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Newberg SpiritualityAgingBrain 2011
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to Generations: Journal of the American Society on Aging
By Andrew B. Newberg
Spirituality
and the Aging Brain
Evidence suggests that meditation, prayer, and other related
religious and spiritual practices may have significant effects
on the aging brain—positive effects that may help improve
memory and cognition, mood, and overall mental health.
I n the past thirty years, scientists have ex- available in the literature. The neuroimaging
plored the neurobiological and clinical effects techniques used in these studies include posi-
of meditation, prayer, and related spiritual tron emission tomography (PET) (Herzog et al.,
practices and experiences. Initial studies 1990−1991; Lou et al., 1999); single photon
measured changes in autonomic activity, such emission computed tomography (SPECT)
as heart rate and blood pressure, and electroen- (Newberg et al., 2001; Newberg et al., 2003); and
cephalographic changes associated with such functional magnetic resonance imaging (fMRI)
practices. Studies have also
looked at changes in hormonal
and immunological function. Functional neuroimaging has opened a new window
Still other studies have exam- into the investigation of meditative states.
ined the clinical effects of
meditation and prayer upon physical and (Lazar et al., 2000; Brefczynski-Lewis et al.,
psychological disorders, including hypertension, 2007; Beauregard and Paquette, 2006).
cancer, depression, and anxiety. Each of these techniques provides different
This article reviews the existing knowledge advantages and disadvantages in the study of
on the neurophysiological and clinical findings meditation. Though fMRI has improved
associated with religious and spiritual practices resolution over SPECT and the ability of
and experiences, and explores the potential health immediate anatomic correlation, it is some-
effects of these practices with regard to aging. times difficult to use for studying meditation
because of machine noise. There is also the
Neuroimaging: A Window into problem of requiring the subject to lie down—
Meditative States an atypical posture for many forms of medita-
Functional neuroimaging has opened a new tion. The environment should allow subjects to
window into the investigation of meditative have a strong meditative experience by enabling
states by exploring the neurological correlates of them to use the postures or actions that are part
these experiences, and a growing number of of their meditation practice. Accommodating
imaging studies of meditative practices are now subjects’ meditation postures is also a problem
Copyright © 2011 American Society on Aging; all rights reserved. This article may not be duplicated,
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Summer 2011 • Vol. 35 . No. 2 | 83
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GE NER ATIO NS – Journal of the American Society on Aging Pages 83–91
when using PET imaging (which also provides on whatever thoughts or feelings enter the mind,
better resolution than SPECT). and the goal is to be more aware of one’s inner
The process of SPECT imaging, however, mental processes.
allows for an injection of a radioactive tracer There is also guided meditation, in which the
during a particular meditation or prayer prac- meditation experience is guided by a leader who
tice, which can then capture the pattern of verbally directs the practitioner, either in person
cerebral blood flow (as it correlates with activ- or on tape. Other meditators merely practice the
ity). The problem with SPECT, though, is that meditation of their own volition. There are likely
only one or two states can be studied in a day. important differences between volitional (per-
Functional MRI can measure multiple time formed solely by the practitioner) and guided
points during the same scanning session and can (performed with the assistance of a teacher or
capture changes in cerebral blood flow during recording that instructs the practitioner) medita-
different meditation practices, or throughout a tion practices, which should also be reflected in
particular practice. However, fMRI can only specific differences in cerebral activation.
evaluate cerebral blood flow, while PET and Phenomenological analysis suggests that the
SPECT can evaluate neurotransmitter systems end result of many meditation or prayer prac-
such as serotonin and dopamine. tices is similar, although this result might be
Though each of these functional brain described differently depending upon the culture
imaging techniques offers important advan- and individual. Such spiritual experiences—even
tages and disadvantages for studying medita- mystical experiences—seem to have certain
tion, prayer, or other spiritual phenomena, the similar features (and certain distinctions). It
best approach may depend on a number of seems reasonable that while the initial neuro-
individual factors. physiological activation that occurs during any
given practice may differ, there may eventually
Types of Spiritual Practices be a convergence of experiences and neurophysi-
There are many specific approaches to medita- ological correlates. However, the brain structures
tion and prayer, but they can be divided into two and functions described will likely apply to other
basic categories. The first category is one in types of meditation practices although the
which a person attempts to clear all thought specifics will be slightly different.
from their sphere of attention, and includes
practices such as Theravada—a form of medita- Neurophysiological Changes Associated with
tion in which individuals attempt to reach a Religious and Spiritual Practices
subjective state characterized by a sense of no A number of neurophysiological changes have
space, no time, and no thought. This state is been described in relation to meditation prac-
cognitively experienced as fully integrated and tices and various spiritual states. Brain imaging
unified: there is no sense of a self and other. studies suggest that willful acts and tasks that
The second category is one in which the require sustained attention are initiated via
subject focuses attention on a particular object, activity in the prefrontal cortex (PFC) and
image, phrase, or word, and includes practices anterior cingulate cortex (Ingvar, 1994; Frith
such as Transcendental Meditation and various et al., 1991; Posner and Petersen, 1990). Since
forms of Tibetan Buddhism. This form of practices like meditation and prayer require
meditation is designed to lead to a subjective intense focus of attention, they also have been
experience of absorption with the object of shown to activate these areas (Herzog et al.,
focus. Mindfulness meditation (Kabat-Zinn, 1990−1991; Newberg et al., 2001; Lazar et al.,
1991) is a practice in which attention is focused 2000). A study of Tibetan Buddhist meditators
showed increased activity in the PFC bilaterally Another brain structure, the parietal lobe,
(greater on the right side) and the cingulate might be involved in meditation, prayer prac-
gyrus during meditation. tices, and other spiritual experiences. The
Brain imaging studies of meditation practices parietal regions are heavily involved in the
have generally demonstrated increased thalamic analysis and integration of higher-order visual,
activity, mediated by the excitatory neurotrans- auditory, and somaesthetic information, and
mitter glutamate, which may be proportional to are part of a complex attentional network that
the activity in the PFC. It should also be noted includes the PFC and thalamus (Fernandez-
that the dopaminergic system, via the basal Duque and Posner, 2001). These functions of the
ganglia, is believed to participate in regulating posterior superior parietal lobe might be critical
the glutamate system and the interactions for distinguishing between the self and the
between the prefrontal cortex and subcortical external world. Changes in the orienting areas
structures. A PET study utilizing 11C-Raclopride of the parietal lobe have been thought to be an
to measure the dopaminergic tone during Yoga important mediator in the physiology of medi-
Nidra meditation demonstrated a significant tative and spiritual experiences (Newberg and
increase in dopamine levels during the medita- Iversen, 2003). Some studies have revealed
tion practice (Kjaer et al., 2002). Dopamine is decreased activity in the parietal lobe during
also part of the reward system in the brain; this meditation practices, which might be associated
may help explain some of the positive emotional with the altered sense of self and space frequent-
elements of meditation and prayer practices. ly described by practitioners.
and spiritual practices and experiences that meditators and non-meditators. Collectively,
benefit physical and mental health. these findings suggest that meditation practice
affects cognitive function and that the beneficial
Meditation and Cognition effects of meditation are moderated by intensity
Researchers have also begun to investigate the and length of training.
long-term effects of meditation practices on Several other studies have also pointed out
cognitive processes involved in memory; research the potential effects of meditation on memory
shows that meditation practice and increased and cognition. Chambers, Lo, and Allen (2008)
mindfulness are related to improved attention examined the impact of a ten-day Vipassana
functions and cognitive flexibility (Carter et al., meditation retreat on novice meditators’ work-
2005; Jha, Krompinger, and Baime, 2007; Slagter ing memory capacity, response time on a novel
et al., 2007; Lutz et al., 2008a, 2008b). This may attention task requiring participants to attend
have the most important implication for aging and update information between two categories
as there is a great deal of interest in helping to (e.g., food and household objects, or positive and
maintain high brain function as people age. negative affective words), and five self-report
Pagnoni and Cekic (2007) used a rapid visual measures of cognitive processes and affect.
presentation task to investigate age-related effects They found that meditation training increased
of meditation practice in meditators and non- mindfulness, enhanced working memory
meditators. The authors found an age-related capacity, reduced switch costs in the attention
decrease of attention performance in their task, and reduced anxiety, negative affect,
meditation-naive control group, whereas no such and depression.
decrease was present in meditators. Chan and Tang et al. (2007) examined the impact of five
Woollacott (2007) compared the effects of days of integrative body-mind training (IBMT) on
meditation practice on the Stroop task (which measures assessing visual reasoning, mood, and
measures executive network) and Global−Local physiological responses to stress. This training is
Letters task (which measures orientation net- an approach to meditation that stresses no effort
work) and found that meditation practice was to control thoughts, but has the goal of creating a
associated with increased efficiency of the state of restful alertness. The authors found that
executive attention network, but had no effect meditation benefited performance in conflict
on the orienting network. monitoring and reasoning. They also found that
Moore and Malinowski (2009) compared meditation reduced anxiety, depression, anger,
meditators with a meditation-naive control and fatigue, and increased stress regulation. In
group on tasks that
measure cognitive Meditation practice and increased mindfulness are related
flexibility and speed
of processing visual to improved attention functions and cognitive flexibility.
information and found
that meditators outperformed non-meditators contrast, Jha, Krompinger, and Baime (2007)
on all measures. Also, performance was positive- examined the impact of participation in an
ly correlated to participants’ self-reported scores eight-week MBSR course and found that a group
on the levels of mindfulness measures. A similar of novice meditators who underwent meditation
pattern of results was reported by Valentine and training had improved performance in orienting
Sweet (1999) who found that long-term medita- their attention.
tion practitioners scored significantly higher on We recently performed a study that used a
a test of sustained attention than short-term type of meditation called Kirtan Kriya in which
the individual repetitively vocalizes consonant- rare, there are some cases in which intense
vowel combinations (“sa, ta, na, ma”) while meditation has caused people to have dissocia-
touching their thumb to each of their fingers in tive experiences, which can be frightening. Such
sequence (Newberg et al., 2010). The practice experiences, however, usually do not occur
takes twelve minutes per day, and our subjects unless the practice is performed for many hours
were asked to perform the practice for eight a day over a period of years.
weeks. Before and after the eight-week meditation Even positive experiences can sometimes
program, subjects were evaluated using brain have damaging effects if an individual has
imaging and also cognitive testing. Overall, we problems incorporating them into their current
found significant increases in blood flow in the religious or spiritual belief system. Such a
frontal lobes, which are involved with our ability dichotomy can lead to anxiety and depression if
to focus attention. We found approximately a 10 it sparks a “spiritual crisis.” Additionally, self-
percent improvement in verbal memory and perceived religious transgressions can cause
general cognitive function. Overall, there does emotional and psychological anguish. When a
seem to be some important effects of meditation mix of religious, spiritual, and organic sources is
on cognition, but more research is needed to causing mental illness, treatment can become
elucidate how and why these effects occur. complicated. Healthcare workers must properly
balance treating each source.
Negative Effects of Meditation and Existing evidence suggests that meditation,
Spirituality on Health prayer, and other related religious and spiritual
Although most studies have shown positive practices may have significant effects on the
effects of meditation, religious practices, and aging brain. Many of these effects appear to
spirituality, they may cause a negative impact on be positive, helping to improve memory and
health. Meditation’s most common detrimental cognition, mood, and overall mental health.
effect is usually frustration: the practitioner However, there are potential negative effects
struggles to perform the meditation practice. that must also be considered when beginning
This might be for a variety of reasons, from not a particular practice. We will look to future
being able to follow the instructions properly, or research that may better delineate the
trying to meditate in a distracting environment, physiological and clinical effects of these
to the individual not enjoying the practice. As spiritual practices.
this frustration can turn to embarrassment and
anxiety, it is important that individuals try to do Andrew B. Newberg, M.D., is director of research at
meditation practices that they feel comfortable the Jefferson-Myrna Brind Center of Integrative
with and can perform with relative ease. While Medicine, Thomas Jefferson University in Philadelphia.
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