- Cognitive Training Reduces Depression
- By Jason von Stietz, M.A.
- June 30, 2018
About half of individuals who suffer a traumatic brain injury (TBI) develop depression within a year. However, would a treatment designed to address cognitive symptoms also reduce depression? Researchers from the Center for Brain Health at the University of Texas at Dallas examined the use of cognitive training programs to address depression in those who suffered a TBI. Findings indicated that cognitive training, even when not directed toward psychiatric symptoms, related to not only cognitive improvements but also reductions in depression. The study was discussed in a recent article in Medical Xpress:
The recent study, published in Human Brain Mapping, revealed significant reductions in the severity of depressive symptoms, increased ability to regulate emotions, increases in cortical thickness and recovery from abnormal neural network connectivity after cognitive training.
"To our knowledge, this is the first study to report brain change associated with reduced depression symptoms after cognitive training," said Dr. Kihwan Han, a research scientist at the Center for BrainHealth who works in the lab of Dr. Daniel Krawczyk. Han is the lead author of the study.
"Overall, these findings suggest that cognitive training can reduce depressive symptoms in patients with traumatic brain injury even when the training does not directly target psychiatric symptoms," he said.
A past study involving the same protocol showed cognitive gains as well as similar changes in cortical thickness and neural network connectivity.
This study included 79 individuals with chronic TBI who all were at least six months post-injury. These individuals were randomly assigned into one of two groups: strategy-based training, which used the Strategic Memory Advanced Reasoning Training (SMART) program developed at the center; and information-based training, which used the Brain Health Workshop program. Researchers used the Beck Depressive Inventory to classify 53 of the participants as depressed.
The participants' depressive-symptom severity, psychological functioning scores and data from magnetic resonance imaging brain scans were collected before training, after training and three months post-training. Scans were used to study changes in brain structure and neural network connectivity.
Both training programs consisted of 12 one-and-a half-hour sessions over eight weeks that included quizzes, homework assignments, and projects conducted in small group settings that involved social interactions.
All participants in the depressed group showed significantly reduced depressive symptoms that were associated with improvements in cognitive and daily life functioning. According to Han, the social engagements, cognitive stimulation from new learning opportunities and hope of improvement afforded by both programs may help explain the reductions in depressive symptoms.
Based on the observed brain change patterns, Han suggested that improved emotion regulation also may be related to the reduced depressive symptoms. Over time, the reductions in depression symptom severity correlated with increased cortical thickness within the prefrontal cortex—an area of the brain responsible for executive functions needed for emotional control—and reductions in abnormally elevated neural connectivity within this region.
"Identifying what changes are happening in the brain when interventions successfully reduce depressive symptoms could allow us to create more effective, pharmaceutical-free approaches to help alleviate depression in people who experience chronic traumatic brain injury symptoms," said study author Dr. Sandra Bond Chapman, founder and chief director of the Center for BrainHealth, and Dee Wyly Distinguished University Professor.
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- Is Mindfulness Different Than Relaxation?
- By Jason von Stietz, M.A.
- June 21, 2018
Are the effects of mindfulness meditation the same as relaxation training? Mindfulness meditation often leads to feelings of calmness. However, the goal of mindfulness is to practice non-judgmental present moment awareness and not necessarily. Does this difference in goals lead to changes in the brain’s response? Researchers at Massachusetts General Hospital led a study utilizing functional magnetic resonance imaging to examine the difference in neural activity of participants engaging in mindfulness based stress reduction versus relaxation response training. The study was discussed in a recent article in MedicalXpress:
There are two widely used meditation-based stress reduction courses. One is based on the relaxation response—first described by Herb Benson, MD, director emeritus of the MGH-based Benson-Henry Institute for Mind Body Medicine - which focuses on eliciting a physiologic state of deep rest, the opposite of the "fight or flight" stress response. The other is Mindfulness-Based Stress Reduction, developed by Jon Kabat-Zinn, Ph.D., of the University of Massachusetts Medical School, which emphasizes a particular, non-judgmental attitude termed "mindfulness" as key to stress reduction. Although both interventions are based on meditation, the scientific philosophies and meditative traditions upon which each is founded are different, and these differences are reflected in the instructions and exercises taught to patients.
"If the hypotheses proposed by the programs' creators are in fact correct, they imply that these programs promote wellness through different mechanisms of action," says Sara Lazar, Ph.D., of the MGH Psychiatric Neuroscience Research Program, senior author of the current report and assistant professor of Psychology at Harvard Medical School. "Such a finding would suggest that these programs could potentially have different effects on disease."
To investigate that possibility, healthy adults with high levels of stress were randomized to two 8-week programs—18 completed the relaxation response program, and 16 completed the mindfulness program. Both programs successfully decreased stress and increased mindfulness in participants. However, the mindfulness program resulted in further improvements in measures such as self-compassion and rumination, clearly indicating that the programs are not the same, Lazar says.
To further understand the similarities and differences between the programs, the team measured brain activity during a meditation technique common to both programs—a body scan, in which attention is moved sequentially throughout the body to develop bodily awareness. While the relaxation response program instructs participants to deliberately relax each body area as they become aware of it, the mindfulness program just emphasizes mindful awareness and acceptance "without any attempt to change anything."
Lead author Gunes Sevinc, Ph.D., a research fellow in Lazar's laboratory says, "By directly comparing the body-scan meditations, which differed only in cognitive strategy, we were able to identify the brain regions that are involved in mediating the common and differential strategies employed by each intervention."
The results showed that the strength of neural interaction between brain regions associated with present-moment awareness and bodily attention increased during both types of body-scan meditation. But each program also showed unique patterns of brain activity in line with the different theoretical orientation of each program. The relaxation response body scan strengthened coupling between neural regions commonly associated with deliberate control, including inferior frontal gyrus and supplementary motor areas. Conversely, the mindfulness body scan strengthened coupling between neural regions associated with sensory awareness and perception, including the insula and the pregenual anterior cingulate.
"These findings indicate that the programs are working through different neural mechanisms," says Sevinc, "The relaxation response program is working more through deliberate control mechanisms, while the mindfulness program is working more through sensory awareness mechanisms. It is somewhat analogous to weight training vs. aerobic exercise—both are beneficial, but each has its unique mechanism and contribution."
Norman Farb, Ph.D., of the University of Toronto Department of Psychology, who was not part of the study, says, "Professor Lazar's neuroimaging study helps us to better appreciate how these seemingly similar practices differ in important ways. Both practices seem to promote access to neural representations of the body, but they differ in how such representations are structured. This study is important for beginning to inform the public about key differences between conceptually similar therapeutic approaches, which may in turn allow people to make more skillful decisions about which practice might be right for their personal improvement."
Lazar notes that future studies will be needed to determine whether these neural and psychological differences impact specific diseases in unique ways.
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