# Mindfulness Matters: TheImpact of Mindfulness Based Stress Reduction on Post-Stroke Cognition

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2020 · $460,407

## Abstract

PROJECT SUMMARY
Thrombectomy has significantly improved stroke outcomes. Nearly 80% of our clinic population now present
with small strokes and low NIH Stroke Scale (NIHSS) scores. However, despite “good recoveries”, greater than
40% endorse significant problems with concentration, attention, executive function, processing speed, and
mood during the subacute phase of recovery. This dysfunction prohibits individuals from fully reintegrating into
their prior home and workplace environments and can result in early retirement or loss of independence,
particularly in the older population. Some degree of recovery is observed by 6 months, but it is often
incomplete or too late to reverse prior life-altering decisions. The impaired executive function and processing
speed appear to occur independent of stroke size, location, or co-existing depression.
Magnetoencephalography (MEG) is a functional imaging tool able to evaluate neurophysiologic processes in
real time similar to EEG, but with better spatial resolution. Our prior work with MEG suggests that cerebral
activation patterns are not only slowed and more dispersed during task completion in individuals with minor
stroke compared to controls, but that there is abnormal activity in the frontal lobes, even at rest. Unfortunately,
many patients do not qualify for rehabilitation and there is little data regarding effective treatment options to
hasten or augment recovery.
Mindfulness training may provide an attractive therapeutic option. A combination of meditation, body
awareness, and yoga, Mindfulness Based Stress Reduction (MBSR) is an active process thought to engage
the frontal lobes. MBSR has been shown to improve anxiety and depression in patients with chronic disease
states like migraine and diabetes, and has also been evaluated in a small series of patients with chronic stroke
and traumatic brain injury demonstrating improved performance during tasks of executive function.
We propose to study the effect of MBSR in the early phase of stroke recovery to determine if this intervention
can help to prevent post-stroke morbidity. A cohort of 40 patients (NIHSS <8, mRS 0-2) will be enrolled.
Twenty will be randomized to a standard 8 week course of MBSR, while the control group will instead
participate in a weekly Stroke Support Group (SSG). Depression, cognition, patient perception of recovery, and
degree of re-integration into prior environments will be evaluated pre- and post-intervention to determine the
impact of mindfulness training on subacute post-stroke depression (Aim 3) and cognition (Aim 2). All
participants will undergo neuroimaging using MEG pre- and post-intervention to determine the
neurophysiologic effect of treatment (Aim 1).
Patients with minor stroke have tremendous potential to return to their prior level of function; however, many
fail to return to work or successfully reintegrate into society. MBSR would provide a novel, non-pharmacologic
treatment that is likely to be effective by t...

## Key facts

- **NIH application ID:** 10040512
- **Project number:** 1R21AG068802-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Elisabeth Breese Marsh
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $460,407
- **Award type:** 1
- **Project period:** 2020-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10040512

## Citation

> US National Institutes of Health, RePORTER application 10040512, Mindfulness Matters: TheImpact of Mindfulness Based Stress Reduction on Post-Stroke Cognition (1R21AG068802-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10040512. Licensed CC0.

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