Self-regulation of the posterior cingulate cortex with real-time fMRI neurofeedback augmented mindfulness training in healthy adolescents: A nonrandomized feasibility study

Namik Kirlic,Jennifer L Stewart,Martin P Paulus,Jerzy Bodurka,Aki Tsuchiyagaito,Manpreet K Singh,Masaya Misaki,Timothy J Mcdermott,Zsofia P Cohen,Robin L Aupperle

doi:10.3758/s13415-022-00991-4

Abstract

Mindfulness training (MT) promotes the development of one’s ability to observe and attend to internal and external experiences with objectivity and nonjudgment with evidence to improve psychological well-being. Real-time functional MRI neurofeedback (rtfMRI-nf) is a noninvasive method of modulating activity of a brain region or circuit. The posterior cingulate cortex (PCC) has been hypothesized to be an important hub instantiating a mindful state. This nonrandomized, single-arm study examined the feasibility and tolerability of training typically developing adolescents to self-regulate the posterior cingulate cortex (PCC) using rtfMRI-nf during MT. Thirty-four adolescents (mean age: 15 years; 14 females) completed the neurofeedback augmented mindfulness training task, including Focus-on-Breath (MT), Describe (self-referential thinking), and Rest conditions, across three neurofeedback and two non-neurofeedback runs (Observe, Transfer). Self-report assessments demonstrated the feasibility and tolerability of the task. Neurofeedback runs differed significantly from non-neurofeedback runs for the Focus-on-Breath versus Describe contrast, characterized by decreased activity in the PCC during the Focus-on-Breath condition (z = −2.38 to −6.27). MT neurofeedback neural representation further involved the medial prefrontal cortex, anterior cingulate cortex, dorsolateral prefrontal cortex, posterior insula, hippocampus, and amygdala. State awareness of physical sensations increased following rtfMRI-nf and was maintained at 1-week follow-up (Cohens’ d = 0.69). Findings demonstrate feasibility and tolerability of rtfMRI-nf in healthy adolescents, replicates the role of PCC in MT, and demonstrate a potential neuromodulatory mechanism to leverage and streamline the learning of mindfulness practice. (ClinicalTrials.gov identifier #NCT04053582; August 12, 2019).

Highlights

Mindfulness training (MT) promotes the development of one’s ability to observe and attend to internal experiences, including thoughts, emotions, and behaviors, and gain attentional control of the present experience (Shapiro et al, 2006)
Adolescents reported moderate to high ability to follow instructions on the screen, high ability to mentally decide whether words during the Describe condition described them, moderate ability to clear their mind during the Rest condition, moderate-to-high ability to focus on their breath during the Focus-on-Breath condition, and moderate mind wandering during the Focus-on-Breath condition
The scores on these measures did not differ across fMRI runs (OBS, NF-1, NF- 2, NF-3, and Transfer run (TRS); p > 0.05; Table 1; Fig. 2), and there was not an effect of participant age or sex on any scores (p > 0.05), except for the effect of sex on the ability to focus on breath [F(1,29) = 5.77, p = 0.03], which was higher in males

Summary

Introduction

Mindfulness training (MT) promotes the development of one’s ability to observe and attend to internal experiences, including thoughts, emotions, and behaviors, and gain attentional control of the present experience (Shapiro et al, 2006). MT increases connectivity between the PCC and frontocingulate regions involved in attentional control, as well as with the amygdala and insula, which are involved in emotional and interoceptive awareness (Brewer et al, 2011; Farb et al, 2007) Together, these studies suggest that MT impacts neural activity and functional connectivity of the neurocircuitry involved in self-awareness and attention to internal/external events, as well as circuitry gating emotional responses (Creswell, 2017). These studies suggest that MT impacts neural activity and functional connectivity of the neurocircuitry involved in self-awareness and attention to internal/external events, as well as circuitry gating emotional responses (Creswell, 2017) These data implicate the PCC as the prime candidate for the mechanistic understanding of MT

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