Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Neuropsychiatry

Objective: to detect changes in resting state network RSN in opiate dependent patients receiving mindfulness based therapy (MBT) during their first month of treatment. Method: Data from 32 patients assigned to MBT or treatments as usual (TAU) groups which were investigated by means of resting-state functional MRI at 1.5 Tesla before and after treatment. Independent component analysis (ICA) was used to investigate distinct subsystems of the default mode network (DMN). Brain activity changes after treatment were related to clinically relevant measures such as impulsivity, distress tolerance and mindfulness. Results: Between groups comparisons showed increased mindfulness scores in MBT compared to TAU group posttreatment, which was correlated with a pattern of decreased left superior frontal, left anterior cingulate ACC (p=0.007), right inferior parietal lobule (p=0.02) activity in MBT compared to TAU (p<0.05 cluster-corrected). Within the MBT group, distinct changes were detected over time: an activity decrease was found in right superior frontal cortex. Superior frontal cortical activity showed significant relationship with mindfulness (p=0.032), while within TAU group changes showed; decreased striatal and hippocampal activity and an increased tempro-insular activity with significant correlation to distress tolerance (p=0.044). Conclusion: MBT can be particularly useful during early abstinence from opiate dependence and induces distinct functional connectivity changes that can be detected during restful non meditative states. Distinct changes in DMN connectivity at rest can be clinically related to mindfulness

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