Network-level functional topological changes after mindfulness-based cognitive therapy in mood dysregulated adolescents at familial risk for bipolar disorder: a pilot study

Kun Qin,Luis Rodrigo Patino Duran,Kaitlyn M Bruns,Sian Cotton,Du Lei,John A Sweeney,Qiyong Gong,Thomas J Blom,Melissa P Delbello,Jing Yang,Wenbin Li,Maxwell J Tallman

doi:10.1186/s12888-021-03211-4

Abstract

BackgroundGiven that psychopharmacological approaches routinely used to treat mood-related problems may result in adverse outcomes in mood dysregulated adolescents at familial risk for bipolar disorder (BD), Mindfulness-Based Cognitive Therapy for Children (MBCT-C) provides an alternative effective and safe option. However, little is known about the brain mechanisms of beneficial outcomes from this intervention. Herein, we aimed to investigate the network-level neurofunctional effects of MBCT-C in mood dysregulated adolescents.MethodsTen mood dysregulated adolescents at familial risk for BD underwent a 12-week MBCT-C intervention. Resting-state functional magnetic resonance imaging (fMRI) was performed prior to and following MBCT-C. Topological metrics of three intrinsic functional networks (default mode network (DMN), fronto-parietal network (FPN) and cingulo-opercular network (CON)) were investigated respectively using graph theory analysis.ResultsFollowing MBCT-C, mood dysregulated adolescents showed increased global efficiency and decreased characteristic path length within both CON and FPN. Enhanced functional connectivity strength of frontal and limbic areas were identified within the DMN and CON. Moreover, change in characteristic path length within the CON was suggested to be significantly related to change in the Emotion Regulation Checklist score.Conclusions12-week MBCT-C treatment in mood dysregulated adolescents at familial risk for BD yield network-level neurofunctional effects within the FPN and CON, suggesting enhanced functional integration of the dual-network. Decreased characteristic path length of the CON may be associated with the improvement of emotion regulation following mindfulness training. However, current findings derived from small sample size should be interpreted with caution. Future randomized controlled trials including larger samples are critical to validate our findings.

Highlights

Given that psychopharmacological approaches routinely used to treat mood-related problems may result in adverse outcomes in mood dysregulated adolescents at familial risk for bipolar disorder (BD), MindfulnessBased Cognitive Therapy for Children (MBCT-C) provides an alternative effective and safe option
Nodal topological analysis of nodal metrics did not identify any regional changes within the Default mode network (DMN), fronto-parietal network (FPN) or cingulo-opercular network (CON) that survived False Discovery Rate (FDR) correction
Changes in functional connectivity after Mindfulness-based cognitive therapy (MBCT)-C network-based statistic (NBS) analysis revealed a connected component within the CON comprising 14 nodes and 19 connections with increased functional connectivity in mood dysregulated adolescents following MBCT-C (Fig. 2)

Summary

Introduction

Given that psychopharmacological approaches routinely used to treat mood-related problems may result in adverse outcomes in mood dysregulated adolescents at familial risk for bipolar disorder (BD), MindfulnessBased Cognitive Therapy for Children (MBCT-C) provides an alternative effective and safe option. Neuroimaging studies have demonstrated outcome-related changes after mindfulness-based interventions in both functional and structural brain features in regions (e.g., prefrontal cortex (PFC), anterior cingulate cortex (ACC), and insula) that exhibit abnormalities in individuals at familial risk for BD [10, 11]. These findings suggest that MBCT-C may be an effective intervention strategy for mood dysregulation in high-risk youth via impact on specific brain systems

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