Mind and health: developing a neural marker for mindfulness, a pathway to health

心灵与健康：开发正念神经标记，这是通往健康的途径

• 批准号: 8446060
• 负责人: Carl Fulwiler
• 金额: $ 15.81万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-01 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8446060
• 关键词: Accounting; Address; Affect; Amygdaloid structure; Anger; Anxiety; Attention; Awareness; Behavior; Behavior Therapy; Behavioral; Biological Markers; Body Weight decreased; Brain; Cessation of life; Clinical Research; Clinical Trials; Communities; Data; Dose; Eating; Education; Educational process of instructing; Effectiveness; Emotional; Emotional Stress; Emotions; Ensure; Evaluation; Exercise; Expectancy; Experimental Designs; Food; Fostering; Foundations; Functional Imaging; Functional Magnetic Resonance Imaging; Future; Goals; Health; Health Care Costs; Health behavior; Health behavior change; Individual; Individual Differences; Informal Social Control; Intervention; Knowledge; Magnetic Resonance Imaging; Maintenance; Measurement; Measures; Mediation; Meditation; Mental Depression; Mental Health; Mind; Monitor; Morbidity - disease rate; National Center for Complementary and Alternative Medicine; Neurosciences; Obesity; Outcome; Participant; Pathway interactions; Patient Self-Report; Patients; Personal Satisfaction; Physical activity; Psychological Factors; Qualifying; Randomized; Relapse; Reliance; Research; Research Personnel; Rest; Role; Sampling; Science; Sleep; Solid; Strategic Planning; Stress; Symptoms; Testing; Time; Training; Training Programs; Validation; Work; base; behavior change; biological adaptation to stress; comparison group; depressive symptoms; design; effective intervention; effectiveness trial; experience; follow-up; group intervention; holistic approach; imaging modality; improved; innovation; intervention effect; member; mindfulness; mindfulness-based stress reduction; multi-component intervention; multidisciplinary; neuroimaging; premature; psychologic; psychological outcomes; public health priorities; public health relevance; randomized trial; relating to nervous system; response; trait

DESCRIPTION (provided by applicant): A recent review commissioned by NCCAM concluded that the research on meditation practices is characterized by poor methodological quality and that more rigorous science is needed before firm conclusions can be drawn on the effectiveness of these practices for improving health and well-being. The best studied form of meditation is mindfulness, which is most commonly taught by the Mindfulness-Based Stress Reduction (MBSR) training developed by members of our research team at UMass. The immediate goal of the proposed R34 is to validate a proposed biomarker for the effects of MBSR. Based on our preliminary data, we propose that resting-state fMRI measurement of functional connectivity (FC) in the limbic stress response network will be a valuable biomarker for the effect of MBSR on emotional and stress reactivity and will predict sustained improvements in health behaviors. This biomarker will enable future large-scale randomized trials that focus on the effectiveness of MBSR for long-term health behavior change, such as maintenance of weight loss. The proposed biomarker will allow future studies to refine MBSR interventions based on improved understanding of the effective components and individual differences, reduce reliance on self-reported measures, and provide an objective measure for identifying patients most likely to benefit and those who may need a tailored intervention. Our Specific Aims are to: (1) Validate functional connectivity as a biomarker for responsiveness to MBSR; (2) Investigate the association of functional connectivity change with changes in health behaviors at 6 month follow-up. Our preliminary data demonstrate that FC in the amygdala-orbitofrontal circuit is 1) strongly correlated with trait mindfulness and inversely correlated with emotional reactivity, and 2) enhanced by just 8 weeks of MBSR training Moreover, MBSR produces quantifiable changes in this circuit that correspond to improvements in psychological traits shown to impact health behaviors. We will randomize 100 community participants to MBSR or an attention control. Endpoints include changes in FC, health behavior (sleep quality, physical activity, healthy eating), and related psychological constructs (perceived stress, depression, trait anxiety, and trait anger, and positive affect). Endpoints will be measured at baseline, 8 weeks and 12 weeks, with an additional measurement at 6 months for health behavior and psychological outcomes. We hypothesize that the intervention group will experience a greater increase in FC than the comparison group and that changes in FC will correlate with health behavior and psychological constructs. We will also account for intervention engagement and expectancy. The ability to objectively and quantitatively measure the effects of MBSR/mindfulness on the brain is highly innovative. Our inter-disciplinary research team includes the developer of MBSR, experienced clinical trials / behavioral therapy researchers, and experts in functional imaging methods.

描述（由申请人提供）：NCCAM委托的最新审查得出结论，冥想实践的研究的特征是方法论质量差，并且需要更严格的科学，然后才能就这些实践的有效性提出改善健康和福祉的有效性。冥想的最佳研究形式是正念，最常见的是由UMass研究团队成员开发的基于正念的压力减轻（MBSR）培训。拟议的R34的直接目标是验证MBSR影响的拟议生物标志物。 根据我们的初步数据，我们建议在边缘应力响应网络中静止的FMRI测量功能连通性（FC）将是MBSR对情绪和压力反应性影响的有价值的生物标志物，并将预测健康行为的持续改善。该生物标志物将实现未来的大规模随机试验，该试验的重点是MBSR对长期健康行为改变的有效性，例如维持体重减轻。拟议的生物标志物将允许将来的研究基于对有效组成部分和个体差异的改进，减少对自我报告措施的依赖，并为确定最有可能受益的患者和可能需要定制干预的患者提供客观措施，从而完善MBSR干预措施。我们的具体目的是：（1）验证功能连接性作为对MBSR响应的生物标志物； （2）调查功能连通性变化与6个月随访时健康行为变化的关联。 我们的初步数据表明，杏仁核 - 轨道额叶电路中的FC是1）与特质的正念密切相关，并且与情绪反应性成反比，并且2）仅通过8周的MBSR培训增强了MBSR训练，MBSR在该电路中可量化的可量化变化，与对心理特质有关的改善所影响健康的健康行为产生了可量化的变化。 我们将将100名社区参与者随机用于MBSR或注意力控制。终点包括FC的变化，健康行为（睡眠质量，体育锻炼，健康饮食）以及相关的心理结构（感知到压力，抑郁，特质焦虑和特质愤怒以及积极影响）。终点将在基线，8周零12周时进行测量，并在6个月的健康行为和心理结局时进行额外的测量。我们假设该干预组的FC比比较组更大，而FC的变化将与健康行为和心理结构相关。我们还将考虑干预参与和预期。 客观和定量测量MBSR/正念对大脑的影响的能力具有很高的创新性。我们的跨学科研究团队包括MBSR的开发人员，经验丰富的临床试验 /行为治疗研究人员以及功能成像方法的专家。