Neurofeedback-Augmented Mindfulness Training Elicits Distinct Responses in the Subregions of the Insular Cortex in Healthy Adolescents

Abstract

Mindfulness training (MT) reduces self-referential processing and promotes interoception, the perception of sensations from inside the body, by increasing one’s awareness of and regulating responses to them. The posterior cingulate cortex (PCC) and the insular cortex (INS) are considered hubs for self-referential processing and interoception, respectively. Although MT has been consistently found to decrease PCC, little is known about how MT relates to INS activity. Understanding links between mindfulness and interoception may be particularly important for informing mental health in adolescence, when neuroplasticity and emergence of psychopathology are heightened. We examined INS activity during real-time functional magnetic resonance imaging neurofeedback-augmented mindfulness training (NAMT) targeting the PCC. Healthy adolescents (N = 37; 16 female) completed the NAMT task, including Focus-on-Breath (MT), Describe (self-referential processing), and Rest conditions, across three neurofeedback runs and two non-neurofeedback runs (Observe, Transfer). Regression coefficients estimated from the generalized linear model were extracted from three INS subregions: anterior (aINS), mid (mINS), and posterior (pINS). Mixed model analyses revealed the main effect of run for Focus-on-Breath vs. Describe contrast in aINS [R2 = 0.39] and pINS [R2 = 0.33], but not mINS [R2 = 0.34]. Post hoc analyses revealed greater aINS activity and reduced pINS activity during neurofeedback runs, and such activities were related to lower self-reported life satisfaction and less pain behavior, respectively. These findings revealed the specific involvement of insula subregions in rtfMRI-nf MT.

Modest Effects of Neurofeedback-Assisted Meditation Using a Wearable Device on Stress Reduction: A Randomized, Double-Blind, and Controlled Study

“…Compared with the control group, in which no statistically significant change was observed, the neurofeedback-assisted meditation group showed a remarkable decrease in the PSS score, which was meaningful as it confirmed the effect of neurofeedback-assisted meditation treatment over time. 39 This is consistent with the results of previous studies showing that practicing mindfulness meditation had a positive effect on stress reduction. This implies that the effect of neurofeedback assistance can further maximize the effect of meditation over a short period of time.…”

Mindfulness, Interoception, and the Body

“…The final paper in the Special Issue [ 41 ] examined the neural effects of mindfulness training: in particular, how the insula—a key interoceptive brain area—might be modulated in healthy adolescents. Given that some studies have shown changes to interoception following mindfulness training, it is to be expected that changes to interoceptive brain regions also occur.…”

“…Mindfulness training (MT) shows promise as an early intervention to help prevent mental health issues and increase wellbeing in adolescents [ 45 ], and it is possible it may exert its effects via changes to interoception. Yu and colleagues [ 41 ] sought to test whether MT causes changes in interoceptive brain regions in adolescents. They employed fMRI-based neurofeedback-augmented mindfulness training, and found the differential effects of neurofeedback runs on sub-regions of the insula: increases in the activation of the anterior insula and decreases in the posterior insula.…”

A tale of two targets: examining the differential effects of posterior cingulate cortex- and amygdala-targeted fMRI-neurofeedback in a PTSD pilot study

“…Taken together, these findings highlight the PCC’s clinical relevance in PTSD psychopathology and suggest that regulating activity within the region via rt-fMRI-NFB may generate positive clinical outcomes. Critically, however, very few studies have examined the neurobiological mechanisms associated with the regulation of the PCC with rt-fMRI-NFB ( Zhang et al, 2013 ; Garrison et al, 2013a , b ; Kirlic et al, 2022 ; Yu et al, 2022 ), with only one study examining the regulation of this region in PTSD ( Nicholson et al, 2021 ; Lieberman et al, 2023 ).…”