For women with breast cancer, combining creative art therapy with Mindfulness-based Stress Reduction (MBSR) in an 8-week program changed brain activity in ways that are associated with lower stress and anxiety.

Cancer and stress go hand-in-hand, and high stress levels can lead to poorer health outcomes in cancer patients. Previously, lead author Daniel Monti, MD, of the Jefferson-Myrna Brind Center of Integrative Medicine has published on the success of Mindfulness-based Art Therapy (MBAT) in helping cancer patients lower stress levels and improve quality of life.

“Our goal was to observe possible mechanisms for the observed psychosocial effects of MBAT by evaluating the cerebral blood flow (CBF) changes associated with an MBAT intervention in comparison with a control of equal time and attention,” said Monti. “This type of expressive art and meditation program has never before been studied for physiological impact and the correlation of that impact to improvements in stress and anxiety.”

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The investigators randomly assigned 18 patients to the MBAT program or to a control group that received an education program. All of the enrolled patients had received the diagnosis of breast cancer between 6 months and 3 years prior to enrollment in this study, and all the patients were not in active treatment. The MBAT program consisted of MBSR curriculum, which included awareness of breathing, awareness of emotion, along with mindful yoga, walking, eating, and listening. This was paired with expressive art tasks to provide opportunities for self-expression, facilitate coping strategies, improve self-regulation, and provide a way for participants to express emotional information in a personally meaningful manner.

The patient response to the MBAT program was measured with a 90-item symptom checklist that the patients completed before and after participating in the 8-week program. In addition, functional magnetic resonance imaging (fMRI) evaluated CBF both before and after the program to assess changes in the brain’s activity. Scans were performed at rest, during a neutral task (control), meditation task, stressor task, and at rest again. This series of scans was designed to evaluate the general and specific effects and to provide a thorough analysis of the CBF change between the pre- and postprogram scans.

Participants in the MBAT group demonstrated significant effects on cerebral blood flow compared with the control group. The MBAT group showed increases in the emotional centers of the brain including the left insula which helps to perceive emotions, the amygdala which helps to experience stress, the hippocampus that regulates stress responses, and the caudate nucleus that is part of the brain’s reward system. These increases correlated significantly with a lowering of stress and anxiety, as also reflected in the results of the pre- and postprogram anxiety scores among the MBAT intervention group.

Given the improvements in anxiety levels and observed changes in CBF in the MBAT participants, these findings suggest that the MBAT program helps mediate emotional responses in women with breast cancer. 

This study was published in Stress and Health (2012; doi:10.1002/smi.2470).