First Ever Meta-Analysis Supports the Effectiveness of Mindfulness-Based Interventions for Chronic Concussion Symptoms
For those not familiar with the term, a “meta-analysis” is a quantitative, formal, epidemiological study design used to systematically assess the results of previous research to derive conclusions about that body of research. Dr. Rebecca Acabchuk and her team at UConn’s Institute for Collaboration on Health, Intervention and Policy (InCHIP) have just published the first ever systematic review and meta-analysis on the “Therapeutic Effects of Meditation, Yoga and Mindfulness-Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury,” in Applied Psychology: Health and Well-Being, the journal of the International Association of Applied Psychology.
This topic was first introduced in this blog in 2014 and touched on more recently in our review of a Dartmouth study documenting the effectiveness of the “Love your Brain” Yoga program started by Vermont’s snowboarding celebrity Kevin Peace (who was recently featured as the key-note speaker at the annual Vermont Brain Association conference.) In our 2014 blog post, we featured a study in the Journal of Head Trauma Rehabilitation that supported the effectiveness of mindfulness-based practices on improving symptoms, including depression, following traumatic brain injury. One explanation offered in that study was that these practices help improve acceptance and awareness “thereby minimizing the catastrophic assessment of symptoms” associated with traumatic brain injury (TBI) and chronic disability. The Dartmouth study offered further support for this analysis.
The Acabchuk meta-analysis systematically assessed data from 20 studies. The results revealed significant improvements compared to controls in all measured symptoms, with the greatest improvements seen in fatigue, depression and quality of life. The literature review offered an anatomical explanation for the effectiveness of mindfulness based interventions – the brain regions typically affected by mild traumatic brain injury (e.g. frontal, parietal, white matter tracks) overlap markedly with the brain regions that are bolstered by mindfulness-based stress reduction and mindfulness-based cognitive therapy. Difficulties with emotion regulation in mild traumatic brain injury have been linked to impaired function in the default mode and executive networks also impacted in mindfulness-based interventions.
The results in the meta-analysis were surprisingly consistent, given the number of studies, the small sample sizes, the array of mindfulness-based treatments and the control group sizes. These consistent findings lead the authors to recommend further trials with particular emphasis on repeated concussion, on youth and adolescents and on long-term follow up. The authors also encourage studies focusing on the impact of these interventions on sleep, particularly in light of growing research that concussion can cause impairments in normal wake/sleep cycles, which can increase the risk of comorbid disease.
For full disclosure purposes, the author of this blog has for several years taught yoga and promoted mindfulness based interventions to support recovery from TBI as well as other injuries and illnesses. The growing research replaces intuition with science in validating the effectiveness of this work.