Effects of Mindfulness Training on Emotion Regulation in Patients With Depression: Reduced Dorsolateral Prefrontal Cortex Activation Indexes Early Beneficial Changes

Abstract

Mindfulness-based interventions (MBI) have been found to be a promising approach for the treatment of recurrent courses of depression. However, little is known about their neural mechanisms. This fMRI study set out to investigate activation changes in fronto-limbic regions during implicit emotion regulation. Depressed patients with a recurrent lifetime history were randomized to receive a two-week MBI (N=16 completers) or psycho-education and resting (PER, N=22 completers). Before and after, patients underwent fMR imaging while labelling the affect of angry, happy, and neutral facial expressions and completed questionnaires assessing ruminative brooding, the ability to decentre from such thinking, and depressive symptoms. Activation decreased in the right dorsolateral prefrontal cortex (dlPFC) in response to angry faces following MBI, but not following PER. This change was highly correlated with increased decentering, decreased brooding and decreased symptoms. Amygdala activation in response to happy faces decreased following PER, while the MBI group showed a small but insignificant increase. The dlPFC is involved in emotion regulation, namely reappraisal or suppression of negative emotions. Decreased right dlPFC activation might indicate that, following the MBI, patients abstained from engaging in elaboration or suppression of negative affective stimuli; a putatively important mechanism for preventing the escalation of negative mood.

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