The impact of an app-delivered mindfulness-based intervention on resting-state functional connectivity in pediatric
Olivier Brown1,2, Andra Smith2,3, Molly Cairncross4,5,6
1Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
Rationale:
Concussion disrupts brain connectivity, and effective treatments remain limited. Mindfulness-based interventions (MBIs) may influence functional connectivity (FC) of networks affected by concussion, but pediatric trials are lacking. This study investigated whether an app-delivered MBI produced greater FC changes than a sham condition across the default mode (DMN), salience (SN), and central executive (CEN) networks.
Methods:
This randomized clinical trial (NCT05105802) recruited participants aged 12.00-17.99 years from the emergency department or interdisciplinary concussion clinic, then randomly assigned them to MBI or cognitive sham. Brain imaging sessions occurred at 72 h and 4 weeks post-concussion. Region-of-interest and seed-to-voxel analyses examined Group × Time interactions in FC across DMN, SN, and CEN (p < 0.050 FDR ).
Results:
Thirty-six participants were included (MBI: n = 16, median [IQR] age = 14.23 [13.52-15.65] years, 31% female; Sham: n = 20, median [IQR] age = 14.05 [13.13-16.26] years, 45% female). Intention-to-treat analyses revealed significant Group × Time interactions across networks. DMN-CEN FC patterns differed, with MBI participants showing diminished FC. Within DMN, four clusters showed significant interactions (p < 0.050 FDR ), three exhibiting larger FC reductions at 4 weeks in MBI participants. MBI participants showed greater FC increase in one SN cluster (p = 0.040 FDR ) and larger FC decrease in one CEN cluster (p = 0.024 FDR ) at 4 weeks. Per-protocol analyses identified one significant DMN cluster (p < 0.001 FDR ) where MBI participants exhibited greater FC increases.
Conclusion:
Mindfulness-based intervention training led to changes in FC in networks implicated in concussion recovery. Larger studies are needed to support these findings.
Clinical Trial Registration:
https://clinicaltrials.gov/study/NCT05105802, identifier NCT05105802.
