The impact of an app-delivered mindfulness-based intervention on resting-state functional connectivity in pediatric concussion: a pilot study

Abstract

Rationale Concussion disrupts brain connectivity, and effective treatments remain limited. Mindfulness-based interventions (MBIs) may influence functional connectivity (FC) of networks affected by concussion, but pediatric trials are lacking. This study investigated whether an app-delivered MBI produced greater FC changes than a sham condition across the default mode (DMN), salience (SN), and central executive (CEN) networks. Methods This randomized clinical trial (NCT05105802) recruited participants aged 12.00–17.99 years from the emergency department or interdisciplinary concussion clinic, then randomly assigned them to MBI or cognitive sham. Brain imaging sessions occurred at 72 h and 4 weeks post-concussion. Region-of-interest and seed-to-voxel analyses examined Group × Time interactions in FC across DMN, SN, and CEN (p < 0.050FDR). Results Thirty-six participants were included (MBI: n = 16, median [IQR] age = 14.23 [13.52–15.65] years, 31% female; Sham: n = 20, median [IQR] age = 14.05 [13.13–16.26] years, 45% female). Intention-to-treat analyses revealed significant Group × Time interactions across networks. DMN-CEN FC patterns differed, with MBI participants showing diminished FC. Within DMN, four clusters showed significant interactions (p < 0.050FDR), three exhibiting larger FC reductions at 4 weeks in MBI participants. MBI participants showed greater FC increase in one SN cluster (p = 0.040FDR) and larger FC decrease in one CEN cluster (p = 0.024FDR) at 4 weeks. Per-protocol analyses identified one significant DMN cluster (p < 0.001FDR) where MBI participants exhibited greater FC increases. Conclusion Mindfulness-based intervention training led to changes in FC in networks implicated in concussion recovery. Larger studies are needed to support these findings. Clinical trial registration https://clinicaltrials.gov/study/NCT05105802, identifier NCT05105802.