Evidence suggests meditation may improve health and well-being. However, understanding how meditation practices impact therapeutic outcomes is poorly characterized, in part because existing measures cannot track internal attentional states during meditation. To address this, we applied machine learning to track fMRI brain activity patterns associated with distinct mental states during meditation. Individualized brain patterns were distinguished for different forms of internal attention (breath attention, mind wandering, and self-referential processing) during a directed internal attention task. Next, these brain patterns were used to track the internal focus of attention, from moment to moment, for meditators and matched controls 2 during breath-focused meditation. We observed that while all participants spent the majority of time attending to breath (vs. mind wandering or self-referential processing), meditators with more lifetime practice demonstrated greater overall breath attention. This new framework holds promise for elucidating therapeutic mechanisms of meditation and furthering precision medicine approaches to health.Meditation practices, or mental exercises that train qualities of attention, are increasingly used to improve health and well-being in clinical populations as well as the general public.
Meditation and mindfulness-based interventions may cultivate sustained attention 1-3 , compassionand prosocial behavior 4-6 , creativity 7 , improved brain structure and function 8-11 , less implicit bias 12 , reduced stress 13 , and decreased symptoms in clinical populations with pain 14 , depression 13,15 , anxiety 13 , and cancer 16 . Based on these promising results, meditation practices are being implemented in a variety of fields such as medicine, psychology, education, business, law, and politics 17 . Collectively, meditation practices may strengthen interoception (awareness of internal bodily sensations) 18,19 , cognitive processes (including sustained attention, cognitive monitoring, and meta-awareness) 3,20,21 , and emotion regulation (less judgment and more equanimity with internal experiences) 22,23 . With practice, these skills may lead to better monitoring and regulation of physical, emotional, and social processes, contributing to improved health decision-making and behaviors 18,19 . However, the mechanisms through which meditation improves health and well-being are poorly specified, in part because there is currently no precise way to assess the quality of meditation practice 17 . Mental states during meditation are challenging to measure because they are often internal, diverse, and fluctuating. For example, in a core practice of focused attention to the 3 breath, meditators focus their attention on sensations of the breath, until they notice distraction by other internal or external stimuli, and then nonjudgmentally return their focus to the breath. Even in this simple practice, distinct mental states may occur and are dynamically fluctuating over time: the object of attention (breath or dis...