1 2608 48 YOGA FOR PSYCHIATRIC DISORDERS: FROM FAD TO EVIDENCE-BASED INTERVENTION? THERE IS GROWING EVIDENCE FOR YOGA'S NEUROBIOLOGICAL EFFECTS IN PEOPLE WITH PSYCHIATRIC DISORDERS. POSTULATED MECHANISMS OF ACTION INCLUDE: (A) MODULATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS; (B) ENHANCEMENT OF GABAERGIC NEUROTRANSMISSION; (C) AUTONOMIC MODULATION; AND (D) NEUROENDOCRINOLOGICAL EFFECTS. YOGA AS A THERAPEUTIC INTERVENTION IN PSYCHIATRIC DISORDERS APPEARS PROMISING AND MERITS FURTHER ATTENTION IN CLINICAL PRACTICE AND RESEARCH. 2020 2 988 21 EFFECTS OF HATHA YOGA ON BLOOD PRESSURE, SALIVARY ALPHA-AMYLASE, AND CORTISOL FUNCTION AMONG NORMOTENSIVE AND PREHYPERTENSIVE YOUTH. OBJECTIVE: EVIDENCE IS ACCUMULATING, PREDOMINANTLY AMONG CLINICAL TRIALS IN ADULTS, THAT YOGA IMPROVES BLOOD PRESSURE (BP) CONTROL, WITH DOWNREGULATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS AND THE SYMPATHETIC NERVOUS SYSTEM (SNS) PROJECTED AS UNDERLYING MECHANISMS. THIS PILOT STUDY ASSESSED WHETHER HATHA YOGA HAS THE POTENTIAL TO REDUCE BP AMONG YOUTH AND WHETHER DAMPENING OF THE SNS AND/OR HPA ACTIVITY IS A LIKELY PATHWAY OF CHANGE. DESIGN: THIRTY-ONE SEVENTH GRADERS WERE RANDOMLY ASSIGNED TO A HATHA YOGA PROGRAM (HYP) OR ATTENTION CONTROL (AC) MUSIC OR ART CLASS. BASELINE AND 3-MONTH EVALUATIONS INCLUDED RESTING BP; OVERNIGHT URINE SAMPLES; AND SALIVA COLLECTED AT BEDTIME, UPON AWAKENING, AND AT 30 AND 60 MINUTES AFTER AWAKENING FOR ALPHA-AMYLASE AND CORTISOL ASSAYS. RESULTS: TWENTY-EIGHT (14 IN THE HYP GROUP AND 14 IN THE AC GROUP) STUDENTS WERE ASSESSED BOTH BEFORE AND AFTER THE INTERVENTION. BP CHANGES FROM PRE- TO POST-INTERVENTION WERE -3.0/-2.0 MMHG FOR THE HYP GROUP AND -0.07/-0.79 MMHG FOR THE AC GROUP (P=0.30 AND 0.57, RESPECTIVELY). CHANGES IN SYSTOLIC BP (SBP)/DIASTOLIC BP (DBP) FOR THE PREHYPERTENSIVE (75TH-94TH PERCENTILES FOR SBP) SUBGROUP ANALYSES WERE -10.75/-8.25 MMHG FOR THE HYP GROUP (N=4) VERSUS 1.8/1.0 MMHG FOR THE AC GROUP (N=5) (P FOR SBP=0.02; P FOR DBP=0.09). ALTHOUGH NO STATISTICALLY SIGNIFICANT GROUP DIFFERENCES WERE OBSERVED WITH CHANGES IN SNS OR HPA AWAKENING CURVES (AREA UNDER CURVE FOR ALPHA-AMYLASE AND CORTISOL, RESPECTIVELY), A SMALL TO MODERATE EFFECT SIZE WAS SEEN FAVORING A REDUCTION OF ALPHA-AMYLASE ACTIVATION FOR THE HYP GROUP (COHEN D=0.34; PREHYPERTENSIVE D=0.20). CONCLUSIONS: A SCHOOL-BASED HATHA YOGA PROGRAM DEMONSTRATED POTENTIAL TO DECREASE RESTING BP, PARTICULARLY AMONG PREHYPERTENSIVE YOUTH. REDUCED SNS DRIVE MAY BE AN UNDERLYING NEUROHORMONAL PATHWAY BENEFICIALLY AFFECTED BY THE PROGRAM. A LARGE-SCALE EFFICACY/EFFECTIVENESS RANDOMIZED CLINICAL TRIAL IS WARRANTED. 2014 3 2241 14 THE INFLUENCE OF HATHA YOGA AS AN ADD-ON TREATMENT IN MAJOR DEPRESSION ON HYPOTHALAMIC-PITUITARY-ADRENAL-AXIS ACTIVITY: A RANDOMIZED TRIAL. OBJECTIVES: THE IMPACT OF HATHA YOGA AS ADD-ON TREATMENT TO QUETIAPINE FUMARATE EXTENDED RELEASE (QXR) OR ESCITALOPRAM (ESC) IN DEPRESSED PATIENTS ON HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS ACTIVITY WAS ASSESSED. METHODS: 60 INPATIENTS SUFFERING FROM MAJOR DEPRESSIVE DISORDER (MDD) ACCORDING TO DSM-IV WERE RANDOMIZED FOR A 5 WEEK TREATMENT WITH YOGA OR NOT (CONTROL GROUP) AND WITH EITHER QXR (300 MG/DAY) OR ESC (10 MG/DAY). SERIAL DEXAMETHASONE/CORTICOTROPIN RELEASING HORMONE (DEX/CRH) TESTS WERE PERFORMED TO ASSESS HPA AXIS FUNCTION. THE HAMILTON DEPRESSION RATING SCALE (21-HAMD) WAS USED WEEKLY. RESULTS: A MORE PRONOUNCED DOWN REGULATION OF THE HPA AXIS ACTIVITY DUE TO YOGA COULD NOT BE DETECTED. THE STEPWISE LONG TERM CORTISOL REDUCTION WAS SEEN IN BOTH MEDICATION GROUPS, IRRESPECTIVELY OF YOGA ADD-ON TREATMENT. IN ADDITION, CORTISOL IMPROVERS IN WEEK 1 OF THERAPY (REDUCTION IN CORTISOL PEAK VALUE WITHIN THE DEX/CRH TEST) REACHED SIGNIFICANT GREATER AMELIORATION OF DEPRESSIVE SYMPTOMS AFTER 5 WEEKS. CONCLUSIONS: OUR RESULTS SUGGEST THAT ANTIDEPRESSANT AGENTS DOWN REGULATE HPA AXIS FUNCTION TO A GREATER EXTENT THAN ADDITIONAL HATHA YOGA TREATMENT. MOREOVER, AN EARLY REDUCTION OF HPA SYSTEM HYPERACTIVITY AFTER ONE WEEK OF PHARMACOLOGICAL TREATMENT SEEMS TO RAISE THE POSSIBILITY OF A FAVORABLE TREATMENT RESPONSE. 2014 4 2790 17 YOGA THERAPY FOR ANXIETY: A CASE REPORT. YOGA THERAPY IS A MIND-BODY INTERVENTION THAT CAN BE AN IMPORTANT SOLUTION IN THE TREATMENT OF ANXIETY. YOGA THERAPY ALLEVIATES THE HYPERAROUSAL OF THE SYMPATHETIC NERVOUS SYSTEM (SNS) AND THE HYPERVIGILANCE OF THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS THAT OCCURS IN ANXIETY. YOGA THERAPY ACTIVATES THE PARASYMPATHETIC BRANCH OF THE NERVOUS SYSTEM, REPLACING SNS OVERDRIVE, OR THE FLIGHT-OR-FIGHT RESPONSE, WITH THE RELAXATION RESPONSE AND BALANCING THE NERVOUS SYSTEM. YOGA THERAPY INCREASES POSITIVE COPING SKILLS AND BUILDS SELF-ESTEEM WITHOUT HARMFUL SIDE EFFECTS. THE RESULTS OF THIS CASE STUDY HAVE DEMONSTRATED THE CLINICAL EFFICACY OF YOGA THERAPY IN THE TREATMENT OF ANXIETY AND PANIC DISORDER (PD) IN AN ADOLESCENT FEMALE. TREATMENT CONSISTED OF 4 WKS OF INDIVIDUAL SESSIONS (60-MIN SESSION/WK) AND 6 WKS OF GROUP SESSIONS (90-MIN SESSION/WK) WITH DAILY HOME PRACTICE. THE RESULTS OF THE CASE STUDY ARE SIGNIFICANT BECAUSE GROWING NUMBERS OF YOUTH IN THE UNITED STATES ARE PRESENTING WITH ANXIETY AND SEEKING NONPHARMACOLOGICAL OPTIONS. 2013 5 1824 20 PSYCHO-NEURO-ENDOCRINE-IMMUNE MECHANISMS OF ACTION OF YOGA IN TYPE II DIABETES. YOGA HAS BEEN FOUND TO BENEFIT ALL THE COMPONENTS OF HEALTH VIZ. PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL WELL BEING BY INCORPORATING A WIDE VARIETY OF PRACTICES. PATHOPHYSIOLOGY OF TYPE II DM AND CO-MORBIDITIES IN TYPE II DM HAS BEEN CORRELATED WITH STRESS MECHANISMS. STRESS SUPPRESSES BODY'S IMMUNE SYSTEM AND NEURO-HUMORAL ACTIONS THEREBY AFF ECTING NORMAL PSYCHOLOGICAL STATE. IT WOULD NOT BE WRONG TO STATE THAT CORRELATION OF DIABETES WITH STRESS, ANXIETY AND OTHER PSYCHOLOGICAL FACTORS ARE BIDIRECTIONAL AND LEAD TO DIFFICULTY IN UNDERSTANDING THE INTERRELATED MECHANISMS. TYPE II DM CANNOT BE UNDERSTOOD IN ISOLATION WITH PSYCHOLOGICAL FACTORS SUCH AS STRESS, ANXIETY AND DEPRESSION, NEURO-ENDOCRINE AND IMMUNOLOGICAL FACTORS. THERE IS NO REVIEW WHICH TRIES TO UNDERSTAND THESE MECHANISMS EXCLUSIVELY. THE PRESENT LITERATURE REVIEW AIMS TO UNDERSTAND INTERRELATED PSYCHO-NEURO-ENDOCRINE AND IMMUNOLOGICAL MECHANISMS OF ACTION OF YOGA IN TYPE II DIABETES MELLITUS. PUBLISHED LITERATURE CONCERNING MECHANISMS OF ACTION OF YOGA IN TYPE II DM EMPHASIZING PSYCHO-NEURO-ENDOCRINE OR IMMUNOLOGICAL RELATIONS WAS RETRIEVED FROM PUBMED USING KEY WORDS YOGA, TYPE II DIABETES MELLITUS, PSYCHOLOGICAL, NEURAL, ENDOCRINE, IMMUNE AND MECHANISM OF ACTION. THOSE STUDIES WHICH EXPLAINED THE PSYCHO-NEUROENDOCRINE AND IMMUNE MECHANISMS OF ACTION OF YOGA WERE INCLUDED AND REST WERE EXCLUDED. ALTHOUGH PRIMARY AIM OF THIS STUDY IS TO EXPLAIN THESE MECHANISMS IN TYPE II DM, SOME STUDIES IN NON-DIABETIC POPULATION WHICH HAD A SIMILAR PATHWAY OF STRESS MECHANISM WAS INCLUDED BECAUSE MANY INSIGHTFUL STUDIES WERE AVAILABLE IN THAT AREA. SEARCH WAS CONDUCTED USING TERMS YOGA OR YOGIC AND DIABETES OR DIABETIC IN TITLE OR ABSTRACT FOR ENGLISH ARTICLES. OF THE 89 ARTICLES, WE EXCLUDED NON-ENGLISH ARTICLES (22), EDITORIALS (20) AND LETTERS TO EDITOR (10). 37 STUDIES WERE CONSIDERED FOR THIS REVIEW. THE POSTULATED MECHANISM OF ACTION OF YOGA IS THROUGH PARASYMPATHETIC ACTIVATION AND THE ASSOCIATED ANTI STRESS MECHANISM. IT REDUCES PERCEIVED STRESS AND HPA AXIS ACTIVATION THEREBY IMPROVING OVERALL METABOLIC AND PSYCHOLOGICAL PROFILES, INCREASING INSULIN SENSITIVITY, AND IMPROVING GLUCOSE TOLERANCE AND LIPID METABOLISM. YOGA HAS POSITIVE EFFECTS ON IMMUNE SYSTEM OF DIABETICS.- OVERALL, TYPE II DM IS INFLUENCED BY PSYCHO-NEURO-ENDOCRINE AND IMMUNE MECHANISMS WHERE YOGA HAS IMPORTANT POSITIVE ROLE IN COMBATING STRESSORS AND IMPROVING THESE SYSTEMS TO REGAIN HEALTH. 2015 6 1639 16 MODULATION OF IMMUNE RESPONSES IN STRESS BY YOGA. STRESS IS A CONSTANT FACTOR IN TODAY'S FASTPACED LIFE THAT CAN JEOPARDIZE OUR HEALTH IF LEFT UNCHECKED. IT IS ONLY IN THE LAST HALF CENTURY THAT THE ROLE OF STRESS IN EVERY AILMENT FROM THE COMMON COLD TO AIDS HAS BEEN EMPHASIZED, AND THE MECHANISMS INVOLVED IN THIS PROCESS HAVE BEEN STUDIED. STRESS INFLUENCES THE IMMUNE RESPONSE PRESUMABLY THROUGH THE ACTIVATION OF THE HYPOTHALAMIC-PITUITARY ADRENAL AXIS, HYPOTHALAMIC PITUITARY-GONADAL AXIS, AND THE SYMPATHETIC-ADRENAL-MEDULLARY SYSTEM. VARIOUS NEUROTRANSMITTERS, NEUROPEPTIDES, HORMONES, AND CYTOKINES MEDIATE THESE COMPLEX BIDIRECTIONAL INTERACTIONS BETWEEN THE CENTRAL NERVOUS SYSTEM (CNS) AND THE IMMUNE SYSTEM. THE EFFECTS OF STRESS ON THE IMMUNE RESPONSES RESULT IN ALTERATIONS IN THE NUMBER OF IMMUNE CELLS AND CYTOKINE DYSREGULATION. VARIOUS STRESS MANAGEMENT STRATEGIES SUCH AS MEDITATION, YOGA, HYPNOSIS, AND MUSCLE RELAXATION HAVE BEEN SHOWN TO REDUCE THE PSYCHOLOGICAL AND PHYSIOLOGICAL EFFECTS OF STRESS IN CANCERS AND HIV INFECTION. THIS REVIEW AIMS TO DISCUSS THE EFFECT OF STRESS ON THE IMMUNE SYSTEM AND EXAMINE HOW RELAXATION TECHNIQUES SUCH AS YOGA AND MEDITATION COULD REGULATE THE CYTOKINE LEVELS AND HENCE, THE IMMUNE RESPONSES DURING STRESS. 2008 7 2009 21 SUBJECTIVE SLEEP QUALITY AND HORMONAL MODULATION IN LONG-TERM YOGA PRACTITIONERS. YOGA REPRESENTS A FASCINATING MIND-BODY APPROACH, WHEREIN BODY MOVEMENTS (ASANA), BREATHING EXERCISES (PRANAYAMA) AND MEDITATION ARE INTEGRATED INTO A SINGLE MULTIDIMENSIONAL PRACTICE. NUMEROUS BENEFICIAL MENTAL AND PHYSICAL EFFECTS HAVE BEEN CLASSICALLY ASCRIBED TO THIS HOLISTIC ANCIENT METHOD. THE PURPOSE OF THE PRESENT STUDY HAS BEEN TO EXAMINE THE EFFECTS OF LONG-TERM YOGA PRACTICE ON SUBJECTIVE SLEEP QUALITY (SSQ) AND ON SEVERAL HORMONAL PARAMETERS OF THE HYPOTHALAMUS-PITUITARY-ADRENAL (HPA) AXIS. TWENTY-SIX SUBJECTS (16 EXPERIMENTAL AND 10 CONTROLS) WERE RECRUITED TO BE PART OF THE STUDY. EXPERIMENTAL SUBJECTS WERE REGULAR YOGA PRACTITIONERS WITH A MINIMUM OF 3 YEARS OF PRACTICE. BLOOD SAMPLES FOR THE QUANTIFICATION OF ADRENOCORTICOTROPIC HORMONE (ACTH), CORTISOL AND DEHYDROEPIANDROSTERONE SULPHATE (DHEA-S) WERE DRAWN FROM ALL SUBJECTS. LIKEWISE, THE PITTSBURGH SLEEP QUALITY INDEX (PSQI) WAS EMPLOYED TO ASSESS SSQ. AS STATISTICAL ANALYSIS, MANN-WHITNEY U-TEST WAS PERFORMED. THE YOGA GROUP DISPLAYED LOWER PSQI SCORES AND HIGHER BLOOD CORTISOL LEVELS THAN CONTROL SUBJECTS. THEREFORE, IT CAN BE CONCLUDED THAT LONG-TERM YOGA PRACTICE IS ASSOCIATED WITH SIGNIFICANT PSYCHO-BIOLOGICAL DIFFERENCES, INCLUDING BETTER SLEEP QUALITY AS WELL AS A MODULATORY ACTION ON THE LEVELS OF CORTISOL. THESE PRELIMINARY RESULTS SUGGEST INTERESTING CLINICAL IMPLICATIONS WHICH SHOULD BE FURTHER RESEARCHED. 2009 8 2743 17 YOGA PRACTICE IMPROVES EXECUTIVE FUNCTION BY ATTENUATING STRESS LEVELS. BACKGROUND: PROLONGED ACTIVATION OF THE HYPOTHALAMUS-PITUITARY-ADRENAL SYSTEM IS THOUGHT TO HAVE DELETERIOUS EFFECTS ON BRAIN FUNCTION. NEUROENDOCRINE STUDIES SUGGEST THAT BRAIN EXPOSURE TO HIGHER CORTISOL CONCENTRATIONS CONTRIBUTE TO COGNITIVE DEFICITS AS WE AGE. MIND-BODY TECHNIQUES SUCH AS YOGA HAVE SHOWN TO IMPROVE STRESS LEVELS BY RESTORING THE BODY'S SYMPATHETIC-PARASYMPATHETIC BALANCE. THE OBJECTIVE OF THIS STUDY WAS TO DETERMINE WHETHER YOGA PRACTICE MODERATED THE STRESS RESPONSE RESULTING IN IMPROVED EXECUTIVE FUNCTION. METHODS: SEDENTARY COMMUNITY DWELLING OLDER ADULTS (N=118, MEAN AGE=62.02) WERE RANDOMIZED TO AN 8-WEEK YOGA INTERVENTION OR A STRETCHING CONTROL GROUP. AT BASELINE AND FOLLOWING 8 WEEKS, ALL PARTICIPANTS COMPLETED MEASURES OF EXECUTIVE FUNCTION, SELF-REPORTED STRESS AND ANXIETY AND PROVIDED SALIVA SAMPLES BEFORE AND AFTER COGNITIVE TESTING TO ASSESS CORTISOL. RESULTS: YOGA PARTICIPANTS SHOWED IMPROVED ACCURACY ON EXECUTIVE FUNCTION MEASURES AND AN ATTENUATED CORTISOL RESPONSE COMPARED TO THEIR STRETCHING COUNTERPARTS WHO SHOWED INCREASED CORTISOL LEVELS AND POOR COGNITIVE PERFORMANCE AT FOLLOW UP. THE CHANGE IN CORTISOL LEVELS AS WELL AS SELF-REPORTED STRESS AND ANXIETY LEVELS PREDICTED PERFORMANCE ON THE RUNNING SPAN TASK, N-BACK WORKING MEMORY AND TASK SWITCHING PARADIGM (BETA'S=0.27-0.38, P'S