The underlying changes in biological processes that are associated with reported changes in mental and physical health in response to meditation have not been systematically explored
Alterations in Brain and Immune Function Produced by Mindfulness Meditation RICHARD J. DAVIDSON, PHD, JON KABAT-ZINN, PHD, JESSICA SCHUMACHER, MS, MELISSA ROSENKRANZ, BA, DANIEL MULLER, MD, PHD, SAKI F. SANTORELLI, EDD, FERRIS URBANOWSKI, MA, ANNE HARRINGTON, PHD, KATHERINE BONUS, MA, AND JOHN F. SHERIDAN, PHD
Objective: The underlying changes in biological processes that are associated with reported changes in mental and physical health in response to meditation have not been systematically explored. We performed a randomized, controlled study on the effects on brain and immune function of a well-known and widely used 8-week clinical training program in mindfulness meditation applied in a work environment with healthy employees. Methods: We measured brain electrical activity before and immediately after, and then 4 months after an 8-week training program in mindfulness meditation. Twenty-five subjects were tested in the meditation group. A wait-list control group (N � 16) was tested at the same points in time as the meditators. At the end of the 8-week period, subjects in both groups were vaccinated with influenza vaccine. Results: We report for the first time significant increases in left-sided anterior activation, a pattern previously associated with positive affect, in the meditators compared with the nonmedi- tators. We also found significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait-list control group. Finally, the magnitude of increase in left-sided activation predicted the magnitude of antibody titer rise to the vaccine. Conclusions: These findings demonstrate that a short program in mindfulness meditation produces demonstrable effects on brain and immune function. These findings suggest that meditation may change brain and immune function in positive ways and underscore the need for additional research. Key words: meditation, mindfulness, EEG, immune function, brain asymmetry, influenza vaccine
HIV � human immunodeficiency virus; NK � natural killer cell; EEG � electroencephalography; EOG � electrooculography; PA- NAS � Positive and Negative Affective Scale; MBSR � mindful- ness-based stress reduction; MANOVA � multivariate analysis of variance.
INTRODUCTION
With the widespread and growing use of meditative prac-tices in hospitals and academic medical centers for outpatients presenting with a range of chronic stress and pain-related disorders and chronic diseases, under the um- brella of what has come to be called mind/body or integrative medicine, the question of possible biological mechanisms by which meditation may affect somatic, cognitive, and affective processes becomes increasingly important. Research on the biological concomitants of meditation practice is sparse and has mostly focused on changes that occur during a period of meditation compared with a resting control condition in a single experimental session (1–3). Whereas these studies have been informative, they tell us little about changes that are potentially more enduring. Moreover, virtually all forms of meditation profess to alter everyday behavior, effects that are by definition not restricted to the times during which formal
meditation itself is practiced. Thus, in the current report, we focus not on the period of meditation itself, but rather on the more enduring changes that can be detected in baseline brain function as well as brain activity in response to specific emotional challenges.
We focus on emotion-related brain activity because medi- tation has been found in numerous studies to reduce anxiety and increase positive affect (4–8). In an extensive corpus of work on the functional neuroanatomical substrates of emotion and affective style, we have established that the frontal regions of the brain exhibit a specialization for certain forms of positive and negative emotion (9, 10). Left-sided activation in several anterior regions is observed during certain forms of positive emotion and in subjects with more dispositional pos- itive affect (10, 11). We therefore hypothesized that because meditation decreases anxiety and increases positive affect, subjects who were practicing meditation should show in- creased left-sided activation in these territories compared with those in a wait-list control group.
Recent studies have established that greater relative left- sided anterior activation at baseline is associated with en- hanced immune function using measures of NK activity (12, 13). There has been a paucity of serious research attention to possible immune alterations that might be produced by med- itation (14). This is somewhat surprising in light of the fact that negative psychosocial influences on immunity have now been well established (15–17). Recent research indicates that relaxation and stress management procedures increase T-cy- totoxic/suppressor (CD3�CD) lymphocytes in HIV-infected men (18). On the basis of recent research demonstrating the negative impact of stressful life events on antibody titers in response to influenza vaccine (19), we vaccinated all subjects at the end of the 8-week meditation program (in mid Novem- ber), along with the subjects in wait-list control group at the same time. We hypothesized that the meditators would show greater antibody titers in response to the vaccine compared with the subjects in the wait-list control group. On the basis of
From Laboratory for Affective Neuroscience (R.J.D., J.S., M.R.), Depart- ment of Psychology, University of Wisconsin, Madison, Wisconsin; Stress Reduction Clinic, Division of Preventive and Behavioral Medicine (J.K.-Z., S.F.S., F.U.), Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts; Departments of Medicine and Microbiol- ogy (D.M.), University of Wisconsin Medical School; Department of the History of Science (A.H.), Harvard University, Cambridge, Massachusetts; Departments of Preventive Cardiology and Sports Medicine (K.B.), Univer- sity of Wisconsin-Madison Hospitals and Clinics Center for Mindfulness, Madison, Wisconsin; and Department of Oral Biology (J.F.S.), College of Dentistry, Ohio State University, Columbus, Ohio.
Address reprint requests to: Richard J. Davidson, PhD, Laboratory for Affective Neuroscience, University of Wisconsin, 1202 W. Johnson St., Madison, WI 53706. Email: rjdavids@facstaff.wisc.edu
Received for publication April 4, 2002; revision received December 27, 2002.
DOI: 10.1097/01.PSY.0000077505.67574.E3
564 Psychosomatic Medicine 65:564–570 (2003) 0033-3174/03/6504-0564 Copyright © 2003 by the American Psychosomatic Society
the association we have previously reported between anterior activation asymmetry and NK activity, we also predicted that the magnitude of change toward greater relative left-sided activation would be associated with a larger increase in anti- body titers in response to the vaccine.
METHODS Measures of brain electrical activity were recorded before random assign-
ment to each of the two groups (Time 1) and then again immediately after (Time 2) and four months after (Time 3) the training period ended. Brain electrical activity, or EEG, and EOG (for correcting EEG for eye movements) was recorded during both baseline conditions and in response to a positive and negative emotion induction using methods that have been extensively de- scribed in previous research (20, 21). EEG was recorded from 27 sites distributed across the scalp and referenced to linked ears during 8 1-minute baseline trials, four with eyes open and four with eyes closed, presented in counterbalanced order according to our established procedures (22). EEG was also recorded during a 1-minute period before and a 3-minute period after subjects wrote about one of three of the most positive and negative experi- ences in their life. These events were listed on a questionnaire administered to subjects before the start of the entire protocol. For this task, the EEG was aggregated across the 1-minute period before and the 3-minute period after the writing itself. Data were not collected during writing because of movement artifact. The EEG was parsed into 1.024-second epochs, overlapped by 50% and then processed with the use of a fast Hartley transform method to derive measures of spectral power density in the �-band (8–13 Hz), which is inversely related to activation (20, 22). Asymmetric activation was indexed using an asymmetry score that is computed by subtracting log-transformed left hemisphere �-power densities from the comparable measure derived from homologous right-sided electrodes.
After each of the writing periods, subjects were given the PANAS (23) in state form. In addition, at each assessment, they were administered the PANAS in trait form, along with the Spielberger State-Trait Anxiety Inven- tory (24) in trait form. In addition, subjects in the meditation group were asked to provide daily reports of the frequency and number of minutes and tech- niques of formal meditation practice.
Blood draws were then obtained at 3 to 5 weeks and then again at 8 to 9 weeks after vaccination to examine antibody titers in response to the vaccine using the hemagglutination inhibition assay (19).
A total of 48 right-handed subjects who were employees of a biotechnol- ogy corporation in Madison, Wisconsin, were recruited to participate. Of these, 41 subjects completed some of the measures for at least two of the assessments. The initial laboratory evaluation was conducted before random group assignment. Subjects were then randomly assigned to the meditation group (N � 25; 19 female) and the wait-list control group (N � 16; 10 female) at a ratio of approximately 3:2. There were no differences between groups in the number of subjects who failed to complete the study. Average age of subjects was 36 years and did not differ between group (range � 23 to 56 years). All but two subjects were white (one Asian-American in the…
