Meditative and Mindfulness-Focused Interventions in Neurology: Principles, Science, and Patient Selection

Abstract

A growing body of research suggests that meditative- and mindfulness-focused interventions may improve neuropsychiatric symptoms that commonly occur in a range of neurological disorders. In this article, the principles of meditation and mindfulness are first defined, as well as briefly describing the neurobiological mechanisms implicated in these interventions. Thereafter, a range of meditative- and mindfulness-focused interventions are detailed, along with their supporting evidence to treat neuropsychiatric symptoms in neurological conditions (e.g., headache, movement disorders, chronic pain, etc.). Overall, these interventions warrant further investigation among individuals with neurological conditions. When recommending these interventions, health care professionals must consider a combination of structural (e.g., insurance reimbursement) and patient factors (e.g., ability to tolerate a group setting).

The Western origins of mindfulness therapy in ancient Rome

“…First, psychotherapy is the mainstay of treatment in neuropsychiatric conditions, alongside psychopharmacology and more invasive procedures. A growing body of research suggests that specific techniques such as cognitive behavioural therapy may significantly improve psychiatric symptoms that commonly occur in a range of neurological disorders [3]. In the UK, the National Institute for Health and Clinical Excellence recommends the use of cognitive behavioural therapy interventions in the treatment pathways of adult patients with depression in the context of a chronic physical health problem, with relevant implications on a wide range of neurological conditions [4].…”

“…Such therapeutic techniques recognise a range of widely used approaches, from mindfulness-focused interventions to acceptance and commitment therapy, which have been incorporated into evidence-based recommendations [10]. The use of mindfulness-based cognitive therapy and mindfulness-based stress reduction is supported by the strongest level of evidence [3]. A growing body of research suggests that mindfulness may improve neuropsychiatric symptoms that commonly occur in a range of neurological disorders [11].…”

“…Neuroimaging studies have shown an association between mindfulness-based interventions and grey matter changes, with involvement of the insula, and, possibly, the anterior cingulum and adjacent paracingulate cortex [50]. The practice of mindfulness has also been linked to reduced activity and connectivity of cortical midline structures, including the posteromedial parietal cortex (default mode network) [3]. The precuneus and adjacent posterior cingulate cortex are thought to be involved in self-referential processing, including rumination, worry, and self-criticism [51,52].…”

Systematic Review of High-Dimensional Omics in Mind-Body Medicine

“…Mind-body interventions are reported as effective for a vast range of clinical conditions [4][5][6][7][8][9][10] and are also successfully translating into technology-driven healthcare [11][12][13][14]. The properties/structure of mind-body medicine also imply that they are meaningfully compatible with augmented reality/AR as telehealth develops into the future.…”

Psychotherapeutic Tools to Enhance the Neurologist-Patient Interaction

“…27 In other articles in this special issue of Seminars in Neurology, you will read more about specific modalities and how they apply to your patient population. 28,29 ►Table 2 describes the salient features of theoretical approaches representative of different therapeutic approaches. 30 ►Table 3 describes the ecological settings of therapy, essentially, "who else is in the room?"…”