About 60 neurologists crowded (standing room only) around a small stage at the recent AAN meeting to learn about meditation—something that just a few years ago many would have dismissed as decidedly woowoo.
Not only would they stay for the lecture, Meditation for the Practicing Neurologist, they would also stick around and participate in the 20-minute guided meditation that followed. The speaker was Sarah Mulukutla, MD, MPH, a neurologist and long-time meditator from Stamford, Connecticut. Her session was part of the international meeting’s Live Well program designed to provide wellness solutions to neurologists—a group that suffers from particularly low work-life balance among physicians.
Whether the attendees were there for themselves or to see what meditation might do for their patients, they were presented with some pretty convincing science. Though for some, the ease and serenity with which Mulukutla handled the audiovisual blunders at the beginning of her talk was enough to convince them of meditation’s validity.
Mulukutla defined meditation as a practice of self-reflective mental training to quiet the mind. Some prefer the term mindfulness training over meditation. The benefits of this practice have been studied by the scientific community in earnest for the last decade. An article published by the American Psychological Association provides a good survey of research and includes the following benefits of the practice:
- Reduced Rumination
- Stress Reduction
- Boosts working memory
- More cognitive flexibility
- Relationship satisfaction.
According to Mulukutla, much of the research on meditation points to an area of the brain called the default mode network (DMN). A 2016 study published in the Yale Journal of Biology and Medicine says:
“The DMN includes brain regions with high degrees of functional connectivity and is active in the brain at rest, but becomes deactivated when task performance is initiated.”
In other words, Mulukutla said the DMN is where mind wandering happens. “It’s where we think about ourselves and our lives. It was discovered on fMRI when patients were asked to just hang out.” In the world of meditation Mulukutla said this internal chatter and rumination is called the monkey mind. People spend about two-thirds of their time in a state of mind wandering. And research suggests that the kind of self-reflection that happens as a result is associated with increased activity in the DMN. This has been linked to depression, anxiety, and addiction.
Mulukutla referenced Judson Brewer, who has studied long-term meditators and found they are better at suppressing this internal chatter and may even develop more diffuse networks in the DMN. In a 2015 study, Judson Brewer showed that meditation reduced DMN activity beyond the usual suppression that happens when doing an active task. He and others say the seat of this activity can be further narrowed to the posterior cingulate cortex.
The significance of the DMN and neurological disease is increasingly under study. Authors from this 2016 study give an overview of DMN activity and its relationship to neurological disorders, including Alzheimer’s disease, Parkinson’s disease, and epilepsy.
Researchers are not only seeing changes in activity level on fMRI, they are also seeing that “long-term meditators have structural differences in both gray and white matter.” Mulukutla said, “Over time, certain parts of the brain either get thicker or maintain thickness. One study showed changes after just eight weeks of meditation.”
Mulukutla says the evidence is consistently showing the same areas of the brain to have neuroplastic changes as a result of meditation practice. “It is pretty convincing, and if this is true, it is going to become part of our treatment paradigm for preventing cognitive decline.”
In a 2013 proof-of-concept study, Rebecca Wells and her colleagues found adults with mild cognitive impairment could safely participate and adhere to a mindfulness-based stress reduction program. In addition to enjoying the program, participants had improved well-being and interpersonal skills, and decreased stress reactivity.
The science of meditation continues to evolve, and whether it has convinced you yet to start meditating yourself or suggesting it to your patients, it is certainly worthy of taking notice. It doesn’t appear to hurt, and if the smiles and peaceful carriage of all those attendees following Mulukutla’s after-lecture practice are an indicator, it can be quite enjoyable—woowoo or not, that is certainly worth something.