A pilot and feasibility study evaluating the mechanisms and outcomes of neurofeedback-assisted mindfulness meditation training

Abstract

BACKGROUND: Neurofeedback (NF) has been used for cognitive optimization in non-clinical populations and for therapeutic and rehabilitative purposes in clinical populations, as have mindfulness meditation (MM) training programs. Recent commercial and clinical applications include using NF to help support novice mindfulness meditators in their meditative training. The premise is that NF may help novices learn to meditate more quickly and effectively by providing objective feedback on their brain state during practice. The untested assumption is that novice meditators will therefore also gain desirable cognitive, emotional, and health benefits associated with MM training more quickly, effectively, or perhaps even more robustly. Both NF and MM techniques centrally involve training attention and self-regulation abilities, suggesting some neural mechanistic overlap that could be capitalized on in their combination. However, which aspects of training benefit from, or otherwise interact with the addition of NF with MM practice, and through what psychological (e.g., motivation, expectancy, training experiences) or neurocognitive (e.g., attention, meta-awareness, executive functions) mechanisms, are important questions yet to be investigated by well-controlled studies.

OBJECTIVES: Broadly, the aims of this dissertation project were to: (1) create a feasible MM+NF training protocol to evaluate against MM alone, (2) evaluate which neurocognitive domains of function involved in MM training are enhanced (or interfered with) by adjunctive NF, and (3) understand the psychological or neural mechanisms driving any additional improvements in skill or well-being resulting from MM+NF training compared to MM alone.

METHODS: A sample of emerging adults (n = 28) with no prior meditation experience were randomly assigned to either a MM-Only, MM+NF, or MM+Sham NF in-lab training condition. The meditation training was for 8 consecutive days, alternating in days between in-lab experimentally assigned meditation condition and at-home practice of a 20-minute breath-focused concentrative mindfulness meditation. A multimethod approach was employed for evaluating participant experiences and outcomes that involved electroencephalographic (EEG) recordings, neurocognitive tests, and self-report measures.

RESULTS: Training conditions were highly comparable across all key efficacy, mechanism, and experiential outcome measures. All groups similarly improved in self-reported psychological wellness and cognitive outcomes across training, with effects largely sustained at a 10-day follow-up. For neurocognitive testing, groups were also comparable in performance. All training conditions showed increased speed and accuracy, concomitant with higher intraindividual variability of reaction times post-training. No EEG changes were found in pre/post resting state recordings or for in-lab meditations recorded across training.

CONCLUSIONS: Results support feasibility of the study design and acceptability of the training procedures. MM training was not significantly improved or worsened with the integration of real and sham NF. However, the final sample size was underpowered to adequately delineate medium-to-small effect sizes for primary efficacy and mechanistic measures. The strengths and limitations of this study offer guidance and recommendations for future work aimed at studying or developing NF-assisted meditation training procedures and protocols.