Influence of mindfulness meditation on intracranial EEG parameters in epileptic and non-epileptic brain areas.

Objective: Mind-wandering is a pervasive human brain state and, when in excess, may promote negative affect and neuropsychiatric conditions. Mindfulness meditation may promote alternate brain states, improving affect and reducing stress. An understanding of the neural basis between these brain states could thus advance treatment of neuropsychiatric conditions, including those associated with epilepsy.

Methods: To explore the neural basis of mindfulness meditation versus mind-wandering, we enrolled eight patients in a trial of structured mindfulness meditation and open mind-wandering who underwent stereo electroencephalography (sEEG) within the mesial temporal lobe for seizure localization. Electrophysiology was compared between mind-wandering and mindfulness separately for epileptic and non-epileptic MTL. Using fitting-one-over-f modeling, periodic components of electrophysiology were compared in canonical frequency bands of theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz), and gamma (30-55 Hz). Aperiodic components of the power spectra were assessed by the model offset, knee, and exponent.

Results: We found a significant reduction in gamma power (30-55 Hz) within the mesial temporal lobe (MTL) during mindfulness meditation compared with mind-wandering in non-epileptic (p = 1.20E-4) but not in epileptic MTL (p = 0.352).There was also a significant difference between epileptic versus non-epileptic MTL in gamma power between conditions (p = 0.011). There were no significant changes in power across any frequency band within epileptic mesial temporal MTL between brain states. Conversely, there were significant differences between mind-wandering and mindfulness within epileptic MTL in aperiodic components (offset, knee, and exponent, all p < 0.05), while no differences in aperiodic components were seen in non-epileptic MTL (all p > 0.70).

Significance: Intracranial electrophysiologic modulations between brain state (mind-wandering versus mindfulness) may differ between epileptic and non-epileptic MTL. Modulations in gamma activity in non-epileptic MTL may represent functional changes in brain state, while aperiodic changes in epileptic MTL may modulate propensity for seizures.