BACKGROUND: Depression is a prevalent and debilitating affective disorder characterized by the dominance and persistence of depressive rumination. Mindfulness-based cognitive therapy (MBCT) is an effective treatment for recurrent depression developed specifically to target rumination and recurrence risk by training metacognitive awareness and adaptive attention, emotion, and self-regulation skills. However, the underlying mechanisms by which mindfulness training impacts maladaptive depressive rumination are not well understood, and a deeper understanding of its effects on the complex brain dynamics during depressive rumination is needed. METHODS: In a randomized controlled functional magnetic resonance imaging (fMRI) study (N = 80), we examined dynamic neural changes during resting-state fMRI of an experimentally induced rumination state before and after treatment with MBCT (n = 27) for recurrent depression in addition to treatment as usual (TAU) or TAU alone (n = 21). More specifically, we characterized the changes during a depressive rumination state as a repertoire of metastable substates, each with an occurrence frequency (fractional occupancy) and stability (lifetimes). RESULTS: We found that MBCT training compared with TAU altered the fractional occupancy of a salience-somatomotor metastable substate during the depressive rumination state. These dynamic network changes in turn were associated with reduced trait rumination posttreatment and reduced depressive symptoms at the 3-month follow-up. CONCLUSIONS: In a ruminative state, changes in the dynamics of the somatosensory-salience network following mindfulness training was associated with improved clinical outcomes and reduced trait rumination, which may provide insight into candidate brain mechanisms or markers of treatment response to MBCT.
Journal article
2026-09-01T00:00:00+00:00
6
Depression, Dynamic brain connectivity, Mechanisms, Mindfulness, Rumination