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Systematic Review of the Efficacy of Mindfulness-Based Interventions as a Form of Neuropsychological Rehabilitation

Abstract

Objectives

The current study presents a systematic review of the evidence for mindfulness-based interventions (MBIs) as a form of neuropsychological rehabilitation, a holistic approach to treatment that may be particularly well suited to persons with neurological illness and injury.

Methods

Following the PRISMA guidelines for systematic reviews, we included controlled trials of MBIs conducted in a neurological population, specifically employing the practice of mindfulness meditation. A search protocol for CINAHL Complete, Cochrane Central Register of Controlled Trials, MEDLINE with Full Text, PsycINFO, and PubMed was executed by three of the authors in September 2019 to promote reliability and obtain the initial list of abstracts (n = 32). Two authors independently reviewed and extracted data from each of the final 32 articles.

Results

The most frequent diagnoses of interest were various forms of late-life cognitive decline and ADHD, followed by acquired brain injury, multiple sclerosis, Parkinson’s disease, and epilepsy. Most trials assessing psychological variables found significant benefits of MBIs across various symptoms, including fatigue, self-reported cognitive function, and specific neurological symptoms. Most studies investigating cognitive and/or neural outcomes found significant benefits as well. Positive findings were evident across different patient populations.

Conclusions

There is promising evidence to support the application of MBIs for the amelioration of clinical-neuropsychological symptoms in the neurorehabilitation context, particularly for persons with ADHD and late-life cognitive decline. Further work is needed to clarify the importance of tailoring, as well as whether taking a transdiagnostic approach to symptoms would enhance the capacity to measure significant effects.

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Authors

Contributions

CMS: conceptualized the systematic review, contributed to the generation of the automated search protocol, independently conducted the automated search protocol and manual retrieval of relevant primary source articles, contributed to the selection of the final sample of eligible source articles, performed study quality ratings for a portion of said source articles (with the exception of those she co-authored), and wrote the bulk of the paper. JIA: contributed to the generation of the automated search protocol, independently conducted the automated search protocol, contributed to the extraction of data from candidate articles, contributed to the selection of the final sample of eligible source articles, performed study quality ratings for a portion of said source articles, and contributed to the revisions for this paper. KS: contributed to the generation of the automated search protocol, independently conducted the automated search protocol, contributed to the extraction of data from candidate articles, contributed to the selection of the final sample of eligible source articles, performed study quality ratings for a portion of said source articles, and contributed to the revisions for this paper. JV: contributed to the generation of the automated search protocol, independently conducted the automated search protocol, contributed to the extraction of data from candidate articles, contributed to the selection of the final sample of eligible source articles, and performed study quality ratings for a portion of said source articles.

Corresponding author

Correspondence to Colette M. Smart.

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Ethics approval

As a secondary analysis of previously published work, the current systematic review was not considered to require an institutional ethics review. Given that the referenced articles, Smart et al. (2016) and Smart and Segalowitz (2017), were performed by the first author, we may attest that all procedures performed for these studies were in accordance with the ethical standards of the institution and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The remaining referenced articles each reported that institutional ethical approval was obtained for their study.

Conflict of Interest

The first author has a book that has recently come out that is based on two articles referenced in this review (Smart & Segalowitz, 2017; Smart et al., 2016). The book involves the publication of the mindfulness treatment manual used in these studies. Because of this potential conflict, all study quality ratings for the systematic review were done blind to the first author and completed by the other three authors.

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Smart, C.M., Ali, J.I., Viczko, J. et al. Systematic Review of the Efficacy of Mindfulness-Based Interventions as a Form of Neuropsychological Rehabilitation. Mindfulness 13, 301–317 (2022). https://doi.org/10.1007/s12671-021-01779-2

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Keyword

  • Mindfulness; Brain injury; Stroke; Dementia; ADHD; Rehabilitation