Augmenting Mindfulness Training Through Experience-driven Neurofeedback
Condition: Stress
Study type: Interventional

Summary: 
      The overall goal of the proposed study is to develop and test real time neurofeedback
      (EEG-RTNF) as a tool to augment Mindfulness Based Stress Reduction (MBSR). This study is
      based on the theoretical model that (1) mind-wandering and self-referential processing are
      associated with stress, (2) meditation redirects the wandering mind toward present-centered
      awareness, (3) meditation also decreases activity in hubs of the default mode network (DMN)
      involved in mind-wandering and self-referential processing, and thus (4) meditation leading
      to decreased activity in these hubs should lead to reduced stress and improved health and
      well-being. Milestones include: (1) test whether EEG-RTNF from the PCC during meditation
      augments MBSR in novices; and (2) test whether MBSR with EEG-RTNF from the PCC leads to
      real-world outcomes in reduced stress and improved attention.
    

Detailed description: 
      Mindfulness Based Stress Reduction (MBSR) is an effective intervention for promoting positive
      cognitive and behavioral changes for improved health. However, MBSR delivery may be
      suboptimal. Recent work on potential neural mechanisms underlying the meditation practices
      that are core to MBSR may be utilized to improve MBSR delivery and efficacy. The
      investigators have shown recently that the posterior cingulate cortex (PCC), a brain region
      implicated in anxiety, addiction, Alzheimer's, ADHD, and other medical maladies, is
      selectively deactivated during three meditation practices that are core to MBSR suggesting a
      central role for the PCC in the neurobiology of MBSR. The investigators have also recently
      confirmed that PCC deactivation corresponds with the subjective experience of meditation in
      meditators. The proposed study will use EEG-RTNF from the PCC during meditation as an
      innovative strategy to augment MBSR and improve outcomes.

      The task of mindfulness-the principle component of MBSR-is to maintain attention on and
      acceptance toward present-moment experience, and to redirect attention to one's immediate
      experience when it has strayed. This present-centered awareness may be considered a
      counterpoint to self-referential processing and mind-wandering. Consistent with a role for
      the PCC in mind-wandering, the PCC is specifically deactivated during three meditation
      practices (mindfulness of the breath, loving-kindness, and choiceless awareness) in
      experienced meditators compared to novices). Supporting these findings, a research study.
      showed that PCC deactivation during meditation correlated with a behavioral measure of
      attention (the Rapid Visual Information Processing Task, RVIP) in experienced meditators,
      suggesting that PCC deactivation is associated with improved attention in meditators. Another
      research study showed that the PCC is deactivated when experienced meditators mindfully view
      emotional images suggesting that PCC deactivation is associated with emotional stability and
      enhanced present-moment awareness.

      EEG-RTNF is an emerging technology similar to classic biofeedback in which individuals
      receive moment-to-moment feedback of their brain activity during a particular task, typically
      by a dynamic visual display (e.g., a graph).
    

Intervention name(s): EEG-no RTNF; EEG-RTNF
Intervention type(s): Behavioral; Behavioral
Intervention description(s): All EEG sessions are done on an individual basis. Group 2 will receive EEG (no RTNF) at weeks 3, 4, 6, and 7 of MBSR. At these time points, subjects will take part in a 1-hour EEG-RTNF session., comprised of six 3.5-minute runs. Each run will begin with a 30-second active baseline task in which subjects view adjectives and think about and decide if the word describes them. Following baseline, subjects will meditate for 3 to 7 minutes with EEG-RTNF. All subjects will be instructed to practice meditation during EEG-RTNF training, and to keep their eyes closed.; All EEG sessions are done on an individual basis. Group 1 will receive EEG-RTNF training from the PCC at weeks 3, 4, 6, and 7 of MBSR. At these time points, subjects will take part in a 1-hour EEG-RTNF session., comprised of six 3.5-minute runs. Each run will begin with a 30-second active baseline task in which subjects view adjectives and think about and decide if the word describes them. Following baseline, subjects will meditate for 3 to 7 minutes with EEG-RTNF. All subjects will be instructed to practice meditation during EEG-RTNF training, and to keep their eyes closed.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment