Clinical Neurology and Neurosurgery 115 (2013) 2419–2425 Contents lists available at ScienceDirect Clinical Neurology and Neurosurgery jou rn al h om epage: www.elsevier.com/locate/clineuro Review Mindfulness based intervention in Parkinson’s disease leads to structural brain changes on MRI A randomized controlled longitudinal trial Barbara A. Pickut a,b,g,h,∗ , Wim Van Hecke a,c , Eric Kerckhofs d , Peter Mariën e,g , Sven Vanneste a , Patrick Cras a,b,h , Paul M. Parizel a,f a University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Belgium b Department of Neurology, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium c icoMetrix, Tervuursesteenweg 244, B-3001 Leuven, Belgium d Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium e Department of Clinical and Experimental Neurolinguistics, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium f Department of Radiology, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium g Department of Neurology and Memory Clinic, Ziekenhuis Netwerk Antwerp, Lindendreef 1, B-2020 Antwerp, Belgium h Born Bunge Institute, Universiteitsplein 1, B-2610 Wilrijk, Belgium a r t i c l e i n f o Article history: Received 28 June 2013 Received in revised form 4 September 2013 Accepted 2 October 2013 Available online 16 October 2013 Keywords: Parkinson’s disease Magnetic resonance imaging Gray matter density Mindfulness based intervention Mindfulness based stress reduction a b s t r a c t Objective: The aim of the current study is to investigate structural changes on brain MRI using voxel based morphometry (VBM) related to an eight-week mindfulness based intervention (MBI) in Parkinson’s Disease (PD). Methods: A total of 27 out of 30 PD patients completed a randomized controlled longitudinal trial. Four- teen patients participated in a structured eight-week program of MBI. Thirteen patients received usual care (UC) alone. MRI data sets of the brain were obtained at baseline and after eight weeks follow-up. VBM analysis was performed using DARTEL from the SPM8 software. The resulting difference maps were sta- tistically compared to examine gray matter density (GMD) differences. Results were reported at p < 0.001, uncorrected for multiple comparisons. Results: Increased GMD was found in the MBI compared to the UC group in the region of interest (ROI) analysis in the right amygdala, and bilaterally in the hippocampus. Whole brain analysis showed increased GMD in the left and right caudate nucleus, the left occipital lobe at the lingual gyrus and cuneus, the left thalamus, and bilaterally in the temporo-parietal junction. In contrast, GMD differences were found in the UC group in the left anterior lobe and dentate nucleus of the cerebellum. Conclusions: To the best of our knowledge this is the first quantitative analysis of neurobiological effects of MBI in PD. Increased GMD was found in the MBI group in the neural networks that have been postulated to play an important role in PD. These areas have also been implicated in the functional networks mediating the benefits of meditation. © 2013 Elsevier B.V. All rights reserved. Contents 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2420 2. Materials and methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2420 2.1. Study participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2420 2.2. Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2421 2.3. MRI data acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2421 2.4. MRI data analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2421 ∗ Corresponding author at: University Hospital Antwerp, Department of Neurology, Wilrijkstraat 10, B-2650 Edegem, Belgium. Tel.: +32 3 821 52 12; fax: +32 3 821 43 12. E-mail addresses: barbara.pickut@ua.ac.be, pickut@telenet.be (B.A. Pickut). 0303-8467/$ – see front matter © 2013 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.clineuro.2013.10.002