Dynamic Repertoire of Brain Networks in Mindfulness-Based Cognitive Therapy During Rumination: A Randomized Controlled Trial.

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 ( 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.