Effects of mindfulness training on brain structure, depressive symptoms, and sleep in adolescence

2566 

Abstract Submission 

Tara Samson¹, Benjamin Sipes¹, Angela Jakary¹, Tiffany Ngan¹, Yi Li¹, Eva Henje², Tony Yang¹, Olga Tymofiyeva¹

¹University of California, San Francisco, San Francisco, CA, ²University of Umeå, Umeå, Sweden

Tara Samson  
University of California, San Francisco
San Francisco, CA

Benjamin Sipes  
University of California, San Francisco
San Francisco, CA

Angela Jakary  
University of California, San Francisco
San Francisco, CA

Tiffany Ngan  
University of California, San Francisco
San Francisco, CA

Yi Li  
University of California, San Francisco
San Francisco, CA

Eva Henje  
University of Umeå
Umeå, Sweden

Tony Yang  
University of California, San Francisco
San Francisco, CA

Olga Tymofiyeva, PhD  
University of California, San Francisco
San Francisco, CA

Quality sleep is a key component of healthy development in youth, yet many teens deal with chronic sleep disturbances (Seton et al., 2021). Research suggests mindfulness-based therapies can treat both depressive symptoms and associated sleep disturbances, and improving sleep quality may consequently alleviate depressive symptoms (Yang et al., 2022; Smith et al., 2021). Further, sleep disturbances, depressive symptoms, and mindfulness all have neural associations with the medial prefrontal cortex (mPFC) (Cheng et al., 2022; Scott et al., 2021). The Training for Awareness, Resilience, and Action (TARA) program addresses depressive symptoms including sleep disturbances in adolescents with mindfulness strategies such as breathing techniques, meditation, and yoga-based movements. The present study explores associations between (1) depressive symptoms and sleep disturbances and (2) the neural and behavioral effects TARA may have on these measures.

121 healthy adolescents (15.9±1.3 yrs, range 14-18 yrs, 52 females) underwent a 3T MRI scan that included a T1-weighted sequence and a DTI sequence with 30 directions. Subjects were randomized to TARA (n=56) or a control waiting period (n=56) for 12 weeks, then scanned again. Our analyses focused on the ventromedial prefrontal cortex (vmPFC) which corresponds to the medial orbitofrontal cortex (mOFC) in the AAL atlas used in our study. Node strength was calculated as the sum of the connections from the vmPFC to all other brain regions weighted by the average fractional anisotropy (FA) along the tractography streamlines (Figure 1) (Rubinov et al., 2010). All participants completed self reports before and after the intervention which included the Insomnia Severity Index (ISI) and the Reynolds Adolescent Depression Scale-2nd edition (RADS-2).

Firstly, we observed positive correlations between sleep disturbances (ISI) and depressive symptoms (RADS-2) at baseline (r=0.531; p<0.001) and follow-up (r=0.574; p<0.001) in all participants. Changes in sleep quality between baseline and follow-up were also positively associated with changes in depressive symptoms in the TARA group only (r=0.296; p=0.027). Sleep quality improved significantly more in adolescents who participated in TARA than in waitlist controls (p=0.008, Figure 2), while depressive symptoms did not improve in either group.

Secondly, the structural node strength of the vmPFC was negatively correlated with sleep disturbances at both the baseline (r=-0.214; p=0.020) and follow-up (r=-0.210; p=0.047) scans. Changes in depressive symptoms were significantly associated with changes in vmPFC node strength (r=-0.243; p=0.021), but changes in sleep quality were not.

In addition to supporting the well-established relationship between depressive symptoms and sleep disturbances, our study indicates that sleep disturbances may be more immediately impacted by mindfulness training than overall depressive symptoms. This finding aligns with prior work suggesting mindfulness training can improve sleep quality in the short-term without changing overall depressive symptoms (Smith et al., 2021). Our results also suggest that the vmPFC is a key brain region of interest for future work at the intersection of adolescent mindfulness, sleep, and depression. Such work may investigate the rates at which mindfulness training changes vmPFC structural or functional connectivity, improves sleep quality, and attenuates depressive symptoms in both healthy adolescents and those suffering from a depressive disorder.

Psychiatric (eg. Depression, Anxiety, Schizophrenia)

Early life, Adolescence, Aging

Connectivity (eg. functional, effective, structural) ²

Sleep and Wakefulness ¹

Affective Disorders

Development

Emotions

MRI

Pediatric Disorders

Psychiatric Disorders

Sleep

Therapy

WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC