Neurobiological Changes Induced by Mindfulness and Meditation: A Systematic Review

Meditation is a mental practice focused on cultivating present-moment awareness and emotional control, historically rooted in Buddhist, Hindu, and Taoist traditions but widely adopted in modern health and personal development. Mindfulness meditation, emphasizing non-judgmental awareness of thoughts, emotions, and bodily sensations, is associated with reduced stress, anxiety, and depression, improved emotional stability, and resilience. Various techniques (e.g., mindfulness, Transcendental Meditation, Zen, loving-kindness, body scan) offer distinct pathways to well-being. The research question guiding this systematic review is to synthesize evidence on neurobiological changes linked to mindfulness and meditation practices, including structural and functional brain alterations, neurotransmitter and hormonal modulation, and their relevance to mental health, pain, and neurorehabilitation. The purpose is to integrate findings across neuroimaging, electrophysiology, and biomarker studies to clarify mechanisms and clinical implications, highlighting the importance of these practices for improving emotional regulation, cognitive function, and stress resilience.

Prior literature indicates mindfulness practice induces neuroplasticity, including increased cortical thickness particularly in prefrontal and anterior cingulate cortices, decreased amygdala size and reactivity, and altered default mode network activity and connectivity. Functional changes include reduced mind-wandering and rumination, improved emotional processing, and strengthened self-regulation. Neurochemical evidence links mindfulness to increased GABA levels, enhanced serotonin, elevated BDNF, and reduced cortisol, supporting improved mood, decreased anxiety, and stress modulation. Behavioral and social findings include superior pain reduction versus placebo, improved coping, and increased inter-brain synchrony during social interactions, suggesting enhanced empathy and emotional regulation. Applications extend to addiction treatment (e.g., smoking cessation), chronic disease management (e.g., multiple sclerosis), and diverse clinical contexts, although effects on physiological markers like cortisol and on impulsivity show mixed outcomes in the literature. MBSR, an 8-week structured program, is the most researched intervention, demonstrating reductions in stress, anxiety, depression, pain, and positive changes in brain structure/function and psychological well-being.

A comprehensive search was conducted in PubMed, Web of Science, Cochrane Library, and Embase using keywords: Mindfulness AND Neurobiological correlates, without time limits. The review followed PRISMA guidelines and was registered on OSF (GV2JY). PICO framework: Population—individuals engaging in mindfulness/meditation (including MBSR) across clinical and nonclinical groups; Intervention—mindfulness/meditation practices; Comparison—non-mindfulness, standard care, or other interventions; Outcomes—neurobiological changes assessed via neuroimaging (fMRI, MRI), electrophysiology (EEG), and biomarkers (neurotransmitters, cortical thickness). Inclusion criteria: English-language human studies (original/protocol) describing neurobiological changes associated with mindfulness/meditation, including functional assessments. Exclusion criteria: insufficient neurobiological data, reviews (though references screened), non-English. PRISMA counts: 151 records identified (PubMed 40; Web of Science 32; Cochrane 57; Embase 22); 40 duplicates removed; 0 non-English excluded; 111 titles/abstracts screened; 79 excluded by title, 4 by abstract; 28 full-texts assessed; 6 excluded for inadequate/missing data; 13 excluded for inadequate study design; 9 studies included. Multiple expert teams independently screened and resolved discrepancies.

Across nine studies, mindfulness and meditation practices were associated with distinct neurobiological and psychological outcomes: (1) MBSR increased cortical thickness in the right insula and somatosensory cortex in meditation-naïve adults and decreased worry, state anxiety, depression, and alexithymia, with insula thickness correlating with reduced alexithymia (Santarnecchi et al., 2014; n=23; 8 weeks). (2) Mindfulness meditation reduced pain intensity and unpleasantness more than placebo and sham conditions, engaging orbitofrontal, subgenual anterior cingulate, and anterior insular cortices; placebo effects implicated sensory regions and dorsolateral prefrontal cortex (Zeidan et al., 2015; n=75; 4 arms; fMRI; p<0.05). (3) App-based mindfulness training decreased posterior cingulate cortex reactivity to smoking cues, predicting reduced cigarette consumption, with a stronger association in women (Janes et al., 2019; n=67; 33 MT vs 34 control; fMRI). (4) An 8-week mindfulness intervention did not reduce impulsivity or alter neural correlates relative to controls; long-term meditators (n=31) exhibited lower attentional but higher motor and non-planning impulsivity, reduced striatal gray matter, higher cortico-striatal-thalamic connectivity, and lower spontaneous eye-blink rate compared to meditation-naïve participants (Korponay et al., 2019; n=105 naïve + 31 long-term). (5) In multiple sclerosis, MBSR improved behavioral outcomes and increased right hippocampus head volume; higher inflammatory gene expression (CTRA) correlated with worse anxiety, depression, stress, loneliness, and lower eudaimonic well-being; hair cortisol showed no pre-post change (Hemond et al., 2024; n=23; 8 weeks). (6) A 4-week abbreviated MBSR course led to significant reductions in back pain and somatic-affective depression and increased frontal lobe hemodynamic activity related to emotional awareness; both MBSR and control improved overall depression, but MBSR had unique benefits (Braden et al., 2016; n=23; 12 MBSR vs 11 control). (7) During Acem meditation, repeating a meditation sound elicited greater bilateral inferior frontal gyrus (BA47) activation than concentrative control tasks, with activation increasing across continuous bouts (Davanger et al., 2010; n=4 advanced male practitioners; fMRI). (8) Personality traits modulated sgACC/vmPFC metabolism: harm avoidance negatively correlated while self-transcendence positively correlated with glucose metabolism; high HA + high ST exhibited metabolism comparable to low-scorers (Hakamata et al., 2013; n=140; PET; TCI). (9) In naturalistic social interactions, trait mindful awareness predicted increased dyadic inter-brain synchrony in theta (~5–8 Hz) and beta (~26–27 Hz) bands but did not replicate prior lab-based individual brain response findings (Chen et al., 2022; n=379 individuals; 62 dyads; EEG). Overall, MBSR and mindfulness practices enhance brain regions for emotional processing and sensory perception, improve anxiety and depression, and demonstrate unique analgesic mechanisms independent of placebo.

The findings address the core question of how mindfulness and meditation influence neurobiology by demonstrating structural changes (e.g., increased cortical thickness in the insula and somatosensory cortex), functional alterations (distinct pain modulation via orbitofrontal and cingulate circuits, reduced PCC reactivity to addiction cues), and psychosocial effects (improved anxiety/depression, enhanced inter-brain synchrony). These neurobiological adaptations support improved emotional regulation, cognitive control, and stress resilience, reinforcing the clinical utility of MBSR and related practices. In neurorehabilitation, enhanced interoceptive and sensory processing, pain modulation independent of placebo, and strengthened connectivity in networks related to self-regulation and executive function may facilitate recovery in conditions such as stroke, traumatic brain injury, and multiple sclerosis. Mixed findings on impulsivity highlight heterogeneity across populations and practice duration. Naturalistic EEG evidence suggests mindfulness may bolster interpersonal neural coupling, indicating broader social and communication benefits. Collectively, the results suggest mindfulness interventions can be integrated into multidisciplinary care to address pain, mood, and cognitive-emotional regulation, with neuroimaging and biomarker changes serving as mechanistic indicators.

This systematic review identifies consistent neurobiological and psychological benefits of mindfulness and meditation, particularly MBSR, including increased cortical thickness in regions critical for emotion regulation and sensory processing, distinct analgesic mechanisms, reduced anxiety and depression, and enhanced stress resilience. Connectivity changes and neurotransmitter/hormonal modulation further support improved mood and cognitive functioning. Future research should employ diverse samples and settings, compare short- versus long-term practice, and integrate advanced multimodal neuroimaging and electrophysiology to elucidate mechanisms. Studies in naturalistic and culturally varied contexts, and trials optimized for different clinical populations, are needed to refine intervention delivery, enhance generalizability, and maximize clinical efficacy.

Heterogeneity in study designs, populations, and methodologies limits integrative synthesis and generalizability. Several studies have small sample sizes, and differences between short-term and long-term mindfulness practice complicate interpretation. Effects on impulsivity and certain physiological measures (e.g., cortisol) are inconsistent. The English-only inclusion criterion may have excluded relevant non-English studies, reducing comprehensiveness. Use of commercially available EEG systems in naturalistic settings introduces methodological constraints. These factors collectively temper the certainty of conclusions and underscore the need for larger, standardized, and diverse studies.