1 1347 180 HYPOXIA IN CNS PATHOLOGIES: EMERGING ROLE OF MIRNA-BASED NEUROTHERAPEUTICS AND YOGA BASED ALTERNATIVE THERAPIES. CELLULAR RESPIRATION IS A VITAL PROCESS FOR THE EXISTENCE OF LIFE. ANY CONDITION THAT RESULTS IN DEPRIVATION OF OXYGEN (ALSO TERMED AS HYPOXIA) MAY EVENTUALLY LEAD TO DELETERIOUS EFFECTS ON THE FUNCTIONING OF TISSUES. BRAIN BEING THE HIGHEST CONSUMER OF OXYGEN IS PRONE TO INCREASED RISK OF HYPOXIA-INDUCED NEUROLOGICAL INSULTS. THIS IN TURN HAS BEEN ASSOCIATED WITH MANY DISEASES OF CENTRAL NERVOUS SYSTEM (CNS) SUCH AS STROKE, ALZHEIMER'S, ENCEPHALOPATHY ETC. ALTHOUGH SEVERAL STUDIES HAVE INVESTIGATED THE PATHOPHYSIOLOGICAL MECHANISMS UNDERLYING ISCHEMIC/HYPOXIC CNS DISEASES, THE KNOWLEDGE ABOUT PROTECTIVE THERAPEUTIC STRATEGIES TO AMELIORATE THE AFFECTED NEURONAL CELLS IS MEAGER. THIS HAS AUGMENTED THE NEED TO IMPROVE OUR UNDERSTANDING OF THE HYPOXIC AND ISCHEMIC EVENTS OCCURRING IN THE BRAIN AND IDENTIFY NOVEL AND ALTERNATE TREATMENT MODALITIES FOR SUCH INSULTS. MICRORNA (MIRNAS), SMALL NON-CODING RNA MOLECULES, HAVE RECENTLY EMERGED AS POTENTIAL NEUROPROTECTIVE AGENTS AS WELL AS TARGETS, UNDER HYPOXIC CONDITIONS. THESE 18-22 NUCLEOTIDE LONG RNA MOLECULES ARE PROFUSELY PRESENT IN BRAIN AND OTHER ORGANS AND FUNCTION AS GENE REGULATORS BY CLEAVING AND SILENCING THE GENE EXPRESSION. IN BRAIN, THESE ARE KNOWN TO BE INVOLVED IN NEURONAL DIFFERENTIATION AND PLASTICITY. THEREFORE, TARGETING MIRNA EXPRESSION REPRESENTS A NOVEL THERAPEUTIC APPROACH TO INTERCEDE AGAINST HYPOXIC AND ISCHEMIC BRAIN INJURY. IN THE FIRST PART OF THIS REVIEW, WE WILL DISCUSS THE NEUROPHYSIOLOGICAL CHANGES CAUSED AS A RESULT OF HYPOXIA, FOLLOWED BY THE CONTRIBUTION OF HYPOXIA IN THE NEURODEGENERATIVE DISEASES. SECONDLY, WE WILL PROVIDE RECENT UPDATES AND INSIGHTS INTO THE ROLES OF MIRNA IN THE REGULATION OF GENES IN OXYGEN AND GLUCOSE DEPRIVED BRAIN IN ASSOCIATION WITH CIRCADIAN RHYTHMS AND HOW THESE CAN BE TARGETED AS NEUROPROTECTIVE AGENTS FOR CNS INJURIES. FINALLY, WE WILL EMPHASIZE ON ALTERNATE BREATHING OR YOGIC INTERVENTIONS TO OVERCOME THE HYPOXIA ASSOCIATED ANOMALIES THAT COULD ULTIMATELY LEAD TO IMPROVEMENT IN CEREBRAL PERFUSION. 2017 2 758 22 EFFECT OF SLOW BREATHING ON AUTONOMIC TONE & BAROREFLEX SENSITIVITY IN YOGA PRACTITIONERS. BACKGROUND & OBJECTIVES: SLOW BREATHING INCREASES PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY (BRS) IN HEALTHY INDIVIDUALS, ALSO SIMILARLY OBSERVED IN YOGA PRACTITIONERS. PRANAYAMA WHICH IS AN IMPORTANT COMPONENT OF YOGA WHEN PRACTICED AT A SLOW PACE WAS AT A RESPIRATORY FREQUENCY OF AROUND 0.1 HZ (6 BREATHS/MIN). THEREFORE, IT WAS HYPOTHESIZED THAT YOGA PRACTITIONERS MIGHT HAVE ADAPTED TO SLOW BREATHING. THIS STUDY WAS AIMED TO DECIPHER THE ROLE OF YOGA ON CARDIOVASCULAR VARIABILITY DURING SLOW BREATHING (0.1 HZ) IN YOGA PRACTITIONERS. METHODS: A CROSS-SECTIONAL STUDY WAS UNDERTAKEN IN NAIVE-TO-YOGA INDIVIDUALS (N=40) AND YOGA PRACTITIONERS (N=40) WITH AN AVERAGE AGE OF 31.08 +/- 7.31 AND 29.93 +/- 7.57 YR, RESPECTIVELY. THE ANALYSIS OF HEART RATE VARIABILITY, BLOOD PRESSURE VARIABILITY (BPV) AND BRS DURING SPONTANEOUS AND SLOW BREATHING WAS COMPARED BETWEEN THE TWO GROUPS. RESULTS: DURING SLOW BREATHING, THE HEART RATE (P<0.01) WAS LOWER, RESPIRATORY RATE INTERVAL (P<0.05) AND PNN50 PER CENT (P=0.01) WERE HIGHER, MEAN SYSTOLIC BP (SBP) (P<0.05) AND SDSD (STANDARD DEVIATION OF SUCCESSIVE BEAT TO BEAT SYSTOLIC BLOOD PRESSURE DIFFERENCES) (P<0.01) OF SBP VARIABILITY WERE LOWER WITH SEQUENCE BRS (P<0.001) AND ALPHA LOW FREQUENCY (P<0.01) AND ALPHA HIGH FREQUENCY (P<0.001) OF SPECTRAL BRS WERE HIGHER IN YOGA PRACTITIONERS. INTERPRETATION & CONCLUSIONS: THE PRESENT STUDY INDICATED HIGHER PARASYMPATHETIC ACTIVITY AND BRS WITH LOWER SBP VARIABILITY AT REST AND DURING SLOW BREATHING IN YOGA PRACTITIONERS COMPARED TO NAIVE GROUP. FINDINGS INDICATE THAT THE SHORT-TERM PRACTICE OF SLOW BREATHING COMPLEMENTS THE AUGMENTED PARASYMPATHETIC ACTIVITY AND BRS IN THE YOGA GROUP. 2020 3 1252 28 FEASIBILITY, ACCEPTABILITY AND EVALUATION OF MEDITATION TO AUGMENT YOGA PRACTICE AMONG PERSONS DIAGNOSED WITH SCHIZOPHRENIA. OBJECTIVE: TO DESIGN A MEDITATION PROTOCOL AND TEST ITS FEASIBILITY, ACCEPTABILITY AND EFFICACY IN CONJUNCTION WITH YT FOR PERSONS WITH SCHIZOPHRENIA (SZ). METHODS: THE MEDITATION PROTOCOL CONSISTED OF ANAPANA (OBSERVING NORMAL RESPIRATION) AND YOGA NIDRA (SUPINE, RESTFUL AWARENESS). IN A SINGLE BLIND RANDOMIZED CONTROLLED TRIAL, MEDICATED AND CLINICALLY STABLE OUTPATIENTS DIAGNOSED WITH SZ WERE RANDOMIZED TO RECEIVE TREATMENT AS USUAL (TAU), TAU AUGMENTED WITH YOGA TRAINING (YT), OR TAU AUGMENTED WITH MEDITATION AND YOGA TRAINING (MYT) FOR THREE WEEKS (N=145). ACCEPTABILITY, CLINICAL, SOCIAL AND COGNITIVE FUNCTIONS WERE ASSESSED AFTER 3 WEEKS AND 3 MONTHS POST RANDOMIZATION USING WITHIN GROUP AND BETWEEN GROUPS ANALYSES WITH REPEATED MEASURES MULTIVARIATE TESTS. RESULTS: NO GROUP-WISE DIFFERENCES IN COMPLIANCE, STUDY DISCONTINUATION, MAJOR/SERIOUS SIDE EFFECTS OR ADVERSE EVENTS WERE NOTED. FOR SIX ASSESSED CLINICAL VARIABLES, THE DIRECTION OF CHANGES WERE IN THE DESIRED DIRECTION AND THE EFFECT SIZES WERE GREATER IN THE MYT GROUP COMPARED WITH THE TAU GROUP AT BOTH TIME POINTS. CHANGES IN SOCIAL FUNCTION VARIABLES WERE GREATER AT 3 MONTHS THAN AT 3 WEEKS. NOMINALLY SIGNIFICANT IMPROVEMENT IN INDIVIDUAL COGNITIVE DOMAINS WERE NOTED IN ALL GROUPS AT BOTH TIME POINTS. ALL EFFECT SIZES WERE IN THE SMALL TO MEDIUM RANGE. CONCLUSION: MYT IS FEASIBLE, ACCEPTABLE AND SHOWS MODEST BENEFITS FOR PERSONS WITH SZ. MYT CAN ALSO IMPROVE QUALITY OF LIFE AND CLINICAL SYMPTOMS. LARGER STUDIES OF LONGER DURATION ARE WARRANTED. 2022 4 370 22 AUTONOMIC TONE AND BAROREFLEX SENSITIVITY DURING 70 DEGREES HEAD-UP TILT IN YOGA PRACTITIONERS. INTRODUCTION: THE INTERVENTION OF YOGA WAS SHOWN TO IMPROVE THE AUTONOMIC CONDITIONING IN HUMANS EVIDENT FROM THE ENHANCEMENT OF PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY (BRS). FROM THE DOCUMENTED HEALTH BENEFITS OF YOGA, WE HYPOTHESIZED THAT THE EXPERIENCE OF YOGA MAY RESULT IN ADAPTATION TO THE ORTHOSTATIC STRESS DUE TO ENHANCED BRS. AIM: TO DECIPHER THE EFFECTS OF YOGA IN THE MODULATION OF AUTONOMIC FUNCTION DURING ORTHOSTATIC CHALLENGE. MATERIALS AND METHODS: THIS WAS A COMPARATIVE STUDY DESIGN CONDUCTED IN AUTONOMIC FUNCTION TEST LAB, OF THE DEPARTMENT OF PHYSIOLOGY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA. HEART RATE VARIABILITY (HRV), BLOOD PRESSURE VARIABILITY, AND BRS WERE ANALYZED ON FORTY NAIVE TO YOGA (NY) SUBJECTS AND FORTY YOGA PRACTITIONERS WITH AN AVERAGE AGE OF 31.08 +/- 7.31 YEARS AND 29.93 +/- 7.57 YEARS, RESPECTIVELY. ALL PARTICIPANTS WERE HEALTHY. SEVENTY DEGREES HEAD UP TILT (HUT) WAS USED AS AN INTERVENTION TO EVALUATE THE CARDIOVASCULAR VARIABILITY DURING ORTHOSTATIC CHALLENGE. RESULTS: DURING HUT, THE R-R INTERVAL (P = 0.042), ROOT MEAN SQUARE OF SUCCESIVE R-R INTERVAL DIFFERENCES (RMSSD) (P = 0.039), STANDARD DEVIATION OF INSTANTANEOUS BEAT-TO-BEAT R-R INTERVAL VARIABILITY (SD1) (P = 0.039) OF HRV, AND SEQUENCE BRS (P = 0.017) AND ALPHA LOW FREQUENCY OF SPECTRAL BRS (P = 0.002) WERE HIGHER IN THE YOGA GROUP. THE DELTA DECREASE IN RRI (P = 0.033) AND BRS (P < 0.01) WAS HIGHER IN THE YOGA GROUP THAN THE NY GROUP. CONCLUSION: THE EFFERENT VAGAL ACTIVITY AND BRS WERE HIGHER IN YOGA PRACTITIONERS. THE DELTA CHANGE (DECREASE) IN PARASYMPATHETIC ACTIVITY AND BRS WAS HIGHER, WITH RELATIVELY STABLE SYSTOLIC BLOOD PRESSURE INDICATING AN ADAPTIVE RESPONSE TO ORTHOSTATIC CHALLENGE BY THE YOGA PRACTITIONERS COMPARED TO THE NY GROUP. 2020 5 2065 40 THE CARDIOVASCULAR VARIABILITY DURING TRANSIENT 6 DEGREES HEAD DOWN TILT AND SLOW BREATHING IN YOGA EXPERIENCED HEALTHY INDIVIDUALS. OBJECTIVE: THE INTERVENTION OF YOGA HAS BEEN SHOWN TO IMPROVE AUTONOMIC CONDITIONING IN HUMANS AND BETTER ADAPTABILITY TO ORTHOSTATIC CHALLENGES. SIMILARLY, SLOW BREATHING AT 0.1 HZ AKIN TO PRANAYAMA ALSO INCREASES BAROREFLEX SENSITIVITY (BRS). HENCE, WE INTENDED TO INVESTIGATE WHETHER YOGA PRACTITIONERS HAVE DIFFERENT AUTONOMIC RESPONSES AT REST,DURING SLOW DEEP BREATHINGAS WELL AS DURING 6 DEGREES HEAD DOWN TILT (HDT) COMPARED TO NAIVE GROUP INDIVIDUALS. AIM: THE AIM OF THE STUDY WAS TO EVALUATE THE ACUTE EFFECTS OF SLOW BREATHING ON CARDIOVASCULAR VARIABILITY DURING HDT IN YOGA PRACTITIONERS COMPARED TO YOGA-NAIVE INDIVIDUALS. SETTINGS AND DESIGN: THIS WAS A COMPARATIVE STUDY WITH REPEATED MEASURES DESIGN CONDUCTED IN AUTONOMIC FUNCTION TEST LAB OF THE DEPARTMENT OF PHYSIOLOGY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA. MATERIALS AND METHODS: TIME DOMAIN AND FREQUENCY DOMAIN PARAMETERS OF HEART RATE VARIABILITY, BLOOD PRESSURE VARIABILITY (BPV), AND BRS WERE EVALUATED DURING 6 DEGREES HDT AND SLOW BREATHING AT 0.1 HZ ON FORTY YOGA-NAIVE INDIVIDUALS AND FORTY YOGA PRACTITIONERS WITH AN AVERAGE AGE OF 31.08 +/- 7.31 YEARS AND 29.93 +/- 7.57 YEARS, RESPECTIVELY. ALL OF THE PARTICIPANTS WERE HEALTHY. STATISTICAL ANALYSIS USED: GENERAL LINEAR MIXED MODEL ANOVA WAS APPLIED WITH YOGA EXPERIENCE AS A BETWEEN-GROUP FACTOR IN REPEATED MEASURES. INDEPENDENT SAMPLE T-TEST WAS APPLIED FOR BETWEEN GROUP COMPARISON OF RESPIRATORY RATE, DEMOGRAPHIC, AND ANTHROPOMETRIC DATA. P <0.05 IS CONSIDERED STATISTICALLY SIGNIFICANT. RESULTS: BETWEEN-GROUP COMPARISON DURING HDT WITH SPONTANEOUS BREATHING HAS SHOWN A SIGNIFICANTLY LOWER HEART RATE (P = 0.004) WITH HIGHER RR INTERVAL (RRI) (P = 0.002) AND PNN50% (P = 0.019) IN YOGA PRACTITIONERS. THE SEQUENCE BRS (P < 0.0001) AND ALPHA LOW FREQUENCY (LF) OF SPECTRAL BRS (P = 0.035) WERE ALSO SIGNIFICANTLY HIGHER IN THE YOGA GROUP COMPARED TO THE NAIVE GROUP. SIMILARLY, DURING HDT WITH SLOW BREATHING, THE HEART RATE WAS LOWER (P = 0.01); WITH HIGHER RRI (P = 0.009); PNN50% (P = 0.048). STANDARD DEVIATION OF SUCCESSIVE RR INTERVAL DIFFERENCE OF SYSTOLIC BPV WAS LOWER (P = 0.024) WITH HIGHER SEQUENCE BRS (P = 0.001) AND ALPHA LF OF SPECTRAL BRS (P = 0.002) IN YOGA GROUP THAN NAIVE GROUP. CONCLUSION: THE YOGA EXPERIENCED INDIVIDUALS EXHIBIT HIGHER RESTING PARASYMPATHETIC ACTIVITY, LOWER SYSTOLIC BPV, AND HIGHER BRS THAN NAIVE TO YOGA INDIVIDUALS. IT IS INFERRED FROM THE FINDINGS THAT YOGA PRACTITIONERS WERE BETTER ADAPTED TO TRANSIENT CEPHALAD FLUID SHIFT THAT HAPPENS DURING 6 DEGREES HDT. FURTHERMORE, ACUTE SLOW BREATHING DURING 6 DEGREES HDT REDUCED THE SYSTOLIC BLOOD PRESSURE IN ALL THE PARTICIPANTS SUGGESTING THE BENEFICIAL ROLE OF SLOW BREATHING DURING EXPOSURE TO EXTREME CONDITIONS SUCH AS MICROGRAVITY WHICH MIGHT HELP IN THE PREVENTION OF ADVERSE EFFECTS OF CEPHALAD FLUID SHIFT DURING LONG-TERM WEIGHTLESSNESS AND MAINTAIN THE ASTRONAUT HEALTH. FUTURE MECHANISTIC STUDIES WITH ACTIVE YOGA INTERVENTION ARE NECESSARY TO UNDERSTAND THE ADAPTIVE MECHANISMS INVOLVING CENTRAL AND VASCULAR MODULATIONS CONTRIBUTING TO EITHER ATTENUATION OR ACCENTUATION OF THE CARDIOVAGAL BAROREFLEX DURING HDT AND SLOW BREATHING IN HEALTHY INDIVIDUALS. 2021 6 418 32 BREATHING-FOCUSED YOGA AS AUGMENTATION FOR UNIPOLAR AND BIPOLAR DEPRESSION: A RANDOMIZED CONTROLLED TRIAL: LE YOGA AXE SUR LA RESPIRATION COMME TRAITEMENT D'APPOINT POUR LA DEPRESSION UNIPOLAIRE ET BIPOLAIRE: UN ESSAI RANDOMISE CONTROLE. OBJECTIVE: PATIENTS WITH DEPRESSION FREQUENTLY EXPERIENCE PERSISTENT RESIDUAL SYMPTOMS EVEN WITH OPTIMAL INTERVENTIONS. THESE PATIENTS OFTEN USE COMPLEMENTARY TREATMENTS, INCLUDING YOGA, AS A PREFERRED ALTERNATIVE OR ADJUNCTIVE TREATMENT. THERE IS EVIDENCE FOR THE BENEFIT OF YOGA FOR DEPRESSION, BUT THIS HAS NOT BEEN RIGOROUSLY EVALUATED, PARTICULARLY IN BIPOLAR DEPRESSION. WE AIMED TO DETERMINE THE FEASIBILITY AND BENEFIT OF MANUALIZED BREATHING-FOCUSED YOGA IN COMPARISON TO PSYCHOEDUCATION AS AUGMENTATION TO PHARMACOTHERAPY FOR IMPROVING RESIDUAL SYMPTOMS OF DEPRESSION IN UNIPOLAR AND BIPOLAR PATIENTS. METHODS: USING A RANDOMIZED SINGLE-BLIND CROSSOVER DESIGN, 72 OUTPATIENTS WITH UNIPOLAR OR BIPOLAR DEPRESSION WERE AUGMENTED WITH THE TWO 8-WEEK INTERVENTIONS AT SEPARATE TIMES, AS ADD-ONS TO CURRENT FIRST-LINE ANTIDEPRESSANTS AND MOOD STABILIZERS. THE PRIMARY OUTCOME MEASURE WAS THE MONTGOMERY-ASBERG DEPRESSION RATING SCALE (MADRS). DUE TO THE HIGH DROPOUT OF PARTICIPANTS AFTER CROSSOVER AT WEEK 8, ANALYSIS FOCUSED ON BETWEEN-GROUP COMPARISONS OF YOGA AND PSYCHOEDUCATION DURING THE INITIAL 8 WEEKS OF THE STUDY. RESULTS: THERE WAS A SIGNIFICANT DECLINE IN DEPRESSIVE SYMPTOMS, AS MEASURED BY THE MADRS, FOLLOWING 8 WEEKS OF YOGA. HOWEVER, THERE WAS NO SIGNIFICANT DIFFERENCE IN MADRS RATINGS BETWEEN INTERVENTION GROUPS. SIMILAR IMPROVEMENTS IN SELF-RATED DEPRESSIVE SYMPTOMS AND WELL-BEING WERE ALSO OBSERVED ACROSS TIME. CONCLUSIONS: BOTH YOGA AND PSYCHOEDUCATION MAY IMPROVE RESIDUAL SYMPTOMS OF UNIPOLAR AND BIPOLAR DEPRESSION AS ADD-ON TO MEDICATIONS. IN-CLASS GROUP SESSIONS AND LONG STUDY DURATIONS MAY REDUCE FEASIBILITY FOR THIS POPULATION. LARGER TRIALS WITH PARALLEL GROUP DESIGN AND SHORTER DURATION MAY BE MORE FEASIBLE. 2021 7 1822 33 PROTOCOL TO EVALUATE THE IMPACT OF YOGA SUPPLEMENTATION ON COGNITIVE FUNCTION IN SCHIZOPHRENIA: A RANDOMISED CONTROLLED TRIAL. BACKGROUND: SCHIZOPHRENIA (SZ) IS A CHRONIC ILLNESS THAT IS TREATED SYMPTOMATICALLY. COGNITIVE DYSFUNCTION IS A CORE FEATURE OF SZ THAT IS RELATIVELY INTRACTABLE TO PHARMACOTHERAPY. YOGA CAN IMPROVE COGNITIVE FUNCTION AMONG HEALTHY INDIVIDUALS. A RECENT OPEN TRIAL INDICATED SIGNIFICANT BENEFITS OF YOGA TRAINING (YT) IN CONJUNCTION WITH CONVENTIONAL PHARMACOTHERAPY AMONG PATIENTS WITH SZ. AIMS: TO DESCRIBE THE PROTOCOL FOR AN ONGOING RANDOMISED CONTROLLED TRIAL DESIGNED TO TEST WHETHER THE REPORTED BENEFICIAL EFFECTS OF YT ON COGNITIVE FUNCTION AMONG SZ PATIENTS CAN BE REPLICATED. SECONDARILY, THE EFFECTS OF YT ON DAILY FUNCTIONING LIVING SKILLS ARE EVALUATED. METHODS: CONSENTING PATIENTS WITH SZ RECEIVE ROUTINE CLINICAL TREATMENT AND ARE RANDOMISED TO ADJUNCTIVE YT, ADJUNCTIVE PHYSICAL EXERCISE (PE) OR TREATMENT AS USUAL (PROPOSED N = 234 TOTAL, N = 78 IN EACH GROUP). THE TRIAL INVOLVES YT OR PE 5 DAYS A WEEK AND LASTS 3 WEEKS. PARTICIPANTS ARE EVALUATED THRICE OVER 6 MONTHS. COGNITIVE FUNCTIONS MEASURED BY TRAIL MAKING TEST, UNIVERSITY OF PENNSYLVANIA NEUROCOGNITIVE COMPUTERISED BATTERY WERE PRIMARY OUTCOME MEASURES WHILE CLINICAL SEVERITY AND DAILY FUNCTIONING MEASURED BY INDEPENDENT LIVING SKILLS SURVEY WERE SECONDARY OUTCOME MEASURES. RESULTS: A TOTAL OF 309 PARTICIPANTS HAVE BEEN RANDOMISED AS OF 31 AUGUST 2013, WHICH EXCEEDED BEYOND 294 PROPOSED AFTER ATTRITION. ONCE PARTICIPANTS BEGIN YT OR PE THEY GENERALLY COMPLETE THE PROTOCOL. NO INJURIES HAVE BEEN REPORTED. CONCLUSIONS: SHORT TERM YT IS FEASIBLE AND ACCEPTABLE TO INDIAN SZ PATIENTS. IF BENEFICIAL EFFECTS OF YT ARE DETECTED, IT WILL PROVIDE A NOVEL ADJUNCTIVE COGNITIVE REMEDIATION STRATEGY FOR SZ PATIENTS. 2014 8 1578 24 MEASUREMENT OF THE EFFECT OF ISHA YOGA ON CARDIAC AUTONOMIC NERVOUS SYSTEM USING SHORT-TERM HEART RATE VARIABILITY. BACKGROUND: BENEFICIAL EFFECTS OF YOGA HAVE BEEN POSTULATED TO BE DUE TO MODULATION OF THE AUTONOMIC NERVOUS SYSTEM. OBJECTIVE: TO ASSESS THE EFFECT OF ISHA YOGA PRACTICES ON CARDIOVASCULAR AUTONOMIC NERVOUS SYSTEM THROUGH SHORT-TERM HEART RATE VARIABILITY (HRV). DESIGN OF THE STUDY: SHORT-TERM HRV OF LONG-TERM REGULAR HEALTHY 14 (12 MALES AND 2 FEMALES) ISHA YOGA PRACTITIONERS WAS COMPARED WITH THAT OF AGE- AND GENDER-MATCHED 14 (12 MALES AND 2 FEMALES) NON-YOGA PRACTITIONERS. METHODS AND MATERIALS: ECG LEAD II AND RESPIRATORY MOVEMENTS WERE RECORDED IN BOTH GROUPS USING POLYRITE DURING SUPINE REST FOR 5 MIN AND CONTROLLED DEEP BREATHING FOR 1 MINUTE. FREQUENCY DOMAIN ANALYSIS [RR INTERVAL IS THE MEAN OF DISTANCE BETWEEN SUBSEQUENT R WAVE PEAKS IN ECG], LOW FREQUENCY (LF) POWER, HIGH FREQUENCY (HF) POWER, LF NORMALIZED UNITS (NU), HF NU, LF/HF RATIO] AND TIME DOMAIN ANALYSIS [STANDARD DEVIATION OF NORMAL TO NORMAL INTERVAL (SDNN), SQUARE OF MEAN SQUARED DIFFERENCE OF SUCCESSIVE NORMAL TO NORMAL INTERVALS (RMSSD), NORMAL TO NORMAL INTERVALS WHICH ARE DIFFERING BY 50 MS (NN50), AND PERCENTAGE OF NN50 (PNN50)] OF HRV VARIABLES WERE ANALYZED FOR SUPINE REST. TIME DOMAIN ANALYSIS WAS RECORDED FOR DEEP BREATHING. RESULTS: RESULTS SHOWED STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN ISHA YOGA PRACTITIONERS AND CONTROLS IN BOTH FREQUENCY AND TIME DOMAIN ANALYSES OF HRV INDICES, WITH NO DIFFERENCE IN RESTING HEART RATE BETWEEN THE GROUPS. CONCLUSIONS: PRACTITIONERS OF ISHA YOGA SHOWED WELL-BALANCED BENEFICIAL ACTIVITY OF VAGAL EFFERENTS, AN OVERALL INCREASED HRV, AND SYMPATHOVAGAL BALANCE, COMPARED TO NON-YOGA PRACTITIONERS DURING SUPINE REST AND DEEP BREATHING. 2012 9 288 28 ADJUNCTIVE COGNITIVE REMEDIATION FOR SCHIZOPHRENIA USING YOGA: AN OPEN, NON-RANDOMIZED TRIAL. BACKGROUND: YOGA THERAPY (YT) IMPROVES COGNITIVE FUNCTION IN HEALTHY INDIVIDUALS, BUT ITS IMPACT ON COGNITIVE FUNCTION AMONG PERSONS WITH SCHIZOPHRENIA (SZ) HAS NOT BEEN INVESTIGATED. AIMS: EVALUATE ADJUNCTIVE YT FOR COGNITIVE DOMAINS IMPAIRED IN SZ. METHODS: PATIENTS WITH SZ RECEIVED YT OR TREATMENT AS USUAL (TAU; N = 65, N = 23, RESPECTIVELY). ACCURACY AND SPEED FOR SEVEN COGNITIVE DOMAINS WERE ASSESSED USING A COMPUTERIZED NEUROCOGNITIVE BATTERY (CNB), THUS MINIMIZING OBSERVER BIAS. SEPARATELY, YT WAS EVALUATED AMONG PATIENTS WITH BIPOLAR I DISORDER (N = 40), MAJOR DEPRESSIVE DISORDER (N = 37), AND CARDIOLOGY OUTPATIENTS (N = 68). ALL PATIENTS ALSO RECEIVED ROUTINE PHARMACOTHERAPY. PATIENTS WERE NOT RANDOMIZED TO YT OR TAU. RESULTS: COMPARED WITH THE SZ/TAU GROUP, THE SZ/YT GROUP SHOWED SIGNIFICANTLY GREATER IMPROVEMENT WITH REGARD TO MEASURES OF ATTENTION FOLLOWING CORRECTIONS FOR MULTIPLE COMPARISONS; THE CHANGES WERE MORE PROMINENT AMONG THE MEN. IN THE OTHER DIAGNOSTIC GROUPS, DIFFERING PATTERNS OF IMPROVEMENTS WERE NOTED WITH SMALL TO MEDIUM EFFECT SIZES. CONCLUSIONS: OUR INITIAL ANALYSES SUGGEST NOMINALLY SIGNIFICANT IMPROVEMENT IN COGNITIVE FUNCTION IN SCHIZOPHRENIA WITH ADJUNCTIVE THERAPIES SUCH AS YT. THE MAGNITUDE OF THE CHANGE VARIES BY COGNITIVE DOMAIN AND MAY ALSO VARY BY DIAGNOSTIC GROUP. 2012 10 2759 26 YOGA PRACTITIONERS EXHIBIT HIGHER PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY AND BETTER ADAPTABILITY TO 40 MM HG LOWER-BODY NEGATIVE PRESSURE. YOGA HAS BEEN SHOWN TO IMPROVE AUTONOMIC CONDITIONING IN HUMANS, AS EVIDENCED BY THE ENHANCEMENT OF PARASYM-PATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY. THEREFORE, WE HYPOTHESIZED THAT THE EXPERIENCE OF YOGA MAY RESULT IN ADAPTATION TO ACUTE HEMODYNAMIC CHANGES. TO DECIPHER THE LONG-TERM EFFECTS OF YOGA ON CARDIOVASCULAR VARIABILITY, YOGA PRACTITIONERS WERE COMPARED TO YOGA-NAIVE SUBJECTS DURING EXPOSURE TO -40 MM HG LOWER-BODY NEGATIVE PRESSURE (LBNP). A COMPARATIVE STUDY WAS CONDUCTED ON 40 YOGANAIVE SUBJECTS AND 40 YOGA PRACTITIONERS WITH AN AVERAGE AGE OF 31.08 +/- 7.31 YEARS AND 29.93 +/- 7.57 YEARS, RESPECTIVELY. HEART RATE VARIABILITY, BLOOD PRESSURE VARIABILITY, BAROREFLEX SENSITIVITY, AND CORRELATION BETWEEN SYSTOLIC BLOOD PRESSURE AND RR INTERVAL WERE EVALUATED AT REST AND DURING LBNP. IN YOGA PRACTITIONERS, THE HEART RATE WAS LOWER IN SUPINE REST (P = 0.011) AND DURING LBNP (P = 0.043); THE PNN50 MEASURE OF HEART RATE VARIABILITY WAS HIGHER IN SUPINE REST (P = 0.011) AND DURING LBNP (P = 0.034). THE YOGA PRACTITIONERS' STANDARD DEVIATION OF SUCCESSIVE BEAT-TO-BEAT BLOOD PRESSURE INTERVALS OF SYSTOLIC BLOOD PRESSURE VARIABILITY WAS LOWER IN SUPINE REST (P = 0.034) AND DURING LBNP (P = 0.007), WITH HIGHER SEQUENCE BAROREFLEX SENSITIVITY (P = 0.019) AND ~ HIGH-FREQUENCY BAROREFLEX SENSITIVITY. MEAN SYSTOLIC BLOOD PRESSURE AND RR INTERVAL WERE INVERSELY CORRELATED IN THE YOGA GROUP (R = -0.317, P = 0.049). THE YOGA PRACTITIONERS EXHIBITED HIGHER PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY WITH LOWER SYSTOLIC BLOOD PRESSURE VARIABILITY, INDICATING BETTER ADAPTABILITY TO LBNP COMPARED TO THE YOGA-NAIVE GROUP. OUR FINDINGS INDICATE THAT THE YOGA MODULE WAS HELPFUL IN CONDITIONS OF HYPOVOLEMIA IN HEALTHY SUBJECTS; IT IS PROPOSED TO BE BENEFICIAL IN CLINICAL CONDITIONS ASSOCIATED WITH SYMPATHETIC DOMINANCE, IMPAIRED BARORE-FLEX SENSITIVITY, AND ORTHOSTATIC INTOLERANCE. 2021 11 289 27 ADJUNCTIVE YOGA TRAINING FOR PERSONS WITH SCHIZOPHRENIA: WHO BENEFITS? OBJECTIVE: THE AIM OF THIS STUDY WAS TO IDENTIFY FACTORS ASSOCIATED WITH ACCEPTABILITY AND EFFICACY OF YOGA TRAINING (YT) FOR IMPROVING COGNITIVE DYSFUNCTION IN INDIVIDUALS WITH SCHIZOPHRENIA (SZ). METHODS: WE ANALYSED DATA FROM TWO PUBLISHED CLINICAL TRIALS OF YT FOR COGNITIVE DYSFUNCTION AMONG INDIANS WITH SZ: (1) A 21-DAY RANDOMISED CONTROLLED TRIAL (RCT, N = 286), 3 AND 6 MONTHS FOLLOW-UP AND (2) A 21-DAY OPEN TRIAL (N = 62). MULTIVARIATE ANALYSES WERE CONDUCTED TO EXAMINE THE ASSOCIATION OF BASELINE CHARACTERISTICS (AGE, SEX, SOCIO-ECONOMIC STATUS, EDUCATIONAL STATUS, DURATION, AND SEVERITY OF ILLNESS) WITH IMPROVEMENT IN COGNITION (I.E. ATTENTION AND FACE MEMORY) FOLLOWING YT. FACTORS ASSOCIATED WITH ACCEPTABILITY WERE IDENTIFIED BY COMPARING BASELINE DEMOGRAPHIC VARIABLES BETWEEN SCREENED AND ENROLLED PARTICIPANTS AS WELL AS COMPLETERS VERSUS NON-COMPLETERS. RESULTS: ENROLLED PARTICIPANTS WERE YOUNGER THAN SCREENED PERSONS WHO DECLINED PARTICIPATION (T = 2.952, P = 0.003). NO OTHER CHARACTERISTICS WERE ASSOCIATED WITH STUDY ENROLLMENT OR COMPLETION. REGARDING EFFICACY, SCHOOLING DURATION WAS NOMINALLY ASSOCIATED WITH GREATER AND SUSTAINED COGNITIVE IMPROVEMENT ON A MEASURE OF FACIAL MEMORY. NO OTHER BASELINE CHARACTERISTICS WERE ASSOCIATED WITH EFFICACY OF YT IN THE OPEN TRIAL, THE RCT, OR THE COMBINED SAMPLES (N = 148). CONCLUSIONS: YT IS ACCEPTABLE EVEN AMONG YOUNGER INDIVIDUALS WITH SZ. IT ALSO ENHANCES SPECIFIC COGNITIVE FUNCTIONS, REGARDLESS OF INDIVIDUAL DIFFERENCES IN SELECTED PSYCHOSOCIAL CHARACTERISTICS. THUS, YOGA COULD BE INCORPORATED AS ADJUNCTIVE THERAPY FOR PATIENTS WITH SZ. IMPORTANTLY, OUR RESULTS SUGGEST COGNITIVE DYSFUNCTION IS REMEDIABLE IN PERSONS WITH SZ ACROSS THE AGE SPECTRUM. 2021 12 1089 36 EFFECTS OF YOGA ON THE AUTONOMIC NERVOUS SYSTEM, GAMMA-AMINOBUTYRIC-ACID, AND ALLOSTASIS IN EPILEPSY, DEPRESSION, AND POST-TRAUMATIC STRESS DISORDER. A THEORY IS PROPOSED TO EXPLAIN THE BENEFITS OF YOGA PRACTICES IN DIVERSE, FREQUENTLY COMORBID MEDICAL CONDITIONS BASED ON THE CONCEPT THAT YOGA PRACTICES REDUCE ALLOSTATIC LOAD IN STRESS RESPONSE SYSTEMS SUCH THAT OPTIMAL HOMEOSTASIS IS RESTORED. IT IS HYPOTHESIZED THAT STRESS INDUCES (1) IMBALANCE OF THE AUTONOMIC NERVOUS SYSTEM (ANS) WITH DECREASED PARASYMPATHETIC NERVOUS SYSTEM (PNS) AND INCREASED SYMPATHETIC NERVOUS SYSTEM (SNS) ACTIVITY, (2) UNDERACTIVITY OF THE GAMMA AMINO-BUTYRIC ACID (GABA) SYSTEM, THE PRIMARY INHIBITORY NEUROTRANSMITTER SYSTEM, AND (3) INCREASED ALLOSTATIC LOAD. IT IS FURTHER HYPOTHESIZED THAT YOGA-BASED PRACTICES (4) CORRECT UNDERACTIVITY OF THE PNS AND GABA SYSTEMS IN PART THROUGH STIMULATION OF THE VAGUS NERVES, THE MAIN PERIPHERAL PATHWAY OF THE PNS, AND (5) REDUCE ALLOSTATIC LOAD. DEPRESSION, EPILEPSY, POST TRAUMATIC STRESS DISORDER (PTSD), AND CHRONIC PAIN EXEMPLIFY MEDICAL CONDITIONS THAT ARE EXACERBATED BY STRESS, HAVE LOW HEART RATE VARIABILITY (HRV) AND LOW GABAERGIC ACTIVITY, RESPOND TO PHARMACOLOGIC AGENTS THAT INCREASE ACTIVITY OF THE GABA SYSTEM, AND SHOW SYMPTOM IMPROVEMENT IN RESPONSE TO YOGA-BASED INTERVENTIONS. THE OBSERVATION THAT TREATMENT RESISTANT CASES OF EPILEPSY AND DEPRESSION RESPOND TO VAGAL NERVE STIMULATION CORROBORATES THE NEED TO CORRECT PNS UNDERACTIVITY AS PART OF A SUCCESSFUL TREATMENT PLAN IN SOME CASES. ACCORDING TO THE PROPOSED THEORY, THE DECREASED PNS AND GABAERGIC ACTIVITY THAT UNDERLIES STRESS-RELATED DISORDERS CAN BE CORRECTED BY YOGA PRACTICES RESULTING IN AMELIORATION OF DISEASE SYMPTOMS. THIS HAS FAR-REACHING IMPLICATIONS FOR THE INTEGRATION OF YOGA-BASED PRACTICES IN THE TREATMENT OF A BROAD ARRAY OF DISORDERS EXACERBATED BY STRESS. 2012 13 161 26 A RANDOMISED CONTROLLED TRIAL OF ADJUNCTIVE YOGA AND ADJUNCTIVE PHYSICAL EXERCISE TRAINING FOR COGNITIVE DYSFUNCTION IN SCHIZOPHRENIA. BACKGROUND: YOGA AND PHYSICAL EXERCISE HAVE BEEN USED AS ADJUNCTIVE INTERVENTION FOR COGNITIVE DYSFUNCTION IN SCHIZOPHRENIA (SZ), BUT CONTROLLED COMPARISONS ARE LACKING. AIMS A SINGLE-BLIND RANDOMISED CONTROLLED TRIAL WAS DESIGNED TO EVALUATE WHETHER YOGA TRAINING OR PHYSICAL EXERCISE TRAINING ENHANCE COGNITIVE FUNCTIONS IN SZ, BASED ON A PRIOR PILOT STUDY. METHODS: CONSENTING, CLINICALLY STABLE, ADULT OUTPATIENTS WITH SZ (N=286) COMPLETED BASELINE ASSESSMENTS AND WERE RANDOMISED TO TREATMENT AS USUAL (TAU), SUPERVISED YOGA TRAINING WITH TAU (YT) OR SUPERVISED PHYSICAL EXERCISE TRAINING WITH TAU (PE). BASED ON THE PILOT STUDY, THE PRIMARY OUTCOME MEASURE WAS SPEED INDEX FOR THE COGNITIVE DOMAIN OF 'ATTENTION' IN THE PENN COMPUTERISED NEUROCOGNITIVE BATTERY. USING MIXED MODELS AND CONTRASTS, COGNITIVE FUNCTIONS AT BASELINE, 21 DAYS (END OF TRAINING), 3 AND 6 MONTHS POST-TRAINING WERE EVALUATED WITH INTENTION-TO-TREAT PARADIGM. RESULTS: SPEED INDEX OF ATTENTION DOMAIN IN THE YT GROUP SHOWED GREATER IMPROVEMENT THAN PE AT 6 MONTHS FOLLOW-UP (P<0.036, EFFECT SIZE 0.51). IN THE PE GROUP, 'ACCURACY INDEX OF ATTENTION DOMAIN SHOWED GREATER IMPROVEMENT THAN TAU ALONE AT 6-MONTH FOLLOW-UP (P<0.025, EFFECT SIZE 0.61). FOR SEVERAL OTHER COGNITIVE DOMAINS, SIGNIFICANT IMPROVEMENTS WERE OBSERVED WITH YT OR PE COMPARED WITH TAU ALONE (P<0.05, EFFECT SIZES 0.30-1.97). CONCLUSIONS: BOTH YT AND PE IMPROVED ATTENTION AND ADDITIONAL COGNITIVE DOMAINS WELL PAST THE TRAINING PERIOD, SUPPORTING OUR PRIOR REPORTED BENEFICIAL EFFECT OF YT ON SPEED INDEX OF ATTENTION DOMAIN. AS ADJUNCTS, YT OR PE CAN BENEFIT INDIVIDUALS WITH SZ. 2017 14 2731 25 YOGA OFFERS CARDIOVASCULAR PROTECTION IN EARLY POSTMENOPAUSAL WOMEN. CONTEXT: POSTMENOPAUSE, AN ESTROGEN DEFICIENT STATE COMES WITH INCREASED INCIDENCE OF CARDIOVASCULAR DISEASES (CVDS). YOGA HAS BEEN DESCRIBED AS HAVING A BENEFICIAL EFFECT ON HEART RATE VARIABILITY (HRV), A MARKER FOR CARDIAC AUTONOMIC ACTIVITY WHICH CAN ASSESS CARDIOVASCULAR RISK, IN VARIOUS POPULATIONS. AIM: THE AIM OF THE STUDY WAS TO STUDY THE EFFECT OF 3-MONTH LONG YOGA PRACTICE ON HRV IN EARLY POSTMENOPAUSAL WOMEN. SETTINGS AND DESIGN: A PROSPECTIVE LONGITUDINAL STUDY OF 67 WOMEN WITHIN 5 YEARS OF MENOPAUSE BETWEEN 45 AND 60 YEARS OF AGE ATTENDING MENOPAUSE CLINIC OF DEPARTMENT OF GYNAECOLOGY, SUCHETA KRIPLANI HOSPITAL FULFILLING INCLUSION AND EXCLUSION CRITERIA AND CONSENTING WERE ENROLLED FOR THE STUDY. SUBJECTS AND METHODS: HRV OF 37 CASES (YOGA GROUP) AND 30 CONTROLS (NON-YOGA GROUP) WAS RECORDED PRE AND 3-MONTH POSTINTERVENTION. STATISTICAL ANALYSIS USED: GRAPHPAD PRISM VERSION 5 SOFTWARE WAS USED. VALUES ARE A MEAN AND STANDARD ERROR OF MEAN. STATISTICAL SIGNIFICANCE WAS SET UP AT P < 0.05. RESULTS: IN HRV, FREQUENCY DOMAIN ANALYSIS SHOWED A SIGNIFICANT FALL IN LOW FREQUENCY (LF) IN NORMALIZED UNITS (NU) AND LF: HIGH FREQUENCY (HF) RATIO AND SIGNIFICANT RISE IN HF IN NU IN THE YOGA GROUP (DEPICTING PARASYMPATHETIC DOMINANCE) AGAINST A SIGNIFICANT RISE IN LF (NU) AND LF: HF RATIO AND SIGNIFICANT FALL IN HF (NU) IN NON-YOGA GROUP (INDICATING SYMPATHETIC DOMINANCE). TIME DOMAIN ANALYSIS SHOWED A SIGNIFICANT DECREASE IN STANDARD DEVIATION OF NN INTERVALS IN NON-YOGA GROUP AGAINST NONSIGNIFICANT CHANGES IN YOGA GROUP INDICATING DETERIORATION IN PARASYMPATHETIC ACTIVITY IN NON-YOGA GROUP. CONCLUSIONS: THREE-MONTH LONG YOGA PRACTICE IMPROVED HRV IN EARLY POSTMENOPAUSAL WOMEN SIGNIFICANTLY AND HAS THE POTENTIAL TO ATTENUATE THE CVD RISK IN POSTMENOPAUSAL WOMEN. 2018 15 350 31 ASSESSMENT OF CARDIAC AUTONOMIC TONE FOLLOWING LONG SUDARSHAN KRIYA YOGA IN ART OF LIVING PRACTITIONERS. OBJECTIVE: THE BREATHING PROCESSES ARE KNOWN TO MODULATE CARDIAC AUTONOMIC TONE AND IMPROVE PSYCHOLOGICAL STATUS. WE INVESTIGATED CARDIAC AUTONOMIC TONE FOLLOWING LONG SUDARSHAN KRIYA YOGA (SKY) USING HEART RATE VARIABILITY (HRV) AND SKIN CONDUCTANCE LEVEL (SCL). METHODS: THIRTY HEALTHY VOLUNTEERS (AGE 28.3 +/- 8.4 YEARS; 23 M: 7 F) PARTICIPATED IN THE STUDY. ELECTROCARDIOGRAM (ECG) AND SCL WERE RECORDED FOR 5 MIN EACH, BEFORE AND AFTER LONG SKY. LONG SKY IS A COMBINATION OF PRANAYAMA AND CYCLIC RHYTHMIC BREATHING AND IS PERFORMED BY FOLLOWING THE GUIDED AUDIO INSTRUCTIONS. HRV ANALYSIS WAS USED FOR THE ASSESSMENT OF CARDIAC AUTONOMIC TONE. TIME AND FREQUENCY DOMAIN PARAMETERS OF HRV WERE CALCULATED BY USING RR INTERVAL OF ECG. SCL WAS ACQUIRED USING GALVANIC SKIN RESPONSE (GSR) AMPLIFIER OF POWERLAB IN MICROSEIMENS (MUS). RESULTS: TIME DOMAIN PARAMETERS OF HRV, INCLUDING MEAN RR INTERVAL (P = 0.000), RESPIRATORY SINUS ARRHYTHMIA (RSA) (P = 0.037), STANDARD DEVIATION OF ALL NN INTERVALS (SDNN) (P = 0.013), NN50 COUNT DIVIDED BY THE TOTAL NUMBER OF ALL NN INTERVALS (PNN50) (P = 0.004), AND SQUARE ROOT OF THE MEAN OF THE SUM OF THE SQUARES OF DIFFERENCES BETWEEN ADJACENT NN INTERVALS (RMSSD) (P = 0.002) INCREASED, AND MEAN HEART RATE DECREASED (P = 0.000) FOLLOWING LONG SKY. IN FREQUENCY DOMAIN ANALYSIS, POWER OF LOW-FREQUENCY (LF) COMPONENT (P = 0.010) AND LF/HF RATIO (P = 0.008) DECREASED SIGNIFICANTLY, WHEREAS POWER OF HIGH FREQUENCY (HF) SIGNIFICANTLY INCREASED (P = 0.010). SCL DECREASED FOLLOWING LONG SKY, ALTHOUGH IT DID NOT ATTAIN STATISTICAL SIGNIFICANCE. CONCLUSIONS: THE RESULTS SUGGEST THAT LONG SKY INDUCES SIGNIFICANT OSCILLATIONS IN CARDIAC AUTONOMIC TONE. PARASYMPATHETIC ACTIVITY INCREASES AND SYMPATHETIC ACTIVITY DECREASES AND SYMPATHOVAGAL BALANCE IMPROVES FOLLOWING LONG SKY. DECREASE IN SYMPATHETIC ACTIVITY IS ALSO DEMONSTRATED BY DECREASE IN CONDUCTANCE ALTHOUGH IT DID NOT REACH STATISTICAL SIGNIFICANCE. FROM THIS STUDY IT CAN BE CONCLUDED THAT LONG SKY HAS A BENEFICIAL EFFECT ON CARDIAC AUTONOMIC TONE, AND PSYCHOPHYSIOLOGICAL RELAXATION. IT MAY SERVE AS A TOOL TO IMPROVE HRV, WHICH IS THE MARKER OF CARDIOVASCULAR HEALTH. 2017 16 2441 33 YOGA AND SCHIZOPHRENIA-A COMPREHENSIVE ASSESSMENT OF NEUROPLASTICITY: PROTOCOL FOR A SINGLE BLIND RANDOMIZED CONTROLLED STUDY OF YOGA IN SCHIZOPHRENIA. INTRODUCTION: SCHIZOPHRENIA IS ONE OF THE MOST SEVERE MENTAL DISORDERS WITH A PREVALENCE OF ABOUT 1% AND A LEADING CAUSE OF DISABILITY AMONG YOUNG ADULTS. PHARMACOTHERAPY IS THE MAINSTAY IN THE MANAGEMENT OF SCHIZOPHRENIA. HOWEVER, EVEN WITH THE BEST OF MEDICATION, SEVERAL PROBLEMS LIKE REFRACTORINESS, NEGATIVE SYMPTOMS, FREQUENT RELAPSES, AND COGNITIVE IMPAIRMENTS PERSIST. METHODS: THIS IS A RANDOMIZED-CONTROLLED CLINICAL STUDY INCLUDING PATIENTS FROM AN URBAN TERTIARY HOSPITAL AND A SEMI-URBAN COMMUNITY CENTER, WITH A BETWEEN-GROUP, REPEATED-MEASURES, LONGITUDINAL DESIGN. THIS STUDY WILL RECRUIT 160 PATIENTS WITH DSM 5 DIAGNOSIS OF SCHIZOPHRENIA WHO ARE ON STABLE MEDICATION FOR A MINIMUM OF 6 WEEKS; THEY WILL BE RANDOMLY ASSIGNED INTO 2 ARMS VIZ., YOGA THERAPY (YT), AND TREATMENT-AS-USUAL (TAU) WITH 80 PATIENTS IN EACH ARM. PARTICIPANTS WILL UNDERGO CLINICAL, LABORATORY, AND RADIOLOGICAL ASSESSMENTS AT BASELINE AND AT INTERVALS OF 1 MONTH, 3 MONTHS, AND 6 MONTHS FROM THE BASELINE. IT IS HYPOTHESIZED THAT YOGA WILL IMPROVE PSYCHOPATHOLOGY AND EMOTION PROCESSING, INCREASE SERUM BRAIN DERIVED NEUROTROPHIC FACTOR (BDNF) AND PLASMA OXYTOCIN LEVELS AND EFFECT CHANGES IN CEREBRAL ACTIVATION IN AREAS OF THE BRAIN ASSOCIATED WITH SCHIZOPHRENIA. DISCUSSION: THIS STUDY AIMS TO MEASURE THE EFFICACY OF A YOGA-BASED INTERVENTION AS AN ADJUNCT IN PATIENTS WITH SCHIZOPHRENIA AS WELL AS THE MECHANISMS OF THESE EFFECTS. TRIAL REGISTRATION: REGISTERED RETROSPECTIVELY WITH CLINICAL TRIAL REGISTRY - INDIA (CTRI) WITH REGISTRATION NUMBER CTRI/2017/08/009219. 2019 17 1530 30 IYENGAR YOGA INCREASES CARDIAC PARASYMPATHETIC NERVOUS MODULATION AMONG HEALTHY YOGA PRACTITIONERS. RELAXATION TECHNIQUES ARE ESTABLISHED IN MANAGING OF CARDIAC PATIENTS DURING REHABILITATION AIMING TO REDUCE FUTURE ADVERSE CARDIAC EVENTS. IT HAS BEEN HYPOTHESIZED THAT RELAXATION-TRAINING PROGRAMS MAY SIGNIFICANTLY IMPROVE CARDIAC AUTONOMIC NERVOUS TONE. HOWEVER, THIS HAS NOT BEEN PROVEN FOR ALL AVAILABLE RELAXATION TECHNIQUES. WE TESTED THIS ASSUMPTION BY INVESTIGATING CARDIAC VAGAL MODULATION DURING YOGA.WE EXAMINED 11 HEALTHY YOGA PRACTITIONERS (7 WOMEN AND 4 MEN, MEAN AGE: 43 +/- 11; RANGE: 26-58 YEARS). EACH INDIVIDUAL WAS SUBJECTED TO TRAINING UNITS OF 90 MIN ONCE A WEEK OVER FIVE SUCCESSIVE WEEKS. DURING TWO SESSIONS, THEY PRACTICED A YOGA PROGRAM DEVELOPED FOR CARDIAC PATIENTS BY B.K.S. IYENGAR. ON THREE SESSIONS, THEY PRACTICED A PLACEBO PROGRAM OF RELAXATION. ON EACH TRAINING DAY THEY UNDERWENT AMBULATORY 24 H HOLTER MONITORING. THE GROUP OF YOGA PRACTITIONERS WAS COMPARED TO A MATCHED GROUP OF HEALTHY INDIVIDUALS NOT PRACTICING ANY RELAXATION TECHNIQUES. PARAMETERS OF HEART RATE VARIABILITY (HRV) WERE DETERMINED HOURLY BY A BLINDED OBSERVER. MEAN RR INTERVAL (INTERVAL BETWEEN TWO R-WAVES OF THE ECG) WAS SIGNIFICANTLY HIGHER DURING THE TIME OF YOGA INTERVENTION COMPARED TO PLACEBO AND TO CONTROL (P < 0.001 FOR BOTH). THE INCREASE IN HRV PARAMETERS WAS SIGNIFICANTLY HIGHER DURING YOGA EXERCISE THAN DURING PLACEBO AND CONTROL ESPECIALLY FOR THE PARAMETERS ASSOCIATED WITH VAGAL TONE, I.E. MEAN STANDARD DEVIATION OF NN (NORMAL BEAT TO NORMAL BEAT OF THE ECG) INTERVALS FOR ALL 5-MIN INTERVALS (SDNNI, P < 0.001 FOR BOTH) AND ROOT MEAN SQUARE SUCCESSIVE DIFFERENCE (RMSSD, P < 0.01 FOR BOTH). IN CONCLUSION, RELAXATION BY YOGA TRAINING IS ASSOCIATED WITH A SIGNIFICANT INCREASE OF CARDIAC VAGAL MODULATION. SINCE THIS METHOD IS EASY TO APPLY WITH NO SIDE EFFECTS, IT COULD BE A SUITABLE INTERVENTION IN CARDIAC REHABILITATION PROGRAMS. 2007 18 588 40 DETERMINING PSYCHONEUROIMMUNOLOGIC MARKERS OF YOGA AS AN INTERVENTION FOR PERSONS DIAGNOSED WITH PTSD: A SYSTEMATIC REVIEW. THERE IS A GROWING BODY OF RESEARCH ON YOGA AS A THERAPEUTIC INTERVENTION FOR PSYCHOLOGICAL SYMPTOMS OF POST-TRAUMATIC STRESS DISORDER (PTSD) ACCOMPANIED BY SPECULATIONS ON UNDERLYING PHYSIOLOGIC MECHANISMS. THE PURPOSE OF THIS SYSTEMATIC REVIEW IS TO IDENTIFY, QUALITATIVELY EVALUATE, AND SYNTHESIZE STUDIES OF YOGA AS AN INTERVENTION FOR PTSD THAT MEASURED PHYSIOLOGIC OUTCOMES IN ORDER TO GAIN INSIGHTS INTO POTENTIAL MECHANISMS. THE FOCUS IS ON STUDIES EVALUATING YOGA AS A THERAPEUTIC INTERVENTION FOR PTSD RATHER THAN FOR TRAUMA EXPOSURE, PTSD PREVENTION, OR SUBCLINICAL PTSD. MULTIPLE DATABASES WERE SEARCHED FOR PUBLICATIONS FROM THE PAST TWO DECADES USING TERMS DERIVED FROM THE QUESTION, "IN PEOPLE WITH PTSD, WHAT IS THE EFFECT OF YOGA ON OBJECTIVE OUTCOMES?" ELIGIBILITY CRITERIA INCLUDED YOGA-ONLY MODALITIES TESTED AS AN INTERVENTION FOR FORMALLY DIAGNOSED PTSD WITH AT LEAST ONE PHYSIOLOGIC OUTCOME. RESULTS OF THIS REVIEW CONFIRMED THAT, THOUGH MUCH OF THE PUBLISHED LITERATURE PROPOSES PHYSIOLOGICAL MECHANISMS UNDERLYING YOGA'S EFFECTS ON PTSD, VERY FEW STUDIES ( N = 3) HAVE ACTUALLY EVALUATED PHYSIOLOGICAL EVIDENCE. ADDITIONALLY, SEVERAL STUDIES HAD METHODOLOGICAL LIMITATIONS. IN LIGHT OF THE LIMITED DATA SUPPORTING YOGA'S BENEFICIAL EFFECTS ON AUTONOMIC NERVOUS SYSTEM DYSREGULATION, WE PRESENT A THEORETICAL MODEL OF THE PSYCHONEUROIMMUNOLOGIC PROCESSES ASSOCIATED WITH PTSD AND THE EFFECTS YOGA MAY HAVE ON THESE PROCESSES TO GUIDE FUTURE RESEARCH. GAPS IN THE LITERATURE REMAIN FOR MECHANISMS RELATED TO ACTIVATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS AND INFLAMMATION. ADDITIONAL RIGOROUS MECHANISTIC STUDIES ARE NEEDED TO GUIDE DEVELOPMENT OF EFFECTIVE YOGA INTERVENTIONS FOR PTSD TO AUGMENT EXISTING EVIDENCE-BASED PTSD TREATMENTS. 2018 19 1318 28 HEART RATE VARIABILITY IN CHRONIC LOW BACK PAIN PATIENTS RANDOMIZED TO YOGA OR STANDARD CARE. BACKGROUND: CHRONIC PAIN CAN ALTER THE AUTONOMIC BALANCE WITH INCREASED SYMPATHETIC ACTIVITY REFLECTED IN ALTERED HEART RATE VARIABILITY (HRV). IT HAS BEEN PROPOSED THAT YOGA CAN BE USEFUL TO CORRECT THE AUTONOMIC IMBALANCE IN PATIENTS WITH CHRONIC PAIN WHO HAVE REDUCED HRV. METHODS AND DESIGNS: IN THE PRESENT RANDOMIZED CONTROLLED TRIAL 62 PATIENTS WITH CHRONIC LOW BACK PAIN ASSOCIATED WITH ALTERED ALIGNMENT OF INTERVERTEBRAL DISCS (AGED BETWEEN 20 AND 45 YEARS, 32 MALES) WERE RANDOMIZED TO 2 GROUPS. ONE GROUP RECEIVED YOGA FOR 3 MONTHS WHILE THE OTHER GROUP CARRIED OUT STANDARD MEDICAL CARE BASED ON THE PHYSICIAN'S ADVICE. THE DURATION WAS THE SAME, I.E., 3 MONTHS. THE HEART RATE VARIABILITY AND RATE OF RESPIRATION WERE ASSESSED AT BASELINE AND AT THE END OF 3 MONTHS. RESULTS: THERE WAS A SIGNIFICANT DIFFERENCE IN THE BASELINE (PRE) VALUES BETWEEN GROUPS (P = 0.008) FOR RESPIRATION RATE WHICH WAS HIGHER IN THE YOGA GROUP. THE CHANGES REPORTED BELOW ARE PRE-POST COMPARISONS WITHIN EACH GROUP. THE YOGA GROUP SHOWED A SIGNIFICANT (P < 0.05; REPEATED MEASURES ANOVA, POST-HOC ANALYSES) DECREASE IN THE LF POWER OF HRV, RATE OF RESPIRATION AND A SIGNIFICANT INCREASE IN THE HF POWER OF HRV AND IN THE PNN50. CONCLUSION: THE RESULTS SUGGEST THAT YOGA PRACTICE CAN SHIFT THE AUTONOMIC BALANCE TOWARDS VAGAL DOMINANCE IN PATIENTS WITH CHRONIC LOW BACK PAIN ASSOCIATED WITH ALTERED ALIGNMENT OF INTERVERTEBRAL DISCS. TRIAL REGISTRATION: THE STUDY IS REGISTERED WITH THE CLINICAL TRIALS REGISTRY OF INDIA ( CTRI/2012/11/003094 ) AND CAN BE ACCESSED AT. 2016 20 76 28 A HEURISTIC MODEL LINKING YOGA PHILOSOPHY AND SELF-REFLECTION TO EXAMINE UNDERLYING MECHANISMS OF ADD-ON YOGA TREATMENT IN SCHIZOPHRENIA. PRELIMINARY EVIDENCE SUGGESTS EFFICACY OF YOGA AS ADD-ON TREATMENT FOR SCHIZOPHRENIA, BUT THE UNDERLYING MECHANISM BY WHICH YOGA IMPROVES THE SYMPTOMS OF SCHIZOPHRENIA IS NOT COMPLETELY UNDERSTOOD. YOGA IMPROVES SELF-REFLECTION IN HEALTHY INDIVIDUALS, AND SELF-REFLECTION ABNORMALITIES ARE TYPICALLY SEEN IN SCHIZOPHRENIA. HOWEVER, WHETHER YOGA TREATMENT IMPROVES IMPAIRMENTS IN SELF-REFLECTION TYPICALLY SEEN IN PATIENTS WITH SCHIZOPHRENIA IS NOT EXAMINED. THIS PAPER DISCUSSES THE POTENTIAL MECHANISM OF YOGA IN THE TREATMENT OF SCHIZOPHRENIA AND PROPOSES A TESTABLE HYPOTHESIS FOR FURTHER EMPIRICAL STUDIES. IT IS PROPOSED THAT SELF-REFLECTION ABNORMALITIES IN SCHIZOPHRENIA IMPROVE WITH YOGA AND THE NEUROBIOLOGICAL CHANGES ASSOCIATED WITH THIS CAN BE EXAMINED USING EMPIRICAL BEHAVIOURAL MEASURES AND NEUROIMAGING MEASURES SUCH AS MAGNETIC RESONANCE IMAGING. 2016