Hölzel et al. (mindfulness and brain scans).

Psychology Being
Investigated
Mindfulness Meditation – Central to this study is the practice of mindfulness
meditation, which is grounded in the theory that focused, non-judgmental
awareness of the present moment can lead to improved mental health and
cognitive functioning. Mindfulness meditation, as a form of mental training, is
theorised to induce changes in the brain through repeated practice.

Neuroplasticity – This is a foundational concept in the study. Neuroplasticity refers

to the brain’s ability to reorganise itself by forming new neural connections
throughout life. The study hypotheses that mindfulness meditation can lead to
changes in brain structures, indicating that the brain is not a static organ but is
malleable and can be shaped by experiences, including meditative practices.

Stress Reduction and Psychological Well-being – The study explores how

mindfulness-based interventions, like MBSR, can reduce stress and improve overall
psychological health. This is based on the theory that mindfulness can alter one’s
relationship to stressful events, thereby reducing the psychological impact of stress.

Brain Areas Associated with Mindfulness Practices – The focus on specific brain
areas (like the hippocampus, PCC, TPJ, and cerebellum) is based on their known
roles in functions such as memory, learning, emotional regulation, and self-
referential processing. The theory suggests that changes in these areas might
underlie the psychological benefits observed with mindfulness practices.

Background
Prior research in the field of mindfulness meditation has consistently highlighted its
positive impact on psychological well-being. Studies have shown significant
reductions in symptoms of stress, anxiety, and depression, alongside improvements
in emotional regulation. This psychological benefit is not just confined to clinical
populations; it extends to healthy individuals as well. Additionally, mindfulness
practices have been linked to cognitive enhancements, including better attention,
concentration, and working memory. These findings are particularly relevant in a
society increasingly grappling with mental health challenges and cognitive overload.
On the neurobiological front, mindfulness meditation has been associated with
structural and functional changes in the brain. Neuroimaging studies have revealed
alterations in brain areas responsible for attention, emotion regulation, and self-
awareness, such as increased grey matter density in the hippocampus and
prefrontal cortex. This supports the concept of neuroplasticity, suggesting that the
brain is adaptable and can be reshaped by experiences like meditation. Moreover,
mindfulness has been shown to modify self-referential processing, which is believed
to reduce tendencies towards rumination and excessive self-focus, common in
mental health conditions like depression. These neurological changes underscore
the tangible impact of mindfulness practices on the brain’s structure and function,
reinforcing their potential as a tool for enhancing mental health and cognitive
functioning.

Aims
● Investigate whether participation in an 8-week Mindfulness-Based Stress
Reduction course (MBSR) could lead to changes in grey matter
concentration in the brain.
● Identify brain regions that changed in association with participation in the
MBSR course.

Procedure
The researchers used a method called voxel-based morphometry to measure
changes in grey matter concentration in the brains of participants who completed
an eight-week mindfulness-based stress reduction (MBSR) program.

Sample
The study included 18 healthy, right-handed individuals who were enrolled in the
MBSR program. The participants were recruited from four MBSR courses held at the
Center for Mindfulness at the University of Massachusetts Medical School. The
courses included physician- and self-referred individuals from across New England
who were seeking stress reduction.

The participants were included in the study if they self-reported as physically and
psychologically healthy and not taking any medications. Further inclusion criteria
were as follows: no meditation classes in the past 6 months, no more than four
classes in the past 5 years, or 10 classes in their lifetime; 25 to 55 years old; no
contraindications for MRI scanning (i.e., metallic implants, claustrophobia);
commitment to attend all eight classes and perform the prescribed daily homework.
Methodology
The study used a pre-post design, meaning that the researchers measured grey
matter concentration in the participants’ brains before and after they completed the
MBSR program. The researchers also compared the participants’ brain scans to a
control group of 17 individuals who did not complete the MBSR program.

The researchers used a variety of controls to ensure that any changes in grey matter
concentration were due to the MBSR program and not other factors. For example,
they made sure that the participants did not have any metallic implants or
claustrophobia, which could affect the MRI scans. They also made sure that the
participants did not have any other meditation experience in the past 6 months, no
more than four classes in the past 5 years, or 10 classes in their lifetime.

The researchers collected data using MRI scans to measure grey matter
concentration in the participants’ brains. They also collected demographic
information about the participants, including age, gender, ethnicity, and education
level.

Results
1. Increase in Gray Matter Concentration in the Left Hippocampus: The
MBSR group showed a significant increase in grey matter concentration in
the left hippocampus compared to the control group.
2. Whole Brain Analysis: Exploratory whole brain analysis revealed four
clusters with significantly greater grey matter concentration at the post
time-point compared to the pre time-point in the MBSR group. These
regions include:

○ Posterior Cingulate Cortex (PCC)

○ Left Temporo-Parietal Junction (TPJ)
○ Two clusters in the cerebellum (one in the cerebellar vermis and
brainstem, and the other in the lateral parts of the posterior and
flocculonodular lobe)
3. Control Group Analysis: No significant changes in grey matter
concentration were observed in the control group for these regions, except
for a decrease in the PCC cluster.
The bar chart above shows the changes in brain grey matter concentration in various regions for
the Mindfulness-Based Stress Reduction (MBSR) group compared to the control group.

Key Observations
1. MBSR Group
○ There were significant increases in grey matter concentration in
all measured brain regions, including the left hippocampus,
posterior cingulate cortex (PCC), left temporo-parietal junction
(TPJ), cerebellar vermis/brainstem, and lateral cerebellum.
2. Control Group
○ No significant changes were observed in most regions, except
for a decrease in grey matter concentration in the PCC.

Conclusion
Participation in an 8-week mindfulness-based stress reduction (MBSR) program was
associated with changes in grey matter concentration in brain regions involved in
learning and memory processes, emotion regulation, self-referential processing, and
perspective taking. The study provides evidence that mindfulness practice can lead
to changes in the brain that may have important implications for mental health and
well-being. The study also suggests that mindfulness practice can lead to
improvements in mindfulness subscales, such as acting with awareness, observing,
and non-judging.
Strengths
● Use of a control group – One strength of the study is the use of a control
group. The study included a control group of individuals who did not
participate in the mindfulness-based stress reduction (MBSR) program.
This allowed the researchers to compare changes in grey matter
concentration between the MBSR group and the control group. The use of
a control group strengthens the internal validity of the study by ruling out
alternative explanations for the observed changes in grey matter
concentration.
● Use of voxel-based morphometry – Another strength of the study is the
use of voxel-based morphometry (VBM) to measure changes in grey
matter concentration in the brain. VBM is a well-established method for
measuring changes in grey matter concentration and has been used in
numerous studies of mindfulness and meditation. The use of VBM
strengthens the validity of the study’s findings by providing a reliable and
objective measure of changes in grey matter concentration.
● Use of a standardised mindfulness program – A third strength of the
study is the use of a standardised mindfulness program. The study used
the mindfulness-based stress reduction (MBSR) program, which is a well-
established and widely used mindfulness program. The use of a
standardised program strengthens the external validity of the study by
increasing the generalizability of the findings to other populations and
settings. Additionally, the use of a standardised program allows for
replication of the study’s findings by other researchers.

Weaknesses
● Small sample size – One weakness of the study is the small sample size.
The study included only 18 participants who completed the mindfulness-
based stress reduction (MBSR) program and 17 individuals in the control
group. A small sample size reduces the generalizability of the study’s
findings and increases the risk of Type II errors (i.e., failing to detect a true
effect). A larger sample size would increase the statistical power of the
study and improve the generalizability of the findings.
● Lack of randomisation – Another weakness of the study is the lack of
randomization. The study did not use random assignment to assign
participants to the MBSR group or the control group. Instead, participants
were self-selected into the groups. This increases the risk of selection bias,
which occurs when participants in one group differ systematically from
participants in another group. A randomised design would have reduced
the risk of selection bias and increased the internal validity of the study.
 ● Lack of blinding – A third weakness of the study is the lack of blinding. The
researchers who conducted the study were not blinded to the group
assignment of the participants. This increases the risk of experimenter bias,
which occurs when the researchers’ expectations or beliefs influence the
outcome of the study. Blinding the researchers to the group assignment of
the participants would have reduced the risk of experimenter bias and
increased the internal validity of the study.

Application of Psychology to
Everyday Life
● Enrollment into MBSR or similar mindfulness programmes for Stress
Reduction.
● The findings of this study have direct implications for stress reduction
using the MBSR programme;
● Stress is commonly experienced by students, workers, home-makers -
everyone these days;
● Since the findings show that the hippocampus shows grey matter
development in response to mindfulness practice, consequent emotional
regulation will help deal with the negative emotions arising from stress.
● Practice of Mindfulness Meditation for Emotional Regulation,
Development of Empathy, Memory, etc;
● even those not actively experiencing stress can practise meditation for
improving the quality of their mental health or as a proactive measure
for preventing mental health issues;
● The benefits derived by the increase in grey matter of areas like the
hippocampus, insula, PCC, etc. can help people gain the aforementioned
mental health benefits.
● Training in Mindfulness Meditation for treatment of Depression, PTSD,
etc.
● This study reaffirms the findings of past studies that mindfulness
meditation can increase grey matter in the hippocampus which is known
to reduce the symptoms of mental disorders such as depression, PTSD,
etc.
● Thus, clinical psychologists can recommend enrollment into MBSR-like
programmes to their patients.

Nature vs Nurture
Study largely supports Nature.
Nature.

1. The human brain by nature demonstrates neuroplasticity - that is, change in

neuronal growth and reconnection of neuronal pathways in response to
practise behaviours even in adulthood.
2. The benefits gained by practising mindfulness are a result of this plasticity of
the human brain.

Nurture.

1. The growth of grey matter in the brain is found only after long-term practice
of mindfulness as outlined above;
2. Thus, correct practise of mindfulness has to be learnt using programmes like
the MBSR and only then benefits be gained - they are not derived
spontaneously.