Overview
Adolescence and early adulthood represent a critical developmental period marked by heightened emotional reactivity and increased vulnerability to anxiety disorders, which affect approximately one-third of U.S. youth. Anxiety is characterized by a narrowing of attention and cognition around threat, reflecting a constriction of the perception box. Breath-focused mindfulness (BFM) can promote perception box expansion by enhancing emotion regulation and reducing emotional reactivity, yet successful mindfulness practice requires a baseline capacity to tolerate distress. This creates a “catch 22” for anxious individuals, who often struggle to engage with mindfulness and experience high attrition rates due to emotional distress.
This study investigates whether temporal interference (TI), a novel non-invasive neuromodulation technique capable of selectively stimulating deep brain regions, may address these problems by enhancing the emotional experience and effectiveness of BFM. Unlike conventional approaches such as transcranial direct current stimulation, TI directly target the amygdala and ventral striatum (VS), brain regions central to anxiety, reward processing, and emotion regulation. Preliminary data demonstrate that TI targeting the VS during BFM enhances neural markers of reward processing and reduces anxiety following a single session.
Using a within-subject, crossover design, we will enroll 60 adolescents and young adults (18–25 years) with clinically significant generalized anxiety disorder. Participants will receive TI targeting either the amygdala (n=30) or VS (n=30) during BFM. Outcomes will include electroencephalography (EEG) measures of emotional reactivity, self-reported mood, and ecological momentary assessment (EMA) of daily mood, emotion regulation, and mindfulness.
We hypothesize that amygdala stimulation will preferentially reduce anxious arousal, whereas VS stimulation will enhance positive affect, together improving engagement with mindfulness and expanding the perception box. If successful, this work will establish TI as a scalable, affordable approach for enhancing mindfulness efficacy, improving emotion regulation, and promoting long-term mental health in anxious youth.