The Default Mode Network of the Brain Underlies Mind Wandering

The Default Mode Network of the Brain Underlies Mind Wandering

 

By John M. de Castro, Ph.D.

 

“the brain appears to support mind wandering by disrupting some of the brain processes that are involved in responding to our surrounding external environment.” – Julia Kam

 

We spend a tremendous amount of waking time with our minds wandering and not on the present environment or the task at hand. We daydream, plan for the future, review the past, ruminate on our failures, exalt in our successes. In fact, we spend almost half of our waking hours off task with our mind wandering. A system of the brain known as the Default Mode Network (DMN) becomes active during wind wandering and relatively quiet during focused on task behavior. Meditation is known to reduce the size, connectivity, and activity of the Default Mode Network (DMN).

 

In today’s Research News article “Lesion network mapping demonstrates that mind-wandering is associated with the default mode network.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704688/ ) Philippi and colleagues recruited patients with circumscribed brain injuries (lesions) and age and education matched non-brain damaged comparison participants. They all underwent brain scanning with Magnetic Resonance Imaging (MRI). They completed a self-report measure of mind wandering.

 

They found that the brain damaged patients had lower frequencies of mind wandering than the healthy comparison participants. They then examined the specific brain areas damaged in the patients lesions and related it to their reduced mind wandering scores. They found that reduced mind wandering was associated with structures in the Default Mode Network (DMN), including the medial prefrontal cortex, parietal lobe, and inferior frontal gyrus.

 

The results are simple and straightforward and suggest that damage to the Default Mode Network (DMN) reduces mind wandering. This finding taken together with the findings that the DMN becomes more active during mind wandering makes a clear case that the DMN is responsible for mind wandering.

 

So, the default mode network of the brain underlies mind wandering.

 

mind-wandering was associated with increased DMN activity and increased DMN-VS connectivity.“ – Xinqi Zhou

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Philippi, C. L., Bruss, J., Boes, A. D., Albazron, F. M., Deifelt Streese, C., Ciaramelli, E., Rudrauf, D., & Tranel, D. (2021). Lesion network mapping demonstrates that mind-wandering is associated with the default mode network. Journal of neuroscience research, 99(1), 361–373. https://doi.org/10.1002/jnr.24648

 

Abstract

Functional neuroimaging research has consistently associated brain structures within the default mode network (DMN) and frontoparietal network (FPN) with mind-wandering. Targeted lesion research has documented impairments in mind-wandering after damage to the medial prefrontal cortex (mPFC) and hippocampal regions associated with the DMN. However, no lesion studies to date have applied lesion network mapping to identify common networks associated with deficits in mind-wandering. In lesion network mapping, resting-state functional connectivity data from healthy participants are used to infer which brain regions are functionally connected to each lesion location from a sample with brain injury. In the current study, we conducted a lesion network mapping analysis to test the hypothesis that lesions affecting the DMN and FPN would be associated with diminished mind-wandering. We assessed mind-wandering frequency on the Imaginal Processes Inventory (IPI) in participants with brain injury (n = 29) and healthy comparison participants without brain injury (n = 19). Lesion network mapping analyses showed the strongest association of reduced mind-wandering with the left inferior parietal lobule within the DMN. In addition, traditional lesion symptom mapping results revealed that reduced mind-wandering was associated with lesions of the dorsal, ventral, and anterior sectors of mPFC, parietal lobule, and inferior frontal gyrus in the DMN (p < 0.05 uncorrected). These findings provide novel lesion support for the role of the DMN in mind-wandering and contribute to a burgeoning literature on the neural correlates of spontaneous cognition.

Significance

Adults spend up to 50% of their waking day mind-wandering, which is the process of turning one’s attention inward to focus on self-generated thoughts or feelings. Mind-wandering can have both costs and benefits, such as increased negative mood or enhanced creative problem-solving. In this study, we report novel findings linking reduced mind-wandering with brain injury located within the default mode network. This work is important because it can help us to determine which brain networks are necessary for self-generated cognition, which may improve our understanding of neuropsychiatric conditions associated with altered self-focused thought.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704688/

 

Movement-Based Therapies are Affective for Rehabilitation from Disease

Movement-Based Therapies are Affective for Rehabilitation from Disease

 

By John M. de Castro, Ph.D.

 

Tai chi is often described as “meditation in motion,” but it might well be called “medication in motion.” There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems.” – Havard Health

 

Mindful movement practices such as yoga and Tai Chi and Qigong have been used for centuries to improve the physical and mental health and well-being of practitioners. But only recently has the effects of these practices come under scientific scrutiny. This research has been accumulating. So, it makes sense to pause and examine what has been learned about the effectiveness of these practice for rehabilitation from disease.

 

In today’s Research News article “Movement-Based Therapies in Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/ ) Phuphanich and colleagues review and summarize the published research studies of the effects of mindful movement practices on rehabilitation from disease.

 

They report that published research has found that yoga practice reduces fatigue, sleep disturbances, depression, and anxiety and improves the immune system in cancer patients. Yoga has been found to be an effective treatment for mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD). Yoga has been found to reduce pain levels, fear avoidance, stress, and sleep disturbance and increases self-efficacy and quality of life in chronic pain patients. Yoga has been found to improve the symptoms of traumatic brain injury, stroke, spinal cord injury, Parkinson disease, dementia, multiple sclerosis, epilepsy, and neuropathies. In addition, yoga has been found to improve systolic and diastolic blood pressures, heart rate, respiratory rate, waist circumference, waist/hip ratio, cholesterol, triglycerides, hemoglobin A1c, and insulin resistance in cardiopulmonary diseases.

 

They report that the published research has found that Tai Chi and Qigong practices reduce falls in the elderly. Tai Chi and Qigong has been found to reduce pain levels and increase quality of life in chronic pain patients. In addition, there is evidence that Tai Chi and Qigong practices improves depression, anxiety, posttraumatic stress disorder, sleep disturbance, schizophrenia, rheumatoid arthritis, spinal cord injury, traumatic brain injury, and immune disorders.

 

These are remarkable findings. The range of disorders that are positively affected by yoga, Tai Chi, and Qigong practices is breathtaking. These practices are also safe and can be widely implemented at relatively low cost and can be performed alone or in groups and at home or in a therapeutic setting. This suggests that these practices should be routinely implemented for rehabilitation from disease.

 

So,  movement-based therapies are affective for rehabilitation from disease.

 

Being mindful through any physical activity can not only improve performance in the activity such as yoga, tennis, swimming, etc, but it can also increase flexibility, confidence in movement and generate a sense of body and mind connection that has the potential for improving your overall sense of well-being.“- Anupama Kommu

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Phuphanich, M. E., Droessler, J., Altman, L., & Eapen, B. C. (2020). Movement-Based Therapies in Rehabilitation. Physical medicine and rehabilitation clinics of North America, 31(4), 577–591. https://doi.org/10.1016/j.pmr.2020.07.002

 

Abstract

Movement therapy refers to a broad range of Eastern and Western mindful movement-based practices used to treat the mind, body, and spirit concurrently. Forms of movement practice are universal across human culture and exist in ancient history. Research demonstrates forms of movement therapy, such as dance, existed in the common ancestor shared by humans and chimpanzees, approximately 6 million years ago. Movement-based therapies innately promote health and wellness by encouraging proactive participation in one’s own health, creating community support and accountability, and so building a foundation for successful, permanent, positive change.

Key Points – Movement-based therapies

  • Decrease fear avoidance and empower individuals to take a proactive role in their own health and wellness.
  • Can benefit patients of any ability; practices are customizable to the individual’s needs and health.
  • Are safe, cost-effective, and potent adjunct treatments used to supplement (not replace) standard care.
  • Deliver patient-centered, integrative care that accounts for the physical, psychological, social, and spiritual aspects of health and illness.
  • Have diverse, evidence-based benefits, including reduction in pain, stress, and debility, and improvements in range of motion, strength, balance, coordination, cardiovascular health, physical fitness, mood, and cognition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/

 

Improve Well-Being and Relaxation of Patients Undergoing Rehabilitation for Acquired Brain Injuries with Yoga Practice

Improve Well-Being and Relaxation of Patients Undergoing Rehabilitation for Acquired Brain Injuries with Yoga Practice

 

By John M. de Castro, Ph.D.

 

“One of the things about yoga that is different from traditional rehabilitation exercises is that it is more whole-body focused. It helps people learn to take their nervous systems to a more calm and relaxed state, which helps with healing.” –Kristine Miller

 

Brain damage is more or less permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. Brain Injury is caused by a number of different events from a violent blow to the head (Traumatic Brain Injury, TBI), to interruption of the blood supply to the brain (strokes), and to demyelinating diseases such as Multiple Sclerosis (MS). These neurological diseases are common and disabling. In the United States it is estimated that annually 1.7 million people sustain Traumatic Brain Injury, while 400,000 people are diagnosed with Multiple Sclerosis, and about 800,000 people have strokes.

 

Regardless of the cause, the brain is damaged, and the tissues that are destroyed are permanently lost. But we know that people can recover to some extent from brain injury.  How is it possible that recovery can occur when there is no replacement of the damaged tissue? There appears to be a number of strategies that are employed by the brain to assist in recovery. Other areas of the brain can take over some of the function, other behavioral strategies can be employed to accomplish the task, and non-injured areas of the brain can adapt and change to compensate for the lost function.

 

Rehabilitation for brain injury patients usually involves strategies to promote these recovery mechanisms. Mindfulness training has been found to be helpful in recover from Traumatic Brain InjuryMultiple Sclerosis, and stroke. Yoga is both a mindfulness practice and an exercise making it a potentially ideal practice to promote rehabilitation from brain injury.

 

In today’s Research News article “The Lived Experience and Patient-reported Benefits of Yoga Participation in an Inpatient Brain Injury Rehabilitation Setting.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937874/), Seeney and Griffin recruited adults with acquired brain injuries who were inpatients in a brain injury rehabilitation unit. They participated in once weekly 1-hour Hatha yoga classes that were modified for brain injury patients. They were measured before and after each yoga class for relaxation, well-being, and satisfaction with the class. After the second yoga class they completed a semi-structured interview on their lived experience while in rehabilitation.

 

They found that over each class and over the first 3 classes compared to baseline there were significant improvements in the relaxation and well-being of the patients. Qualitative analysis of the semi-structured interviews revealed that the participants found that participation in the yoga classes improved their levels of relaxation, their physical well-being including flexibility and movements, present moment awareness, and self-awareness.

 

Although this study was small, short-term, and lacked a control group, the results suggest that yoga training can be successfully implemented in a brain injury rehabilitation unit. It suggests that yoga practice is seen as beneficial by the patients with acquired brain injuries and it improved their well-being and relaxation. Although not investigated, it would be expected that this would improve their rehabilitation.

 

So, improve well-being and relaxation of patients undergoing rehabilitation for acquired brain injuries with yoga practice.

 

A growing science is showing that the dynamic and multifaceted nature of yoga has tremendous potential to foster healing from brain injury. Not only does yoga offer a pathway to improved strength, attention control, and stress management, it can also provide people with powerful opportunities to look inward, connect with themselves more deeply, and discover their capacity to move forward.” – Kyla Pearce

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Seeney, R., & Griffin, J. (2020). The Lived Experience and Patient-reported Benefits of Yoga Participation in an Inpatient Brain Injury Rehabilitation Setting. International journal of yoga, 13(1), 25–31. https://doi.org/10.4103/ijoy.IJOY_46_19

 

Abstract

Context:

The multifactorial benefits of yoga have been well documented in the literature, with the integration of yoga therapy into healthcare being an emerging field. In general, yoga therapy programs are utilized in the community as an adjunct to other therapy. At present, limited rehabilitation units routinely incorporate integrative therapy options within a hospital environment.

Aims:

The aim of this study is to explore the lived experience and patient-reported benefits of yoga in an inpatient brain injury rehabilitation setting.

Settings and Design:

Thirty-one participants were recruited to the study after voluntarily participating in a yoga class within an inpatient brain injury rehabilitation unit of a major metropolitan hospital. Yoga sessions were held weekly for 60 min and consisted of a modified Hatha yoga style. This was a mixed-methods, quasi-experimental one-group pretest–posttest study.

Methodology:

Quantitative data were collected to measure perceptions of relaxation and well-being before and after yoga classes, along with the satisfaction of the class. Semi-structured interviews were utilized to collect qualitative data of experiences and perceptions associated with yoga participation.

Statistical Analysis Used:

Thematic analysis was completed for qualitative data. Quantitative data were analyzed using nonparametric statistical methods, and descriptive statistics were also provided.

Results:

The benefits described by participants are reported in this paper. These include improved relaxation, physical well-being, emotional well-being, being present, and self-awareness.

Conclusions:

This study describes the personal benefits experienced from regular yoga participation within an inpatient rehabilitation setting.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937874/

 

Do Spiritual Experiences Reveal Ultimate Truth or Merely Brain Activity?

Do Spiritual Experiences Reveal Ultimate Truth or Merely Brain Activity?

 

By John M. de Castro, Ph.D.

 

Spiritual experiences, be they called awakenings, mystical experiences, or enlightenments, involve a shift in how the individual perceives reality. This could be viewed as a spiritual revelation. But it could also be viewed as a change in the neural systems integrating and interpreting experiences. So, are spiritual awakenings revelations of a reality beyond physical reality or are they simply hallucinatory experience evoked by changes in the nervous system?

 

One way of investigating this question is to study the brain-spirituality connection. Research along these lines has revealed that there is a clear association between spirituality and the brain. Modern neuroscience has developed methods, such as neuroimaging, to investigate the relationship. Applying these techniques it has been demonstrated that spirituality is associated with changes in the size, activity, and connectivity of the frontal and parietal lobes of the brain (see http://contemplative-studies.org/wp/index.php/2015/07/19/spirituality-mindfulness-and-the-brain/). So spirituality and changes in neural systems co-occur. But, this does not demonstrate a causal connection, whether spirituality alters the brain or brain alteration causes spirituality, or some third factor is responsible for both.

 

A better way to demonstrate if brain activity cause spiritual experiences is to investigate what happens to spirituality when the brain changes. One place to look at this is with accidental brain injuries incurred by humans that afford an opportunity to glimpses associations between brain change and spirituality. In general people who have incurred damage to the right inferior parietal area show an increase in spirituality. So, brain alteration affects spirituality. But, increased spiritual beliefs and spiritual seeking is not the same thing as spiritual experiences. So, we cannot conclude that these changes in the brain are responsible for awakening experiences.

 

Another manipulation of the brain occurs with drugs. Indeed, various hallucinogenic drugs such as mescaline, LSD, psilocybin, etc. have been shown to produce experiences that are extremely similar to spiritual experiences. These drugs have been shown to alter the activity in specific neurochemical systems in the brain and when that happens, experiences that are very similar to spiritual awakenings are evoked. Many people who have used these drugs are altered spiritually but vast numbers of people find hallucinatory drugs as fun recreation but are not affected spiritually.

 

Spiritual seekers who have used psychedelic substances report that they experience something like but not the same as spiritual awakening experiences. The following quote from Alan Watts is illustrative.

“Psychedelic experience is only a glimpse of genuine mystical insight, but a glimpse         which can be matured and deepened by the various ways of meditation in which drugs           are no longer necessary or useful. If you get the message, hang up the phone. For         psychedelic drugs are simply instruments, like microscopes, telescopes, and telephones.       The biologist does not sit with eye permanently glued to the microscope, he goes away      and works on what he has seen…”

Also a quote from Ralph Metzner

            “While psychedelic use is all about altered states, Buddhism is all about altered traits,     and one does not necessarily lead to the other.”

Hence, it appears that although there are great similarities between manipulation of brain chemistry with drugs and the experiences occurring with spiritual awakenings, they are in fact quite different.

 

So, what should we conclude regarding the clear relationship between the brain and spiritual experiences? It has been established that spirituality changes the brain and that changes in the brain are associated with spiritual experiences. Does this indicate that spirituality is nothing but a brain function? This would suggest that spirituality and spiritual experiences are nothing but physical events and don’t represent experience of true transcendence or an indication of a god. If this were true then it would suggest that there is nothing beyond the physical, that spiritual awakenings are nothing other than evoked changes in the nervous system.

 

It should be noted that reported spiritual experiences most frequently involve changes in sensory experiences. We know that sensory experiences are produced by the nervous system. So, it would be expected that if a spiritual experience occurs then there would be changes in the nervous system. As a result it is not surprising that nervous system changes would accompany spiritual experiences.

 

Neural changes may represent the effects of spiritual experiences on the physical body. After all, when we become aware of any kind of remarkable occurrence we react emotionally, physically, and thoughtfully. This would imply that the neural changes occur after the spiritual experience and not before it as a causal relationship would demand. In addition, changing the brain with drugs may simply induce the same effects as the sequela of spiritual experience and not the spiritual experiences themselves.

 

The most common report of spiritual experience is that everything is perceived as one. This oneness experience is not reported to be a change in the actual sensory information, but rather as a perception of the interconnectedness of all things such that they are seen as all a part of a singular entity, like seeing individual waves as all being part of one ocean. The more modern science studies events and their interconnections the more that the truth of oneness is revealed. The entire science of ecology has developed to study the interconnectedness among biological entities, meteorology has determined that atmospheric conditions over the entire planet are interconnected, and geology has revealed the interconnectedness of all movement of the planet’s surface and interior. Just think how interconnected everything is with sunlight. Without this energy, life could not exist and even the weather would not be changing. Everything about us and our planet is interconnected to the sun’s energy.

 

So, perhaps the oneness revealed in spiritual experiences may actually be a more accurate glimpse of the truth of existence. Perhaps, the changes observed in the brain may simply be the effect of this revelation rather than the cause. At this point we cannot reach a clear conclusion as to whether spiritual experiences are material and physical or true revelation of a non-physical reality. But the research is exciting and will continue to explore these ultimate questions regarding existence.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Relieve Fatigue Accompanying Neurologic Disease with Mindfulness

By John M. de Castro, Ph.D.

 

“Mindfulness meditation — or mentally focusing on being in the present moment — has also proven an effective tool to help people with cognitive and behavioral issues after TBI. With meditation of all kinds — from chanting to visual imagery — people can make peace with their new self and not get swept up in the constant maelstrom of mental obsessions.” – Victoria Tilney McDonough

 

Brain damage is more or less permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. Brain Injury is caused by a number of different events from a violent blow to the head (Traumatic Brain Injury, TBI), to interruption of the blood supply to the brain (strokes), and to demyelinating diseases such as Multiple Sclerosis (MS). These neurological diseases are common and disabling. In the United States it is estimated that annually 1.7 million people sustain Traumatic Brain Injury, while 400,000 people are diagnosed with Multiple Sclerosis, and about 800,000 people have strokes.

 

Regardless of the cause, the brain is damaged, and the tissues that are destroyed are permanently lost. But, we know that people can recover to some extent from brain injury.  How is it possible that recovery can occur when there is no replacement of the damaged tissue? There appears to be a number of strategies that are employed by the brain to assist in recovery. Other areas of the brain can take over some of the function, other behavioral strategies can be employed to accomplish the task, and non-injured areas of the brain can adapt and change to compensate for the lost function. Rehabilitation usually involves strategies to promote these recovery mechanisms.

 

Each of these neurologic diseases are accompanied by a profound fatigue. This disrupts rehabilitation as it makes it difficult for the patients to engage in the needed activities. In fact, the depth of fatigue is associated with lower levels of quality of life, everyday functioning, and life expectancy. So, it is important to find methods to reduce fatigue in patients with neurologic diseases. Mindfulness training has been found to be helpful in recover from Traumatic Brain Injury, Multiple Sclerosis, and stroke. It would seem likely then that mindfulness training reduces fatigue.

 

In today’s Research News article “Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1327481707275752/?type=3&theater

or see summary below or view the full text of the study at:

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00912/full

Ulrichsen and colleagues review the published research literature on the effects on fatigue of mindfulness training on adult patients with neurologic diseases. In all of the studies 8-weeks of either Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) were employed as therapy. They found that mindfulness training significantly reduced fatigue with moderate effect size.

 

These are encouraging results as fatigue plays such a crucial role in the disease and its reduction is needed for other rehabilitation activities to be effective. It isn’t clear exactly how mindfulness training reduces fatigue. It is possible that by improving present moment awareness, especially of the patient’s physical state, that worry and rumination that contribute to the feelings of fatigue may be lowered or that the improved attentional mechanisms allows the patients to perform well in spite of fatigue.

 

Regardless, relieve fatigue accompanying neurologic disease with mindfulness.

 

“Imaging studies show that mindfulness soothes the brain patterns underlying pain and, over time, these changes take root and alter the structure of the brain itself, so that patients no longer feel pain with the same intensity. Many say that they barely notice it at all.” – Danny Penman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Ulrichsen KM, Kaufmann T, Dørum ES, Kolskår KK, Richard G, Alnæs D, Arneberg TJ, Westlye LT and Nordvik JE (2016) Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis. Front. Psychol. 7:912. doi: 10.3389/fpsyg.2016.00912

 

Abstract

BACKGROUND: Fatigue is a common symptom following neurological illnesses and injuries, and is rated as one of the most debilitating sequela in conditions such as stroke, traumatic brain injury (TBI), and multiple sclerosis (MS). Yet effective treatments are lacking, suggesting a pressing need for a better understanding of its etiology and mechanisms that may alleviate the symptoms. Recently mindfulness-based interventions have demonstrated promising results for fatigue symptom relief.

OBJECTIVE: Investigate the efficacy of mindfulness-based interventions for fatigue across neurological conditions and acquired brain injuries.

MATERIALS AND METHODS: Systematic literature searches were conducted in PubMed, Medline, Web of Science, and PsycINFO. We included randomized controlled trials applying mindfulness-based interventions in patients with neurological conditions or acquired brain injuries. Four studies (N = 257) were retained for meta-analysis. The studies included patients diagnosed with MS, TBI, and stroke.

RESULTS: The estimated effect size for the total sample was -0.37 (95% CI: -0.58, -0.17).

CONCLUSION: The results indicate that mindfulness-based interventions may relieve fatigue in neurological conditions such as stroke, TBI, and MS. However, the effect size is moderate, and further research is needed in order to determine the effect and improve our understanding of how mindfulness-based interventions affect fatigue symptom perception in patients with neurological conditions.

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00912/full

 

Reduce Fatigue After Brain Injury with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation — or mentally focusing on being in the present moment — has also proven an effective tool to help people with cognitive and behavioral issues after TBI. With meditation of all kinds — from chanting to visual imagery — people can make peace with their new self and not get swept up in the constant maelstrom of mental obsessions.” – Victoria Tilney McDonough

 

Brain damage is more or less permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. There are a number of causes of brain damage including Traumatic Brain Injury, stroke, and Multiple Sclerosis. TBI has many causes of this including car accidents, warfare, violent disputes, etc.. A stroke results from an interruption of the blood supply to the brain, depriving it of needed oxygen and nutrients. This can result in the death of brain cells and depending on the extent of the damage produce profound loss of function. Multiple Sclerosis is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with brain injuries in general is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality.

 

Regardless of the cause, the brain is damaged, and the areas that are destroyed are permanently lost. But, people can recover to some extent from brain injury. Fatigue is the common symptom of all of these neurological disorders and it interferes with treatment and recovery. These patients frequently lack the energy to adhere to their therapeutic regimens. So, there is a pressing need to find treatments that can reduce or eliminate fatigue in these patients. Mindfulness practices have been shown to be helpful in recovery from Traumatic Brain Injury, stroke, and Multiple Sclerosis. They have also been shown to be effective in reducing fatigue due to environmental and medical causes. Hence, mindfulness training may be an effective treatment for the fatigue following brain injury.

 

In today’s Research News article “Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1306292806061309/?type=3&theater

or see summary below or view the full text of the study at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917545/  Ulrichsen and colleagues review the published research literature investigating the usefulness of mindfulness treatments for fatigue following brain injury. They report that the summarized results from four studies indicate that mindfulness training reduces fatigue after brain injury with a moderate but clinically significant effect size (.37). In other words, mindfulness treatment reduces fatigue, but doesn’t eliminate it.

 

These are promising results suggesting that one way that mindfulness training may help improve the recovery after brain injury is by reducing the fatigue that typically accompanies brain injury. This is very important as fatigue is at the center of the reduced quality of life after brain injury. Fatigue also interferes with the patient’s ability to fully engage in their rehabilitation therapy regimens. Additionally, mindfulness training is a safe treatment with no know negative side effects and many additional positive physical and psychological effects on the patients. Hence, these results suggest that mindfulness training should be employed to assist in recovery after brain injury.

 

So, reduce fatigue after brain injury with mindfulness.

 

“It seems then that exploring the benefits of mindfulness and meditation after brain injury can be worthwhile for people living with brain injury, family and supporters.  It can reduce stress and focus concentration and attention.” –  Melanie Atkins

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Ulrichsen, K. M., Kaufmann, T., Dørum, E. S., Kolskår, K. K., Richard, G., Alnæs, D., … Nordvik, J. E. (2016). Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis. Frontiers in Psychology, 7, 912. http://doi.org/10.3389/fpsyg.2016.00912

 

Abstract

Background: Fatigue is a common symptom following neurological illnesses and injuries, and is rated as one of the most debilitating sequela in conditions such as stroke, traumatic brain injury (TBI), and multiple sclerosis (MS). Yet effective treatments are lacking, suggesting a pressing need for a better understanding of its etiology and mechanisms that may alleviate the symptoms. Recently mindfulness-based interventions have demonstrated promising results for fatigue symptom relief.

Objective: Investigate the efficacy of mindfulness-based interventions for fatigue across neurological conditions and acquired brain injuries.

Materials and Methods: Systematic literature searches were conducted in PubMed, Medline, Web of Science, and PsycINFO. We included randomized controlled trials applying mindfulness-based interventions in patients with neurological conditions or acquired brain injuries. Four studies (N = 257) were retained for meta-analysis. The studies included patients diagnosed with MS, TBI, and stroke.

Results: The estimated effect size for the total sample was -0.37 (95% CI: -0.58, -0.17).

Conclusion: The results indicate that mindfulness-based interventions may relieve fatigue in neurological conditions such as stroke, TBI, and MS. However, the effect size is moderate, and further research is needed in order to determine the effect and improve our understanding of how mindfulness-based interventions affect fatigue symptom perception in patients with neurological conditions.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917545/

 

Improve Physical Rehabilitation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When it comes to chronic pain, the key is learning to live with it rather than vainly trying to avoid or eradicate it. Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).” – Christiane Wolf

 

Mindfulness practices have been shown to be effective in promoting physical and psychological health. As a result of mindfulness’ ability to reduce the physiological and psychological responses to stress these practices have been found to be helpful in treating a number of medical disorders. In addition, because of mindfulness’ ability to improve emotion regulation and reduce worry and rumination these practices have been found to be helpful in treating a number of psychological disorders. There is such a wide variety of benefits that the application of mindfulness training is being explored for an ever expanding list of conditions.

 

In today’s Research News article “Mindfulness Interventions in Physical Rehabilitation: A Scoping Review.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1284023361621587/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834757/

Hardison and colleagues examine the effectiveness of mindfulness training in assisting rehabilitation from a variety of physical disorders. To do this, they reviewed the published research literature on the effects of mindfulness training on recovery from any illness, injury, or disability of the neurological, musculoskeletal, or other body system that could be treated within a medical or rehabilitation setting. A number of different mindfulness practices were employed in the studies including Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy, and General Mindfulness.

 

They found that, in general the literature reported that mindfulness training was effective in treating musculoskeletal and pain disorders such as chronic musculoskeletal pain, work-related musculoskeletal injury, and knee surgery. These studies reported mixed results regarding mindfulness training effects on reducing the pain accompanying these disorders, but they routinely found that mindfulness produced significant improvements in acceptance of pain and functioning with pain, and reduced distress. They also found that, in general the published research found that mindfulness training was effective in treating recovery from traumatic brain injury (TBI). Mindfulness training improved the patients’ cognitive functioning, physical health, self-efficacy, quality of life, vitality, emotionality and mental health and reduced the distress produced by the TBI symptoms.

 

These results are potentially very important and suggest that mindfulness training is effective in improving the process of rehabilitation from a number of musculoskeletal and pain disorders and traumatic brain injury. This adds to the already extensive list of applications of mindfulness training to assist in prevention and recovery from medical disorders. It is not known exactly what effects of mindfulness training might be responsible for these benefits. But, it is reasonable to speculate that improvements in stress responses, emotion regulation, and worry and rumination are involved.

 

So, the published research literature suggests that mindfulness training should be included in the interventions recommended for rehabilitation from physical disorders.

 

“From the broadest vantage point, mindful clinical practice holds possibilities when used in conjunction with other strategies. It helps patients to take a step back, assess their experiences and move toward compassionate self-care. We owe it to our patients to help them discover their own pockets of rest, relief and comfort.” – Reji Mathew

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Hardison, M. E., & Roll, S. C. (2016). Mindfulness Interventions in Physical Rehabilitation: A Scoping Review. The American Journal of Occupational Therapy, 70(3), 7003290030p1–7003290030p9. http://doi.org/10.5014/ajot.2016.018069

 

Abstract

A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association’s Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834757/

 

 

Frontal Cortex Damage Increases Mystical Experiences

By John M. de Castro, Ph.D.

 

“Push theories argue that activation of a single ‘God Spot’ causes mystical beliefs, suggesting that injuries to these spots would reduce mysticism. In contrast, pull theories argue that the suppression of our inhibitory functions opens up the brain to mystical experiences,” – Joseph Bulbulia

 

Spiritual experiences, be they called awakenings, mystical experiences, or enlightenments, involve a shift in how the individual perceives reality. This could be viewed as a spiritual revelation. But it could also be viewed as a change in the neural systems integrating and interpreting experiences. So, are spiritual awakenings revelations of a reality beyond physical reality or are they simply hallucinatory experience evoked by changes in the nervous system?

 

One way of investigating this question is to study the brain-spirituality connection. Modern neuroscience research employing sophisticated neuroimaging techniques has investigate this relationship and has revealed that there is a clear association between spirituality and the brain. Neuroimaging techniques that allow the measurement of the nervous system in an intact human have demonstrated that spirituality is associated with changes in the size, activity, and connectivity of the frontal and parietal lobes of the brain. So spirituality and changes in neural systems co-occur. But, this does not demonstrate a causal connection, whether spirituality alters the brain or brain alteration causes spirituality, or some third factor is responsible for both.

 

A better way to demonstrate if brain activity causes spiritual experiences is to investigate what happens to spirituality when the brain changes. One place to look at this is with accidental brain injuries incurred by humans. This affords an opportunity to glimpses associations between brain change and spirituality. In general people who have incurred damage to the right inferior parietal area show an increase in spirituality. So, brain alteration affects spirituality. But, increased spiritual beliefs and spiritual seeking are not the same thing as spiritual experiences. So, we cannot conclude that these changes in the brain are responsible for awakening experiences.

 

In today’s Research News article “Neural correlates of mystical experience”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1201966963160561/?type=3&theater or see below

Cristofori and colleagues study the effects of brain injury incurred by soldiers in the Vietnam war and mystical experiences with a matched group of uninjured Vietnam veterans. The neuroimaging technique of Computerized Axial Tomography (CT Scans) were used to map the areas of the brain damaged in the veterans. They found that one particular area, the dorsolateral prefrontal cortex (dlPFC) was associated with higher levels of mystical experiences. Veterans with damage to that area had significantly higher scores on the Mysticism Scale (M-Scale) than either intact veterans or veterans with damage to other brain areas. These results suggest that damage to the brain causes increased mystical experiences.

 

The prefrontal cortex in general, including the dorsolateral prefrontal cortex (dlPFC) have been shown to be involved in executive function. Executive function regulates cognitive processes, including attention, working memory, reasoning, task flexibility, and problem solving as well as planning and execution. The results from the study suggest that damage to areas underlying these executive function increases mystical experiences. This in turn suggests that reducing higher level thinking induces more mystical experiences. Indeed, Cristofori and colleagues found that the in the brain injured veterans the greater the deficit in executive function, the higher the mysticism score.

 

These results support a theoretical model of mystical experiences proposed by de Castro in which executive function inhibits unprocessed sensory information from reaching consciousness. The model postulates that these raw sensory experiences are the basis of mystical experiences. So, brain damage which disrupts executive function would tend to increase the ability of these unprocessed experiences to reach consciousness.

 

Regardless of the explanation, it is clear that frontal cortex damage increases mystical experiences.

 

“it will first be necessary for science to accept that its ability to understand subjective phenomena is radically limited by its current world-view and that this world-view or paradigm is long overdue for a radical transformation. What will aid enormously in this transformation is for scientists to begin the process of inner research or exploration of their own consciousness so that the states of mind being studied, such as mystical perception, become a part of their own experience. When the consciousness of the researchers starts to undergo a profound transformation, the old world-view or paradigm will correspondingly undergo a similar shift.” – Michael Persinger

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

Study Summary

Irene Cristofori, Joseph Bulbulia, John H. Shaver, Marc Wilson, Frank Krueger, Jordan Grafman. Neural correlates of mystical experience. Neuropsychologia, Volume 80, 8 January 2016, Pages 212-220

 

Highlights

  • We investigated the causal role of brain region in mystical experience.
  • VLSM showed increased mystical experience associated to ip temporal cortexanddlPFC.
  • Patients with selective lesions to dlPFC reported increased mystical experience.
  • Executive functioningcontributes to the down-regulationof mystical experiences.

Abstract

Mystical experiences, or subjectively believed encounters with a supernatural world, are widely reported across cultures and throughout human history. Previous theories speculate that executive brain functions underpin mystical experiences. To evaluate causal hypotheses, structural studies of brain lesion are required. Previous studies suffer from small samples or do not have valid measures of cognitive functioning prior to injury. We investigated mystical experience among participants from the Vietnam Head Injury Study and compared those who suffered penetrating traumatic brain injury (pTBI; n=116) with matched healthy controls (HC; n=32). Voxel-based lesion-symptom mapping analysis showed that lesions to frontal and temporal brain regions were linked with greater mystical experiences. Such regions included the dorsolateral prefrontal cortex(dlPFC) and middle/superior temporal cortex (TC). In a confirmatory analysis, we grouped pTBI patients by lesion location and compared mysticism experiences with the HC group. The dlPFC group presented markedly increased mysticism. Notably, longitudinal analysis of pre-injury data (correlating with general intelligence and executive performance) excludes explanations from individual differences. Our findings support previous speculation linking executive brain functions to mystical experiences, and reveal that executive functioning (dlPFC) causally contributes to the down-regulation of mystical experiences.

 

Mindfulness and Recovery from Brain Injury

Brain damage is more or less permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. Acquired Brain Injury is a form of brain damage caused by a number of different events from a violent blow to the head (Traumatic Brain Injury, TBI), to gunshot wounds, to tumors and strokes. There are many causes of this including car accidents, warfare, violent disputes, cancer, etc.. Regardless of the cause, the brain is damaged, and the areas that are destroyed are permanently lost.

But, we know that people can recover to some extent from brain injury.  How is it possible that recovery can occur when there is no replacement of the damaged tissue? There appears to be a number of strategies that are employed by the brain to assist in recovery. Other areas of the brain can take over some of the function, other behavioral strategies can be employed to accomplish the task, and non-injured areas of the brain can adapt and change to compensate for the lost function.

In today’s article “Mindfulness-Based Stress Reduction (MBSR) Delivered Live on the Internet to Individuals Suffering from Mental Fatigue After an Acquired Brain Injuryhttps://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1016815115009081/?type=1&theater

MBSR is shown to assist in recovery from a particularly troublesome symptom of brain injury, long-lasting mental fatigue. For brain injury victims engaging in mental activities takes tremendous energy and the individual tires (fatigues) quickly. We can theorize that this fatigue comes from having to employ less efficient alternative methods to perform mental tasks that take more energy.

How does MBSR help? It can actually change the brain and make it more efficient in processing mental tasks. It has been shown that mindfulness training can increase the size and connectivity of areas of the brain responsible for focused attention while decreasing the size and connectivity of areas responsible for mind wandering and attentional lapses. By limiting intrusive thoughts, mindfulness improves attentional ability and even memory function.

MBSR can also decrease the emotional reactions of frustration and anger that can occur as a result of struggling to perform a mental task. This can remove an interfering and fatiguing consequence of the disability produced by brain injury. This in turn reduces the energy expended to accomplish the task.

So, mindfulness training can assist the brain injury sufferer by restructuring the uninjured brain tissue to allow for better focused attention and also by reducing emotional reactions to the difficulties. This allows the victim to better engage in mental activities. In essence, it doesn’t heal the damaged tissue, rather it makes the rest of the brain better able to carry out the task.

CMCS