Children born very prematurely, defined as under 32 weeks gestational age, are at a greater risk for developing a wide spectrum of disorders including ADHD, autistic spectrum, and anxiety disorders. Functional connectivity is a measure of the degree to which large-scale brain networks synchronize their activity.

From birth through adulthood, children born very prematurely often show atypical functional connectivity patterns, which are associated with problems in cognitive and emotional functioning. Since mindfulness-based interventions (MBIs) can improve executive cognitive function and emotional regulation in some samples, MBIs may benefit children born very prematurely. 

Siffredi et al. [Psychiatry and Clinical Neuroscience] studied the effects of a MBI on neurobehavioral and functional connectivity measures in young adolescents born very prematurely, comparing them to an independent cohort of adolescents born full term.

The researchers enrolled 63 young Swiss adolescents (average age=12 years; 56% female) born very prematurely in an 8-week mindfulness program modeled after Mindfulness-Based Stress Reduction (MBSR) but modified for younger adolescents. Weekly in-person group MBI sessions were 90 minutes long, and meditations were brief (2-10 minutes) and guided by trained mindfulness teachers. 

Participants completed neurobehavioral assessments before and after intervention, and 39 of the participants also underwent functional magnetic resonance imaging (fMRI) before and after the intervention. A comparison group of 24 young adolescents born full term (average age=12 years; 38% female) also underwent neurobehavioral assessments and fMRI scanning but did not participate in the MBI.

Neurobehavioral assessments included self-rated and parent-rated questionnaires and computerized tasks measuring executive and socio-emotional functioning. fMRIs assessed resting-state dynamic brain functional connectivity: the ways in which correlations and anticorrelations between large-scale brain networks changed over time.

The results found the prematurely born cohort had significantly greater scores for executive and behavioral difficulties on parent-report questionnaires than full-term adolescents at baseline. Parents in the MBI group reported significantly improved executive function, metacognition, and behavioral regulation scores over time. Score improvements were correlated with longer activations in the frontolimbic and amygdala-hippocampus self-regulation networks, dorsolateral prefrontal attentional control network, and visual networks related to attention to relevant stimuli.

There was no evidence that score improvements were associated with functional connectivity changes between large-scale brain systems.

This study reports that a MBI reduces parental ratings of behavioral problems in adolescents who were born very prematurely. These improvements in parental ratings are correlated with longer activation times in brain networks associated with attentional control and emotional regulation.

The study is limited by the absence of a comparator group that also underwent a MBI. All significant between-group differences and MBI-associated changes were at the level of self- and parent-report, and not on objective neuropsychological measures. Thus, some or all the improvement in parental-ratings may be due to expectancy bias.

Reference:

Siffredi, V., Liverani, M. C., Fernandez, N., Freitas, L. G. A., Borradori Tolsa, C., Van De Ville, D., Hüppi, P. S., & Ha-Vinh Leuchter, R. (2024). Impact of a mindfulness-based intervention on neurobehavioral functioning and its association with large-scale brain networks in preterm young adolescents. Psychiatry and Clinical Neurosciences.

Link to study