal range.
Lutz et al., 2004 PNAS Start Compassion meditation
 Phenomenology
vs.
hypothesisͲdrivenresearch

Atthispointintime,meditationneuroscienceisstillatthestageof
observinganddescribingwhathappensphenomenologically.Thereisno
scientifictheoryquiteyet,butthisisthetopicofactiveresearch.
 OngoingresearchatEmoryUniversity

Physiologicalmechanismslinkedwith
meditation:
Meditationmayimproveemotional
andphysicalhealthbyreducing
inflammatoryreactivitytostressand
illness Dr. Chuck Raison, MD,
Department of Psychiatry
and Behavioral Sciences
Depression itselfischaracterizedby
increasedinflammation(Raisonetal.,
TrendsinImmunology, 2006)

Alsoinflammatory:fibromyalgia,
neuropathicpain,heartdisease,
stroke,Alzheimer’’sdisease,etc. Geshe Lobsang Tenzin Negi, PhD,
Department of Religious Studies
 Benefitsofcompassionmeditation:
pilotstudyoncollegestudents

Compassionmeditation
effectsonreductionsin
inflammationandemotional
distressinresponseto
psychologicalstress

Pace et al., Effect of compassion meditation on neuroendocrine, innate

immune and behavioral responses to psychosocial stress,
Psychoneuroendocrinology, 2009

Pace et al., Innate immune, neuroendocrine and behavioral responses to

psychosocial stress do not predict subsequent compassion meditation
practice time, Psychoneuroendocrinology, 2010
 TrierSocialStressTest(TSST)

– publicspeakinginamock““jobinterview”” formatinfrontofapanelof
““expertsinbehavioralanalysis”” andvideocamera
– mentalarithmetic
– anticipatorystress/anxiety
– HeartRateVariabilityandSkinConductanceLevel
– Intravenouslinetotestseveralbloodmarkers(ILͲ6,cortisol,NE,E,NPY,VIP,
NFͲNB,PBMC……)at15minintervals,before,duringandafterthestressor
 TrierSocialStressTesteffects
onimmuneandinflammatorymarkers
 Inflammationmarkers(thelower,thebetter)beforeandafter
compassionmeditationtraining

Pace et al., 2010, Psychoneuroendocrinology

 DoseͲresponserelationshipforimmune
responseafterstressor

Pace et al., 2009, Psychoneuroendocrinology

 DoseͲresponserelationship
foremotionaldistressafterstressor

Pace et al., 2009

Basedontheabovepilotstudies,alargeͲscalerandomizedclinicaltrialtotest
thephysiologicaleffectsofmeditationiscurrentlyunderwayat Emory
UniversityandBostonUniversity(incollaborationwithHarvardandthe
MassachusettsGeneralHospital):

TheCompassionandAttentionLongitudinalMeditationstudy
 TheCompassionAttentionLongitudinal
Meditation(CALM)study

• Compassionmeditationanditseffectoninflammatoryresponsestoacute
andchronicstress

• NIH(R01)fundedstudyatEmoryUniversity,Atlanta,GA
• PrincipalInvestigator:Dr.CharlesRaison
• Compassionvs.MindfulnessͲAttentionvs.Controls
• Targetedenrollment:N=360adultsover5years
 Studyparticipants

• Healthy,age25Ͳ55
• Targetedenrollment:N=360peopleover5years:
– 120MindfulnessͲAttention
– 120Compassion
– 120controls
• Racial/ethnicdiversityrepresentativeofthelargerpopulation
 Whatdoesthestudyconsistof?

• Iterativetrainingover8weeks
• TwiceͲaͲweekoneͲhourmeetings/teachings
• Meditationsubjectsareaskedtomeditate20Ͳ30mineveryday(Practice
timeistrackedbya““portablemeditationlog”” device)
• Controlsubjectsareaskedtokeepadailyjournalofhealthdiscussions
• ThereisNOphysicalexercise(e.g.,yoga)ordietarychangeinvolved;
peoplekeeptheirhabituallifestyle.
 Meditationtraininginthefirstgroup:
MindfulnessͲAttentionTraining(MAT)
Protocoloutlineoverthecourseof8weeks:

• Settlingthebodyandrespirationintheirnaturalstate
• Mindfulnessofbreathingwithrelaxationandstabilityofattention
• Mindfulnessofbreathingwithrelaxation,stabilityandvividness
• Settlingthemindinitsnaturalstate
• Awarenessofawareness

TheMATprotocolwasdesignedbyAlanWallace(SantaBarbaraInstitute
forConsciousness)andGeshe Lobsang Tenzin Negi (EmoryUniversity)
basedonTibetanBuddhism,butcompletelysecularincontent
 Meditationtraininginthesecondgroup:
lovingͲkindnessandcompassionmeditation
Protocoloutlineoverthecourseof8weeks:

• Developingattentionandstabilityofmind,asinMAT(includedinall
subsequentsteps)
• Developingcompassionforoneselfthroughmindfulnessofsensations,
feelingsandemotions
• Cultivatingequanimityandappreciationforothers
• Developingaffectionandempathy
• Wishingandaspirational compassion
• Activecompassionforothers

TheCompassionmeditationprotocolwasdesignedbyGeshe Lobsang
Tenzin Negi (EmoryUniversity)
basedontraditionalTibetan““loͲjong”” =““mindtraining”” techniques,but
completelysecularincontent
 Control:Healthdiscussiongroup

Protocoloutlineoverthecourseof8weeks:

• OneͲhourtalkonahealthͲrelatedtopicbyalocalexpert
• OneͲhouractiveparticipationinsmallgroupdiscussions,roleͲplaying,and
friendlydebatesdesignedtomakethehealthtopicscoveredpersonally
relevant
• Asasubstitutefordailymeditationpractice,thesecontrolsubjectsare
keepingadailylogoftheirreflectionsonhowtoincorporatethecurrent
healthtopicintodailylife
(Logswillnotbecollected,butaveragetimespentonitperdaywillbe
recorded)
 PreͲ andpostͲinterventionassessments
• TrierSocialStressTest(TSST):
– publicspeakinginamock““jobinterview”” formatinfrontofapanelof
““expertsinbehavioralanalysis”” andvideocamera
– mentalarithmetic
– anticipatorystress/anxiety
– HeartRateVariabilityandSkinConductanceLevel
– IntravenouslinetotestILͲ6,cortisol,NE,E,NPY,VIP,NFͲNB,PBMC……
at15minintervals,before,during,andafterthestressor
• Neuropsychiatric,psychosocialandlifestyleassessments
– 12differentselfͲreportandclinicianͲbasedassessments
• Brainimaging(atMGH):structural,diffusionͲbased,andfunctionalMRI
– Onasubsetofthesubjects(targetN=48,or16pergroup)
– FundedseparatelybyanNIHResearchChallengegrant(ARRA)toProfessor
EricSchwartzatBostonUniversity
 Recapofpreviousneuroimaging studies

• SaraLazar,MGH:
– corticalthicknesslargerinmeditators in
regionsassociatedwithattention,
interoception andsensoryprocessing,
includingprefrontalcortexandright
anteriorinsula
– Longitudinalstudy:Stressreduction
(followingMBSRintervention)correlates
withdecreaseinamygdala greymatter
density
• AntoineLutz,RichieDavidson(U.of
WisconsinͲMadison):compassionmeditation
inexperts
– HighͲamplitudegammasynchrony(EEG)
– enhancedactivationofinsula,cingulate
cortices,amygdala,etc.(fMRI)
• andothers……
 Motivationsforbrainimaging

• Changesinstressresponseinvolvethebrain,esp.limbicandsubcortical
structures(e.g.Hypothalamic––pituitary––adrenal(HPA)axis)
– The““where”” question:Whichneuralregionsandcircuitsareinvolved?
• Neuroplasticity:““Useitorloseit””;canwetrainthebraintobemore
– Attentive?Mindful?
– Compassionate?
• Differentreactionstoemotionalstimuli,linkedtobetterqualityoflife
(changeintrait)
• Neuralcorrelatesofmeditativestates asalteredstatesofconsciousness
 Hypothesesonlongitudinaleffectsof
meditationtraining
• Structuralchanges:corticalthickness,greymatterdensity
• Changesinanatomicalconnectivity
• Changesinfunctionalconnectivity(indefaultmodenetwork+other
networks)
• Physiological““trait”” changesintherestingstate
– longitudinaldifferencesinbaselinebrainactivation
– Changesinautonomicphysiology
• Changesinresponsetoemotionalstimuli
– longitudinaldifferencesinbrainresponsetostimuli
– Changesinautonomicphysiology
• Neuralcorrelatesofmeditation:mindfulnessvs.compassionvs.rest
probablyactivatedifferentregionsofthebrain(““state”” changes)
 Brainimagingexperimentaldesign

• Siemens3Twith32Ͳchannelheadcoil
• Simultaneousrecordingsofautonomicphysiologicaldata:
ECG,breathingbelt,pulseͲoxymeter,GSR
• Anatomical(structuralanddiffusionͲbased)scans:
corticalthickness,greymatterdensity,whiteͲmatterconnectivity
• fMRI inrestingstatetomeasurefunctionalconnectivity
• fMRI task:passiveviewingofemotionalvisualstimuli
– Photographsofhumanbeingsinvarioussituations(fromIAPS
database)
– 3emotionalvalences:positive,negative,neutral,presentedinrandom
order
 Thanksto:
BostonUniversity:
EricSchwartz
EmoryUniversity:
ChuckRaison
Geshe Lobsang Tenzin Negi
Harvard/MGH:
LamaWillaMiller
TedKaptchuk
BruceFischl
LarryWald
Vitaly Napadow
SaraLazar
…… andmanyothersforinspirationandfeedback!

Funding:NIH:NCCAMRC1AT005728(E.Schwartz)
andNCCAMR01AT004698(C.Raison)
MindandLifeInstituteVarelaAward(G.Desbordes)
 Thankyou!

Pleasefeelfreetocontactmeifyouhaveanyquestions:gdesbord@bu.edu