TMS-EEG shows mindfulness meditation is associated with an altered excitation/inhibition balance in the dorsolateral prefrontal cortex

Objective Mindfulness meditation is associated with functional brain changes in regions subserving higher order cognitive processes such as attention. However, no research to date has causally probed these areas in meditators using combined transcranial magnetic stimulation (TMS) and electroencephalography (EEG). This study aimed to investigate whether cortical reactivity to TMS differs in a community sample of experienced mindfulness meditators when compared to matched controls Methods TMS was applied to the left and right dorsolateral prefrontal cortices (DLPFC) of 19 controls and 15 meditators while brain responses were measured using EEG. TMS-evoked potentials (P60 and N100) were analysed, and exploratory analyses using the whole EEG scalp field were performed to test whether TMS-evoked global neural response strength or the distribution of neural activity differed between groups. Results Meditators were found to have statistically larger P60/N100 ratios in response to left and right hemisphere DLPFC stimulation compared to controls ( p FDR = 0.004, BF 10 > 39). No differences were observed in P60 or N100 amplitudes when examined in isolation. We also found preliminary evidence for differences in the distribution of neural activity 269-332ms post stimulation. Conclusion These findings demonstrate differences in cortical reactivity to TMS in meditators. Differences in the distribution of neural activity approximately 300ms following stimulation suggest differences in cortico-subcortical reverberation in meditators that may be indicative of greater inhibitory activity in frontal regions. This research contributes to our current understanding of the neurophysiology of mindfulness and highlights opportunities for further exploration into the mechanisms underpinning the benefits of mindfulness meditation.