I meccanismi neurali del MBSR nel disturbo d’ansia generalizzato (GAD)

Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training
Britta K. Hölzel, Elizabeth A. Hoge, Douglas N. Greve, Tim Gard, J. David Creswell, Kirk Warren Brown, Lisa Feldman Barrett, Carl Schwartz, Dieter Vaitl, Sara W. Lazar
NeuroImage: Clinical. Volume 2, 2013, Pages 448–458

“Functional connectivity between amygdala and PFC regions increased significantly pre- to post-intervention within the MBSR, but not SME group. Both, change in VLPFC activation and amygdala–prefrontal connectivity were correlated with change in Beck Anxiety Inventory (BAI) scores, suggesting clinical relevance of these changes. [..] Findings suggest that in GAD, mindfulness training leads to changes in fronto-limbic areas crucial for the regulation of emotion; these changes correspond with reported symptom improvements.”

Traduzione in italiano
“Le connessioni tra l’amigdala e le regioni della corteccia prefrontale aumentano significativamente nel gruppo che ha effettuato l’MBSR (Mindfulness Based Stress Reduction) differentemente dal gruppo che ha seguito interventi psicoeducativi di gestione dello stress. Inoltre sia i cambiamenti nell’attivazione dell’area ventro-laterale della corteccia prefrontale (VLPFC) che le connessioni  del circuito “corteccia prefrontale-amigdala” sono correlate ai cambiamenti nei punteggi del Beck Anxiety Inventory (BAI, questionario sui sintomi ansiosi) risultando in tal modo clinicamente rilevante.
Rispetto dunque al Disturbo d’Ansia Generalizzato (GAD) i risultati suggeriscono che il programma MBSR produce cambiamenti nelle aree fronto-limbiche cruciali per la regolazione delle emozioni; tali cambiamenti corrispondono a miglioramenti riferiti nei sintomi d’ansia.”

Functional connectivity between the seed region in the right amygdala and several regions in the frontal cortex increased from pre- to post-intervention in GAD patients who underwent the MBSR program (N = 15), but not in those who underwent the SME class (N = 11). Anatomical location displayed on an inflated surface with FreeSurfer cortex parcellations (top row), regression coefficients extracted from the clusters from the MBSR (black) and SME (blue) participants at pre- and post-interventions (middle row) and scatter plots of regression coefficients (y-axis) and Beck Anxiety Inventory (BAI, x-axis) for MBSR and SME participants at post (bottom row) for the left rostral anterior cingulate cortex (ACC, column A, pre- to post increase in connectivity: p = 0.0002, multiple comparison corrections within mask of the frontal cortex/insula; correlation with BAI scores: ρ = − .229, ns, uncorrected), right superior frontal cortex (column B, pre–post increase: p = 0.04; correlation: ρ = − .470, p = .015), right rostral middle frontal cortex (column C, pre–post increase: p = 0.03; correlation: ρ = − .572, p = .002), and left rostral middle frontal cortex (column D, pre–post increase: p = 0.01; correlation: ρ = − .646, p < .001).

Functional connectivity between the seed region in the right amygdala and several regions in the frontal cortex increased from pre- to post-intervention in GAD patients who underwent the MBSR program (N = 15), but not in those who underwent the SME class (N = 11). Anatomical location displayed on an inflated surface with FreeSurfer cortex parcellations (top row), regression coefficients extracted from the clusters from the MBSR (black) and SME (blue) participants at pre- and post-interventions (middle row) and scatter plots of regression coefficients (y-axis) and Beck Anxiety Inventory (BAI, x-axis) for MBSR and SME participants at post (bottom row) for the left rostral anterior cingulate cortex (ACC, column A, pre- to post increase in connectivity: p = 0.0002, multiple comparison corrections within mask of the frontal cortex/insula; correlation with BAI scores: ρ = − .229, ns, uncorrected), right superior frontal cortex (column B, pre–post increase: p = 0.04; correlation: ρ = − .470, p = .015), right rostral middle frontal cortex (column C, pre–post increase: p = 0.03; correlation: ρ = − .572, p = .002), and left rostral middle frontal cortex (column D, pre–post increase: p = 0.01; correlation: ρ = − .646, p < .001).

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