Revue des effets de la méditation de pleine conscience sur la santé mentale et physique et sur ses mécanismes d’action

Thanh-Lan Ngô M.D., M.Sc, FRCPC
Psychiatre. Professeure adjointe de clinique, Faculté de médecine, Université de Montréal. Chef du Programme des maladies affectives, pavillon Albert-Prévost, Hôpital du Sacré-Coeur de Montréal.

Résumé

Les interventions basées sur la pleine conscience deviennent de plus en plus populaires. Le présent article présente une recension de ses effets sur la santé mentale et physique, des mécanismes d’action et des recherches en neurobiologie.

Mots clés attention, régulation des émotions, intervention, pleine conscience, mécanisme, méditation, neuroscience, stress

Review of the effects of mindfulness meditation on mental and physical health and its mechanisms of action

Abstract Interventions based on mindfulness have become increasingly pop­ular. This article reviews the empirical literature on its effects on mental and physical health, discusses presumed mechanisms of action as well as its proposed neurobiological underpinning. Mindfulness is associated with increased well-being as well as reduced cognitive reactivity and behavioral avoidance. It seems to con­tribute to enhance immune functions, diminish inflammation, diminish the reac­tivity of the autonomic nervous system, increase telomerase activity, lead to higher levels of plasmatic melatonin and serotonin. It enhances the quality of life for patients suffering from chronic pain, fibromylagia and HIV infection. It facilitates adaptation to the diagnosis of cancer and diabetes. It seems to lead to symptomatic improvement in irritable bowel syndrome, chronic fatigue syndrome, hot flashes, insomnia, stress related hyperphagia. It diminishes craving in substance abuse. The proposed mechanism of action are enhanced metacognitive conscience, interocep­tive exposure, experiential acceptance, self-management, attention control, memory, relaxation. Six mechanism of actions for which neurological underpinnings have been published are: attention regulation (anterior cingulate cortex), body awareness (insula, temporoparietal junction), emotion regulation (modulation of the amygdala by the lateral prefrontal cortex), cognitive re-evaluation (activation of the dorsal medial prefrontal cortex or diminished activity in prefrontal regions), exposure/extinction/reconsolidation (ventromedial prefrontal cortex, hippo­campus, amygdala) and flexible self-concept (prefrontal median cortex, posterior cingulated cortex, insula, temporoparietal junction). The neurobiological effects of meditation are described. These are: (1) the deactivation of the default mode network that generates spontaneous thoughts, contributes to the maintenance of the autobiographical self and is associated with anxiety and depression; (2) the anterior cingulate cortex that underpins attention functions; (3) the anterior insula associated with the perception of visceral sensation, the detection of heartbeat and respiratory rate, and the affective response to pain; (4) the posterior cingulate cortex which helps to understand the context from which a stimulus emerges; (5) the temporoparietal junction which assumes a central role in empathy and compassion; (6) the amygdala implicated in fear responses. The article ends with a short review of the empirical basis supporting the efficacy for mindfulness based intervention and suggested directions for future research.

Keywords attention, emotion regulation, intervention, mindfulness, mechanism, meditation, neuroscience, stress

Auteurs : Thanh-Lan Ngô
Titre : Revue des effets de la méditation de pleine conscience sur la santé mentale et physique et sur ses mécanismes d’action
Revue : Santé mentale au Québec, Volume 39, numéro 2, automne 2013, p. 19-34

URI : http://id.erudit.org/iderudit//1023988ar
DOI : 10.7202//1023988ar

Tous droits réservés © Département de psychiatrie de l’Université de Montréal, 2013