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Effect of app-based mindfulness on extinction recall – a 7T-fMRI study

Björkstrand, Johannes LU ; Olsson, Emil LU ; Clancy, Oisin Hugh LU ; Möller, Stefan LU orcid ; Björkman-Burtscher, Isabella M. LU ; Raheja, Nishika ; Sjöström, David LU orcid ; Persiani, Marino ; Staiano, Walter and Kirk, Ulrich (2026) In Scientific Reports 16(1).
Abstract

Fear-based disorders affect millions worldwide, yet current treatments show limited effectiveness for many patients. While mindfulness is increasingly used clinically for anxiety and trauma disorders, the neural mechanisms underlying its effects on fear processing remain unclear. We conducted a randomized controlled trial using 7T fMRI to test whether mindfulness training enhances fear extinction recall—a process critical for recovery from these disorders. Healthy participants received four weeks of app-based mindfulness meditation (n = 27) or served as waitlist controls (n = 28), then underwent fear conditioning and extinction recall testing. Mindfulness training specifically enhanced extinction recall, reducing threat responses to... (More)

Fear-based disorders affect millions worldwide, yet current treatments show limited effectiveness for many patients. While mindfulness is increasingly used clinically for anxiety and trauma disorders, the neural mechanisms underlying its effects on fear processing remain unclear. We conducted a randomized controlled trial using 7T fMRI to test whether mindfulness training enhances fear extinction recall—a process critical for recovery from these disorders. Healthy participants received four weeks of app-based mindfulness meditation (n = 27) or served as waitlist controls (n = 28), then underwent fear conditioning and extinction recall testing. Mindfulness training specifically enhanced extinction recall, reducing threat responses to extinguished cues by both physiological (skin conductance, p=.028) and neural measures. Critically, our findings reveal a candidate mechanism: mindfulness reduced activation in subcortical threat-processing regions (amygdala, striatum, supplementary motor area) without enhancing cognitive control areas, a pattern consistent with direct modulation of fear circuits rather than top-down inhibition, though top-down contributions cannot be excluded. This pattern is consistent with mindfulness enhancing safety memory retrieval through implicit rather than explicit emotion regulation, providing preliminary neurobiological evidence relevant to optimizing mindfulness-based treatments. Our findings suggest that mindfulness training, whether administered before or alongside exposure therapy, could potentially enhance therapeutic outcomes by improving the consolidation and retrieval of safety memories, although replication in larger clinical samples is needed.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
16
issue
1
article number
9957
publisher
Nature Publishing Group
external identifiers
  • pmid:41882249
  • scopus:105034359890
ISSN
2045-2322
DOI
10.1038/s41598-026-45569-z
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2026.
id
9fae8b23-207e-4d81-8ee3-dea99e15fa06
date added to LUP
2026-06-18 12:37:05
date last changed
2026-07-03 19:36:51
@article{9fae8b23-207e-4d81-8ee3-dea99e15fa06,
  abstract     = {{<p>Fear-based disorders affect millions worldwide, yet current treatments show limited effectiveness for many patients. While mindfulness is increasingly used clinically for anxiety and trauma disorders, the neural mechanisms underlying its effects on fear processing remain unclear. We conducted a randomized controlled trial using 7T fMRI to test whether mindfulness training enhances fear extinction recall—a process critical for recovery from these disorders. Healthy participants received four weeks of app-based mindfulness meditation (n = 27) or served as waitlist controls (n = 28), then underwent fear conditioning and extinction recall testing. Mindfulness training specifically enhanced extinction recall, reducing threat responses to extinguished cues by both physiological (skin conductance, p=.028) and neural measures. Critically, our findings reveal a candidate mechanism: mindfulness reduced activation in subcortical threat-processing regions (amygdala, striatum, supplementary motor area) without enhancing cognitive control areas, a pattern consistent with direct modulation of fear circuits rather than top-down inhibition, though top-down contributions cannot be excluded. This pattern is consistent with mindfulness enhancing safety memory retrieval through implicit rather than explicit emotion regulation, providing preliminary neurobiological evidence relevant to optimizing mindfulness-based treatments. Our findings suggest that mindfulness training, whether administered before or alongside exposure therapy, could potentially enhance therapeutic outcomes by improving the consolidation and retrieval of safety memories, although replication in larger clinical samples is needed.</p>}},
  author       = {{Björkstrand, Johannes and Olsson, Emil and Clancy, Oisin Hugh and Möller, Stefan and Björkman-Burtscher, Isabella M. and Raheja, Nishika and Sjöström, David and Persiani, Marino and Staiano, Walter and Kirk, Ulrich}},
  issn         = {{2045-2322}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Effect of app-based mindfulness on extinction recall – a 7T-fMRI study}},
  url          = {{http://dx.doi.org/10.1038/s41598-026-45569-z}},
  doi          = {{10.1038/s41598-026-45569-z}},
  volume       = {{16}},
  year         = {{2026}},
}