Mindfulness meditation is increasingly incorporated into mental health interventions, and theoretical concepts associated with it have influenced basic research on psychopathology. Here, we review the current understanding of mindfulness meditation through the lens of clinical neuroscience, outlining the core capacities targeted by mindfulness meditation and mapping them onto cognitive and affective constructs of the Research Domain Criteria matrix proposed by the National Institute of Mental Health. We review efficacious applications of mindfulness meditation to specific domains of psychopathology including depression, anxiety, chronic pain, and substance abuse, as well as emerging efforts related to attention disorders, traumatic stress, dysregulated eating, and serious mental illness. Priorities for future research include pinpointing mechanisms, refining methodology, and improving implementation. Mindfulness meditation is a promising basis for interventions, with particular potential relevance to psychiatric comorbidity. The successes and challenges of mindfulness meditation research are instructive for broader interactions between contemplative traditions and clinical psychological science.

Context Emotion regulation deficits figure prominently in generalized anxiety disorder (GAD), as well as other anxiety and mood disorders. Research examining emotion regulation and top-down modulation has implicated reduced coupling of the amygdala with prefrontal and anterior cingulate cortex (ACC), suggesting altered frontolimbic white matter connectivity in GAD. Objective To investigate structural connectivity between ventral prefrontal/ACC areas and the amygdala in GAD, and to assess associations with functional connectivity between those areas. Design Participants underwent diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI) scans. Setting University magnetic resonance imaging facility. Participants Forty-nine GAD patients and 39 healthy volunteers, including a subset of 21 patients without comorbid Axis I diagnoses and 21 healthy volunteers matched for age, sex, and education. Main Outcome Measure Mean fractional anisotropy (FA) values in the left and right uncinate fasciculus, as measured by tract-based analysis for DTI data. Results Lower mean FA values in bilateral uncinate fasciculus indicated reduced frontolimbic structural connectivity in GAD. This reduction in uncinate fasciculus integrity was most pronounced for patients without comorbidity and was not observed in other white matter tracts. Across all subjects, higher FA values were associated with more negative functional coupling between the pregenual ACC and amygdala during the anticipation of aversion. Conclusions Decreased frontolimbic structural connectivity suggests a neural basis for emotion regulation deficits in GAD. The functional significance of these structural differences is underscored by decreased functional connectivity between the ACC and amygdala in subjects with reduced structural integrity of the uncinate fasciculus.

Meditation training can improve mood and emotion regulation, yet the neural mechanisms of these affective changes have yet to be fully elucidated. We evaluated the impact of long- and short-term mindfulness meditation training on the amygdala response to emotional pictures in a healthy, non-clinical population of adults using blood-oxygen level dependent functional magnetic resonance imaging. Long-term meditators (N = 30, 16 female) had 9081 h of lifetime practice on average, primarily in mindfulness meditation. Short-term training consisted of an 8-week Mindfulness- Based Stress Reduction course (N = 32, 22 female), which was compared to an active control condition (N = 35, 19 female) in a randomized controlled trial. Meditation training was associated with less amygdala reactivity to positive pictures relative to controls, but there were no group differences in response to negative pictures. Reductions in reactivity to negative stimuli may require more practice experience or concentrated practice, as hours of retreat practice in long-term meditators was associated with lower amygdala reactivity to negative pictures - yet we did not see this relationship for practice time with MBSR. Short-term training, compared to the control intervention, also led to increased functional connectivity between the amygdala and a region implicated in emotion regulation - ventromedial prefrontal cortex (VMPFC) - during affective pictures. Thus, meditation training may improve affective responding through reduced amygdala reactivity, and heightened amygdala-VMPFC connectivity during affective stimuli may reflect a potential mechanism by which MBSR exerts salutary effects on emotion regulation ability.

An individual's affective style is influenced by many things, including the manner in which an individual responds to an emotional challenge. Emotional response is composed of a number of factors, two of which are the initial reactivity to an emotional stimulus and the subsequent recovery once the stimulus terminates or ceases to be relevant. However, most neuroimaging studies examining emotional processing in humans focus on the magnitude of initial reactivity to a stimulus rather than the prolonged response. In this study, we use functional magnetic resonance imaging to study the time course of amygdala activity in healthy adults in response to presentation of negative images. We split the amygdala time course into an initial reactivity period and a recovery period beginning after the offset of the stimulus. We find that initial reactivity in the amygdala does not predict trait measures of affective style. Conversely, amygdala recovery shows predictive power such that slower amygdala recovery from negative images predicts greater trait neuroticism, in addition to lower levels of likability of a set of social stimuli (neutral faces). These data underscore the importance of taking into account temporal dynamics when studying affective processing using neuroimaging.

Mindfulness meditation training has been shown to increase resting-state functional connectivity between nodes of the frontoparietal executive control network (dorsolateral prefrontal cortex [DLPFC]) and the default mode network (posterior cingulate cortex [PCC]). We investigated whether these effects generalized to a Mindfulness-Based Stress Reduction (MBSR) course and tested for structural and behaviorally relevant consequences of change in connectivity. Healthy, meditation-naïve adults were randomized to either MBSR (N = 48), an active (N = 47) or waitlist (N = 45) control group. Participants completed behavioral testing, resting-state fMRI scans and diffusion tensor scans at pre-randomization (T1), post-intervention (T2) and ~5.5 months later (T3). We found increased T2–T1 PCC–DLPFC resting connectivity for MBSR relative to control groups. Although these effects did not persist through long-term follow-up (T3–T1), MBSR participants showed a significantly stronger relationship between days of practice (T1 to T3) and increased PCC–DLPFC resting connectivity than participants in the active control group. Increased PCC–DLPFC resting connectivity in MBSR participants was associated with increased microstructural connectivity of a white matter tract connecting these regions and increased self-reported attention. These data show that MBSR increases PCC–DLPFC resting connectivity, which is related to increased practice time, attention and structural connectivity.

Studies consistently implicate aberrance of the brain’s reward-processing and decision-making networks in disorders featuring high levels of impulsivity, such as attention-deficit hyperactivity disorder, substance use disorder, and psychopathy. However, less is known about the neurobiological determinants of individual differences in impulsivity in the general population. In this study of 105 healthy adults, we examined relationships between impulsivity and three neurobiological metrics – gray matter volume, resting-state functional connectivity, and spontaneous eye-blink rate, a physiological indicator of central dopaminergic activity. Impulsivity was measured both by performance on a task of behavioral inhibition (go/no-go task) and by self-ratings of attentional, motor, and non-planning impulsivity using the Barratt Impulsiveness Scale (BIS-11). Overall, we found that less gray matter in medial orbitofrontal cortex and paracingulate gyrus, greater resting-state functional connectivity between nodes of the basal ganglia-thalamo-cortical network, and lower spontaneous eye-blink rate were associated with greater impulsivity. Specifically, less prefrontal gray matter was associated with higher BIS-11 motor and non-planning impulsivity scores, but was not related to task performance; greater correlated resting-state functional connectivity between the basal ganglia and thalamus, motor cortices, and prefrontal cortex was associated with worse no-go trial accuracy on the task and with higher BIS-11 motor impulsivity scores; lower spontaneous eye-blink rate was associated with worse no-go trial accuracy and with higher BIS-11 motor impulsivity scores. These data provide evidence that individual differences in impulsivity in the general population are related to variability in multiple neurobiological metrics in the brain’s reward-processing and decision-making networks.

Empathy, the ability to understand others’ emotions, can occur through perspective taking and experience sharing. Neural systems active when adults empathize include regions underlying perspective taking (e.g. medial prefrontal cortex; MPFC) and experience sharing (e.g. inferior parietal lobule; IPL). It is unknown whether adolescents utilize networks implicated in both experience sharing and perspective taking when accurately empathizing. This question is critical given the importance of accurately understanding others’ emotions for developing and maintaining adaptive peer relationships during adolescence. We extend the literature on empathy in adolescence by determining the neural basis of empathic accuracy, a behavioral assay of empathy that does not bias participants toward the exclusive use of perspective taking or experience sharing. Participants (N = 155, aged 11.1–15.5 years) watched videos of ‘targets’ describing emotional events and continuously rated the targets’ emotions during functional magnetic resonance imaging scanning. Empathic accuracy related to activation in regions underlying perspective taking (MPFC, temporoparietal junction and superior temporal sulcus), while activation in regions underlying experience sharing (IPL, anterior cingulate cortex and anterior insula) related to lower empathic accuracy. These results provide novel insight into the neural basis of empathic accuracy in adolescence and suggest that perspective taking processes may be effective for increasing empathy.

The ability to understand emotional experiences of others, empathy, is a valuable skill for effective social interactions. Various types of training increase empathy in adolescents, but their impact on brain circuits underlying empathy has not been examined. Video games provide a unique medium familiar and engaging to adolescents and can be used to deliver training at scale. We developed an empathy training video game, Crystals of Kaydor (Crystals), and investigated whether playing Crystals increases empathic accuracy (EA) and related brain activation in adolescents (N = 74; 27 female; mean age(sd) = 12.8(0.7) years; age range 11–14 years). Participants completed a resting state functional MRI (rs-fMRI) scan and an EA task during an fMRI scan before and after 2 weeks of daily gameplay with either the empathy training game, Crystals (N = 34), or the commercial video game Bastion (N = 40), an active control condition. There were no group differences in EA improvement following gameplay, however, engagement with training aspects of Crystals was associated with a higher increase in EA-related activation in right temporoparietal junction following gameplay. Moreover, rs-fMRI connectivity in empathy-related brain circuits (posterior cingulate–medial prefrontal cortex; MPFC) was stronger after Crystals gameplay compared to Bastion. The more individuals’ EA increased following Crystals versus Bastion, the stronger their rs-fMRI connectivity in brain circuits relevant for emotion regulation (amygdala-MPFC). These findings suggest that a video game designed to increase empathic accuracy produces behaviorally-relevant, functional neural changes in fewer than 6 h of gameplay in adolescents.