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正念冥想的神经生物学和临床特征的系统评价。

A systematic review of neurobiological and clinical features of mindfulness meditations.

机构信息

Institute of Psychiatry, University of Bologna, 40123 Bologna, Italy.

出版信息

Psychol Med. 2010 Aug;40(8):1239-52. doi: 10.1017/S0033291709991747. Epub 2009 Nov 27.

Abstract

BACKGROUND

Mindfulness meditation (MM) practices constitute an important group of meditative practices that have received growing attention. The aim of the present paper was to systematically review current evidence on the neurobiological changes and clinical benefits related to MM practice in psychiatric disorders, in physical illnesses and in healthy subjects.

METHOD

A literature search was undertaken using Medline, ISI Web of Knowledge, the Cochrane collaboration database and references of retrieved articles. Controlled and cross-sectional studies with controls published in English up to November 2008 were included.

RESULTS

Electroencephalographic (EEG) studies have revealed a significant increase in alpha and theta activity during meditation. Neuroimaging studies showed that MM practice activates the prefrontal cortex (PFC) and the anterior cingulate cortex (ACC) and that long-term meditation practice is associated with an enhancement of cerebral areas related to attention. From a clinical viewpoint, Mindfulness-Based Stress Reduction (MBSR) has shown efficacy for many psychiatric and physical conditions and also for healthy subjects, Mindfulness-Based Cognitive Therapy (MBCT) is mainly efficacious in reducing relapses of depression in patients with three or more episodes, Zen meditation significantly reduces blood pressure and Vipassana meditation shows efficacy in reducing alcohol and substance abuse in prisoners. However, given the low-quality designs of current studies it is difficult to establish whether clinical outcomes are due to specific or non-specific effects of MM.

DISCUSSION

Despite encouraging findings, several limitations affect current studies. Suggestions are given for future research based on better designed methodology and for future directions of investigation.

摘要

背景

正念冥想(MM)练习构成了一个重要的冥想实践群体,受到越来越多的关注。本研究的目的是系统地回顾当前关于 MM 实践与精神障碍、躯体疾病和健康人群相关的神经生物学变化和临床获益的证据。

方法

使用 Medline、ISI Web of Knowledge、Cochrane 协作数据库和检索文章的参考文献进行文献检索。纳入了截止到 2008 年 11 月以英文发表的有对照和横断面研究,且包含对照。

结果

脑电图(EEG)研究表明,冥想时阿尔法和 theta 活动显著增加。神经影像学研究显示,MM 练习激活了前额叶皮层(PFC)和前扣带皮层(ACC),长期的冥想练习与注意力相关的大脑区域的增强有关。从临床角度来看,正念减压(MBSR)已被证明对许多精神和躯体疾病有效,对健康人群也有效;正念认知疗法(MBCT)主要在减少有三次或以上发作的抑郁患者的复发方面有效;禅宗冥想显著降低血压;内观冥想在减少囚犯的酒精和药物滥用方面有效。然而,由于目前研究设计质量较低,很难确定临床结果是否归因于 MM 的特定或非特定效应。

讨论

尽管有令人鼓舞的发现,但当前的研究仍存在一些局限性。根据更好的设计方法学,提出了未来研究的建议,并为未来的研究方向提供了建议。

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