Abstract
Background/Objectives: Mindfulness-based interventions are widely used to reduce psychological distress. Their long-term neurophysiological correlates remain insufficiently characterized. Using a portable Muse InteraXon(®) EEG device, this study aimed to evaluate (i) the extent to which a 12-month combined mindfulness and gratitude-based intervention reduces anxiety, depression, and perceived stress, and (ii) whether these changes are accompanied by corresponding EEG-derived neurophysiological alterations, exploring longitudinal brain-behavior associations. Methods: Fifty participants completed psychological assessments at baseline, 6 months, and 12 months using validated scales (BDI-II, DASS-21, EMAS). A subcohort of 25 participants also underwent EEG recordings with a portable Muse device at the same time points. Longitudinal changes were analyzed using linear mixed-effect models, and exploratory brain-behavior associations were assessed with change-score analyses and Spearman's correlations with false discovery rate correction. Results: Across the full cohort (n = 50), psychological outcomes showed longitudinal improvements over 12 months, with reductions in BDI-21, DASS-21 depression, anxiety, and stress subscales, and EMAS-State scores (all p < 0.001; linear mixed-effect models). In the EEG subcohort (n = 25), longitudinal analyses showed increased alpha power and reduced beta and gamma power in frontal and temporoparietal regions (pFDR < 0.05), along with a modest decrease in delta power at 12 months, while theta power remained stable. Exploratory analyses showed non-significant trends in the hypothesized directions that did not remain statistically significant after correction for multiple comparisons (e.g., Δalpha vs. Δstate anxiety: ρ ≈ -0.44; Δbeta vs. Δdepression: ρ ≈ 0.43) or after FDR correction. Conclusions: The mindfulness- and gratitude-based intervention was associated with sustained improvements in psychological outcomes and suggests accompanying dynamic modulation of neurophysiology. EEG appears to reflect time-dependent neural adaptation rather than a static predictor of treatment response.