Tymofiyeva Olga, Sipes Benjamin S, Luks Tracy, Hamlat Elissa J, Samson Tara E, Hoffmann Thomas J, Glidden David V, Jakary Angela, Li Yi, Ngan Tiffany, Henje Eva, Yang Tony T
Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA, United States.
Front Psychol. 2024 Aug 13;15:1410319. doi: 10.3389/fpsyg.2024.1410319. eCollection 2024.
This study evaluated changes in the white matter of the brain and psychological health variables, resulting from a neuroscience-based mindfulness intervention, the Training for Awareness, Resilience, and Action (TARA), in a population of healthy adolescents.
A total of 100 healthy adolescents (57 female, age ranges 14-18 years) were randomized into the 12-week TARA intervention or a waitlist-control group. All participants were imaged with diffusion MRI to quantify white matter connectivity between brain regions. Imaging occurred at baseline/randomization and after 12 weeks of baseline (pre- and post-intervention in the TARA group). We hypothesized that structural connectivity in the striatum and interoceptive networks would increase following the TARA intervention, and that, this increased connectivity would relate to psychological health metrics from the Strengths and Difficulties Questionnaire (SDQ) and the Insomnia Severity Index (ISI). The TARA intervention and all assessments, except for the MRIs, were fully remotely delivered using secure telehealth platforms and online electronic data capture systems.
The TARA intervention showed high consistency, tolerability, safety, recruitment, fidelity, adherence, and retention. After 12 weeks, the TARA group, but not controls, also demonstrated significantly improved sleep quality ( = 0.02), and changes in the right putamen node strength were related to this improved sleep quality ( = -0.42, = 0.006). Similarly, the TARA group, but not controls, had significantly increased right insula node strength related to improved emotional well-being ( = -0.31, = 0.04). Finally, we used the network-based statistics to identify a white matter interoception network that strengthened following TARA ( = 0.009).
These results suggest that the TARA mindfulness-based intervention in healthy adolescents is feasible and safe, and it may act to increase structural connectivity strength in interoceptive brain regions. Furthermore, these white matter changes are associated with improved adolescent sleep quality and emotional well-being. Our results suggest that TARA could be a promising fully remotely delivered intervention for improving psychological well-being in adolescents. As our findings suggest that TARA affects brain regions in healthy adolescents, which are also known to be altered during depression in adolescents, future studies will examine the effects of TARA on depressed adolescents.
本研究评估了基于神经科学的正念干预——觉察、恢复力与行动训练（TARA），对健康青少年群体大脑白质和心理健康变量的影响。
总共100名健康青少年（57名女性，年龄在14 - 18岁之间）被随机分为12周的TARA干预组或等待名单对照组。所有参与者均接受磁共振扩散成像，以量化脑区之间的白质连接性。成像在基线/随机分组时以及基线后的12周（TARA组的干预前和干预后）进行。我们假设，TARA干预后纹状体和内感受网络的结构连接性会增加，并且这种增加的连接性将与优势与困难问卷（SDQ）和失眠严重程度指数（ISI）中的心理健康指标相关。TARA干预及除磁共振成像外的所有评估均通过安全的远程医疗平台和在线电子数据采集系统完全远程进行。
TARA干预显示出高度的一致性、耐受性、安全性、招募率、保真度、依从性和保留率。12周后，TARA组而非对照组的睡眠质量也有显著改善（ = 0.02），右侧壳核节点强度的变化与这种改善的睡眠质量相关（ = -0.42， = 0.006）。同样，TARA组而非对照组的右侧脑岛节点强度显著增加，与情绪幸福感的改善相关（ = -0.31， = 0.04）。最后，我们使用基于网络的统计方法识别出一个在TARA干预后得到强化的白质内感受网络（ = 0.009）。
这些结果表明，针对健康青少年的基于TARA正念的干预是可行且安全的，它可能会增加内感受脑区的结构连接强度。此外，这些白质变化与青少年睡眠质量和情绪幸福感的改善相关。我们的结果表明，TARA可能是一种有前景的完全远程实施的干预措施，用于改善青少年的心理健康。由于我们的研究结果表明TARA会影响健康青少年的脑区，而这些脑区在青少年抑郁期间也会发生改变，未来的研究将考察TARA对抑郁青少年的影响。
