The mediation role of brain structure in the meditation treatment of Schizophrenia: an RCT study
Poster No:
564
Submission Type:
Abstract Submission
Authors:
Qing Wang1, Ting Xue2, Donghong Cui3
Institutions:
1Shanghai Mental Health Center, Shanghai, [Select a State], 2Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, 3Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
First Author:
Co-Author(s):
Ting Xue
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai
Introduction:
Schizophrenia (SZ), characterized by complex cognitive and behavioral disturbances, represents a significant challenge in mental health [1]. Emerging research has highlighted the therapeutic potential of meditation, a practice rooted in ancient Eastern traditions, particularly in the context of mental disorders. This practice, involving heightened awareness and a focus on the present, has shown promise in the modulation of neurological functions. Recent scientific endeavors have begun to unravel the benefits of meditation in managing conditions like anxiety and depression. However, its efficacy in schizophrenia remains under-explored.
We designed a randomized controlled trial (RCT) to study the treatment effect of meditation and the mediation role of brain structural changes for the chronic SZ patients afflicted with persistent hallucinations and delusions, the design of this study has been illustrated in Fig. 1.
The results showed that, 3-month meditation can slightly improve the positive and negative symptoms, but not significant while 8-month meditation can significantly improve the PANSS score by 10.6 (p=0.008). We have further estimated the average treatment effect (ATE = 10.2, p=0.003) of 8-month meditation with overlap weighting [2], which allows for causal interpretation. In addition, we discovered the mediation role of rh_lingual thickness and lh_caudalanteriorcingulate for the 3-month negative PANSS decrease.
This study has demonstrated the effectiveness of meditation for chronic SZ patients and reported its average treatment effect. The rh_lingual and lh_caudalanteriorcingulate seems to play a mediator role for such treatment effects, which calls for further investigation of their structural and functional roles in the underlying mechanism.
We designed a randomized controlled trial (RCT) to study the treatment effect of meditation and the mediation role of brain structural changes for the chronic SZ patients afflicted with persistent hallucinations and delusions, the design of this study has been illustrated in Fig. 1.
The results showed that, 3-month meditation can slightly improve the positive and negative symptoms, but not significant while 8-month meditation can significantly improve the PANSS score by 10.6 (p=0.008). We have further estimated the average treatment effect (ATE = 10.2, p=0.003) of 8-month meditation with overlap weighting [2], which allows for causal interpretation. In addition, we discovered the mediation role of rh_lingual thickness and lh_caudalanteriorcingulate for the 3-month negative PANSS decrease.
This study has demonstrated the effectiveness of meditation for chronic SZ patients and reported its average treatment effect. The rh_lingual and lh_caudalanteriorcingulate seems to play a mediator role for such treatment effects, which calls for further investigation of their structural and functional roles in the underlying mechanism.
Methods:
The study design has been illustrated in Fig. 1. To estimate the treatment effects of meditation, we focus on PANSS score (positive, negative, sum) decrease of 3 months and 8 months. For the estimation of the average treatment effect (ATE), we use overlap weighting to estimate ATE [2]. All these models have been tested with missing data imputed and excluded. For the mediator analysis, we first test the treatment effect on brain structure (freesurfer 7.0.3 results[3]) and then the effect of brain structures on the final PANSS changes. All the model details and results are illustrated in Fig. 2.
Results:
The results show that: 1) 8-month meditation can significantly reduce the PANSS score of SZ patients by 10.61 (p=0.008) while 3 month meditation can only reduce PANSS score by 5.08 (p=0.235, not significant), this trend is the same for both positive PANSS decrease and negative PANSS decrease. 2) The average treatment effect (PANSS decrease) of 8-month meditation is 10.21 (p=0.003) for PANSS sum, 5.03 (p=0.0002) for PANSS positive and 2.93 (p=0.232) for PANSS negative. The results are stable with or without multiple imputation. 3) Meditation can increase can significantly increase the rh_lingual volume by 0.06 (p=0.035) and such changes can reduce the 3-month PANSS negative score by 3.32 (p=0.068). Both lh_caudalanteriorcingulate volume and area has similar effects on 3month PANSS negative score.
Conclusions:
In summary, we carried out an RCT to study the effect of meditation for chronic Schizophrenia (SZ) patients, and 8-month meditation can significantly reduce the PANSS score by about 10. The conditional treatment effect and the average treatment effect are similar. In addition, we discovered 2 potential brain structural mediators : the right hemisphere lingual gyrus (may involve in the visual hallucinations) and left hemisphere caudal anterior cingulate cortex (emotional dysregulation etc.) These findings lead to further investigation of the functional changes related to these regions. Our papers are currently under review and more results and details will be shared during 2024 OHBM meeting.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1
Modeling and Analysis Methods:
Other Methods
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Anatomy and Functional Systems 2
Keywords:
Data analysis
Psychiatric Disorders
Schizophrenia
Statistical Methods
Treatment
Other - meditation
1|2Indicates the priority used for review
Provide references using author date format
2. Li Fan, et al. American Journal of Epidemiology, no. 1, 188 (2019): 250-257.
3. Esteban Oscar, et al. Nature Protocols 15, no. 7 (2020): 2186–2202.