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 2 450 43 CHANGES IN CIRCULATING MICRORNA AFTER RECUMBENT ISOMETRIC YOGA PRACTICE BY PATIENTS WITH MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME: AN EXPLORATIVE PILOT STUDY. BACKGROUND: YOGA IS A REPRESENTATIVE MIND-BODY THERAPY. OUR PREVIOUS STUDIES HAVE DEMONSTRATED THAT ISOMETRIC YOGA (I.E. YOGA PROGRAMS THAT WE DEVELOPED SO INDIVIDUALS CAN PRACTICE YOGA POSES WITH A SELF-ADJUSTABLE ISOMETRIC LOAD) REDUCES THE FATIGUE OF PATIENTS WITH MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME (ME/CFS); HOWEVER, THE UNDERLYING MECHANISMS REMAIN UNCLEAR. SEVERAL STUDIES HAVE SUGGESTED THAT THE MICRO-RIBONUCLEIC ACID (MIRNA) EXPRESSION OF ME/CFS PATIENTS IS DIFFERENT FROM THAT OF HEALTHY SUBJECTS. HOWEVER, IT HAS NOT TO DATE BEEN DETERMINED IF THE PRACTICE OF ISOMETRIC YOGA CAN AFFECT MIRNA EXPRESSION. THEREFORE, WE SOUGHT TO INVESTIGATE IF ISOMETRIC YOGA IS ASSOCIATED WITH CHANGES IN THE EXPRESSION LEVELS OF SERUM MIRNA OF PATIENTS WITH ME/CFS. METHODS: THE STUDY INCLUDED NINE PATIENTS WITH ME/CFS WHO FAILED TO SHOW SATISFACTORY IMPROVEMENT AFTER AT LEAST 6 MONTHS OF TREATMENT ADMINISTERED AT OUR HOSPITAL. PATIENTS PRACTICED RECUMBENT ISOMETRIC YOGA FOR 3 MONTHS; THEY MET WITH A YOGA INSTRUCTOR EVERY 2 TO 4 WEEKS AND PARTICIPATED IN DAILY IN-HOME SESSIONS. THE EFFECT OF RECUMBENT ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY COMPARING PRE- AND POST-INTERVENTION SCORES ON THE JAPANESE VERSION OF THE 11-ITEM CHALDER FATIGUE SCALE (CFQ 11). PATIENT BLOOD SAMPLES WERE DRAWN PRE- AND POST-INTERVENTION, JUST PRIOR TO PRACTICING RECUMBENT ISOMETRIC YOGA WITH AN INSTRUCTOR. THE SERUM WAS USED FOR MIRNA ARRAY ANALYSIS WITH KNOWN HUMAN MIRNAS. RESULTS: THE AVERAGE CFQ 11 SCORE DECREASED SIGNIFICANTLY (FROM 25.3 +/- 5.5 TO 17.0 +/- 5.8, P < 0.0001) AFTER PRACTICING RECUMBENT ISOMETRIC YOGA FOR 3 MONTHS. THE MIRNA MICROARRAY ANALYSIS REVEALED THAT FOUR MIRNAS WERE SIGNIFICANTLY UPREGULATED, AND 42 WERE DOWNREGULATED AFTER THE INTERVENTION PERIOD. CONCLUSIONS: THIS EXPLORATIVE PILOT STUDY IS THE FIRST TO DEMONSTRATE CHANGES IN THE SERUM LEVELS OF SEVERAL MIRNAS AFTER REGULAR PRACTICE OF RECUMBENT ISOMETRIC YOGA. THESE MIRNAS MIGHT REPRESENT BIOMARKERS FOR THE FATIGUE-RELIEVING EFFECTS OF ISOMETRIC YOGA OF PATIENTS WITH ME/CFS. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) 000023472. REGISTERED AUG 4, 2016. 2019 3 610 30 DEVELOPMENT OF A RECUMBENT ISOMETRIC YOGA PROGRAM FOR PATIENTS WITH SEVERE CHRONIC FATIGUE SYNDROME/MYALGIC ENCEPHALOMYELITIS: A PILOT STUDY TO ASSESS FEASIBILITY AND EFFICACY. BACKGROUND: OUR PREVIOUS RANDOMIZED CONTROLLED TRIAL DEMONSTRATED THAT ISOMETRIC YOGA IN A SITTING POSITION REDUCES FATIGUE IN PATIENTS WITH CHRONIC FATIGUE SYNDROME/MYALGIC ENCEPHALOMYELITIS (CFS/ME). HOWEVER, SOME PATIENTS EXPERIENCE DIFFICULTIES SITTING OR PRACTICING ISOMETRIC YOGA IN A SITTING POSITION FOR LONG PERIODS. TO DATE, THERAPEUTIC INTERVENTIONS FOR PATIENTS WITH SEVERE SYMPTOMS HAVE NOT BEEN ESTABLISHED. THEREFORE, WE DEVELOPED A RECUMBENT ISOMETRIC YOGA PROGRAM, WHICH TAKES APPROXIMATELY 20 MIN TO COMPLETE, DESIGNED TO REDUCE FATIGUE IN PATIENTS WITH SEVERE CFS/ME. THE AIM OF THIS PILOT STUDY WAS TO ASSESS THE FEASIBILITY, SAFETY, AND USEFULNESS OF THIS PROGRAM. METHODS: THIS PILOT STUDY INCLUDED 12 ADULT PATIENTS WITH CFS/ME. SIX PATIENTS WERE RELUCTANT TO PRACTICE ISOMETRIC YOGA IN A SITTING POSITION BECAUSE OF THE SEVERITY OF THEIR FATIGUE (GROUP 1). THE REMAINING SIX PATIENTS HAD PREVIOUSLY PRACTICED ISOMETRIC YOGA IN A SITTING POSITION (GROUP 2). FOR 3 MONTHS, THE PATIENTS OF BOTH GROUPS PRACTICED RECUMBENT ISOMETRIC YOGA EVERY 2 TO 4 WEEKS WITH A YOGA INSTRUCTOR AND AT HOME ON OTHER DAYS IF THEY COULD. THE SHORT-TERM EFFECTS OF ISOMETRIC YOGA ON FATIGUE WERE ASSESSED USING THE PROFILE OF MOOD STATUS (POMS) QUESTIONNAIRE IMMEDIATELY BEFORE AND AFTER THEIR FINAL SESSION WITH THE YOGA INSTRUCTOR. THE LONG-TERM EFFECTS OF ISOMETRIC YOGA ON FATIGUE WERE ASSESSED USING THE CHALDER FATIGUE SCALE (FS) QUESTIONNAIRE BEFORE AND AFTER THE INTERVENTION PERIOD. ADVERSE EVENTS, SATISFACTION WITH THE PROGRAM, AND PREFERENCE OF YOGA POSITION (SITTING OR RECUMBENT) WERE ALSO RECORDED. RESULTS: ALL SUBJECTS COMPLETED THE INTERVENTION. IN BOTH GROUPS, THE POMS FATIGUE SCORE WAS SIGNIFICANTLY DECREASED AFTER PRACTICING THE 20-MIN YOGA PROGRAM AND THE CHALDER FS SCORE WAS DECREASED SIGNIFICANTLY AFTER THE 3-MONTH INTERVENTION PERIOD. THERE WERE NO SERIOUS ADVERSE EVENTS. ALL SUBJECTS IN GROUP 2 PREFERRED THE RECUMBENT ISOMETRIC YOGA PROGRAM OVER A SITTING YOGA PROGRAM. CONCLUSIONS: THIS STUDY SUGGESTS THAT RECUMBENT ISOMETRIC YOGA IS A FEASIBLE AND ACCEPTABLE TREATMENT FOR PATIENTS WITH CFS/ME, EVEN FOR PATIENTS WHO EXPERIENCE DIFFICULTY PRACTICING ISOMETRIC YOGA IN THE SITTING POSITION. 2017 4 2250 30 THE LONGITUDINAL EFFECTS OF SEATED ISOMETRIC YOGA ON BLOOD BIOMARKERS, AUTONOMIC FUNCTIONS, AND PSYCHOLOGICAL PARAMETERS OF PATIENTS WITH CHRONIC FATIGUE SYNDROME: A PILOT STUDY. BACKGROUND: IN A PREVIOUS RANDOMIZED CONTROLLED TRIAL, WE FOUND THAT PRACTICING SEATED ISOMETRIC YOGA REGULARLY FOR 2 MONTHS IMPROVED THE FATIGUE OF PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) WHO ARE RESISTANT TO CONVENTIONAL THERAPY. THE AIM OF THIS PILOT STUDY WAS TO INVESTIGATE THE POSSIBLE MECHANISMS BEHIND THIS FINDING BY COMPARING BLOOD BIOMARKERS, AUTONOMIC NERVOUS FUNCTION, AND PSYCHOLOGICAL INDICES BEFORE VERSUS AFTER AN INTERVENTION PERIOD OF SEATED ISOMETRIC YOGA PRACTICE. METHODS: FIFTEEN PATIENTS WITH CFS WHO DID NOT SHOW SATISFACTORY IMPROVEMENTS AFTER AT LEAST 6 MONTHS OF CONVENTIONAL THERAPY PRACTICED SEATED ISOMETRIC YOGA (BIWEEKLY 20-MIN SESSIONS WITH A YOGA INSTRUCTOR AND DAILY PRACTICE AT HOME) FOR 2 MONTHS. THE LONGITUDINAL EFFECTS OF SEATED ISOMETRIC YOGA ON FATIGUE, BLOOD BIOMARKERS, AUTONOMIC FUNCTION, AND PSYCHOLOGICAL STATE WERE INVESTIGATED BY COMPARING THE FOLLOWING PARAMETERS BEFORE AND AFTER THE INTERVENTION PERIOD: FATIGUE SEVERITY WAS ASSESSED BY THE CHALDER FATIGUE SCALE (FS) SCORE. LEVELS OF THE BLOOD BIOMARKERS CORTISOL, DHEA-S, TNF-ALPHA, IL-6, PROLACTIN, CARNITINE, TGF-BETA1, BDNF, MHPG, HVA, AND ALPHA-MSH WERE MEASURED. THE AUTONOMIC NERVOUS FUNCTIONS ASSESSED WERE HEART RATE (HR) AND HR VARIABILITY. PSYCHOLOGICAL INDICES INCLUDED THE 20-ITEM TORONTO ALEXITHYMIA SCALE (TAS-20) AND THE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS). RESULTS: PRACTICING SEATED ISOMETRIC YOGA FOR 2 MONTHS RESULTED IN SIGNIFICANT REDUCTIONS IN THE CHALDER FS (P = 0.002) AND HADS-DEPRESSION (P = 0.02) SCORES. NO SIGNIFICANT CHANGES WERE OBSERVED IN ANY OTHER PARAMETER EVALUATED. THE CHANGE IN CHALDER FS SCORE WAS NOT CORRELATED WITH THE CHANGE IN HADS-DEPRESSION SCORE. HOWEVER, THIS CHANGE WAS POSITIVELY CORRELATED WITH CHANGES IN THE SERUM TNF-ALPHA LEVELS (P = 0.048), THE HIGH FREQUENCY COMPONENT OF HR VARIABILITY (P = 0.042), AND TAS-20 SCORES (P = 0.001). CONCLUSIONS: REGULAR PRACTICE OF SEATED ISOMETRIC YOGA FOR 2 MONTHS REDUCED THE FATIGUE AND DEPRESSIVE SYMPTOM SCORES OF PATIENTS WITH CFS WITHOUT AFFECTING ANY OTHER PARAMETERS WE INVESTIGATED. THIS STUDY FAILED TO IDENTIFY THE MARKERS RESPONSIBLE FOR THE LONGITUDINAL FATIGUE-RELIEVING EFFECT OF SEATED ISOMETRIC YOGA. HOWEVER, CONSIDERING THAT THE REDUCED FATIGUE WAS ASSOCIATED WITH DECREASED SERUM TNF-ALPHA LEVEL AND TAS-20 SCORES, FATIGUE IMPROVEMENT MIGHT BE RELATED TO REDUCED INFLAMMATION AND IMPROVED ALEXITHYMIA IN THESE PATIENTS. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. REGISTERED DEC 27, 2012. 2019 5 451 28 CHANGES IN FATIGUE, AUTONOMIC FUNCTIONS, AND BLOOD BIOMARKERS DUE TO SITTING ISOMETRIC YOGA IN PATIENTS WITH CHRONIC FATIGUE SYNDROME. BACKGROUND: IN A PREVIOUS RANDOMIZED CONTROLLED TRIAL, WE FOUND THAT SITTING ISOMETRIC YOGA IMPROVES FATIGUE IN PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) WHO ARE RESISTANT TO CONVENTIONAL THERAPY. THE AIM OF THIS STUDY WAS TO INVESTIGATE POSSIBLE MECHANISMS BEHIND THIS FINDING, FOCUSING ON THE SHORT-TERM FATIGUE-RELIEVING EFFECT, BY COMPARING AUTONOMIC NERVOUS FUNCTION AND BLOOD BIOMARKERS BEFORE AND AFTER A SESSION OF ISOMETRIC YOGA. METHODS: FIFTEEN PATIENTS WITH CFS WHO REMAINED SYMPTOMATIC DESPITE AT LEAST 6 MONTHS OF CONVENTIONAL THERAPY PRACTICED SITTING ISOMETRIC YOGA (BIWEEKLY 20 MIN PRACTICE WITH A YOGA INSTRUCTOR AND DAILY HOME PRACTICE) FOR EIGHT WEEKS. ACUTE EFFECTS OF SITTING ISOMETRIC YOGA ON FATIGUE, AUTONOMIC FUNCTION, AND BLOOD BIOMARKERS WERE INVESTIGATED AFTER THE FINAL SESSION WITH AN INSTRUCTOR. THE EFFECT OF A SINGLE SESSION OF SITTING ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY THE PROFILE OF MOOD STATUS (POMS) QUESTIONNAIRE IMMEDIATELY BEFORE AND AFTER THE SESSION. AUTONOMIC NERVOUS FUNCTION (HEART RATE (HR) VARIABILITY) AND BLOOD BIOMARKERS (CORTISOL, DHEA-S, TNF-ALPHA, IL-6, IFN-GAMMA, IFN-ALPHA, PROLACTIN, CARNITINE, TGF-BETA1, BDNF, MHPG, AND HVA) WERE COMPARED BEFORE AND AFTER THE SESSION. RESULTS: SITTING ISOMETRIC YOGA SIGNIFICANTLY REDUCED THE POMS FATIGUE SCORE (P < 0.01) AND INCREASED THE VIGOR SCORE (P < 0.01). IT ALSO REDUCED HR (P < 0.05) AND INCREASED THE HIGH FREQUENCY POWER (P < 0.05) OF HR VARIABILITY. SITTING ISOMETRIC YOGA INCREASED SERUM LEVELS OF DHEA-S (P < 0.05), REDUCED LEVELS OF CORTISOL (P < 0.05) AND TNF-ALPHA (P < 0.05), AND HAD A TENDENCY TO REDUCE SERUM LEVELS OF PROLACTIN (P < 0.1). DECREASES IN FATIGUE SCORES CORRELATED WITH CHANGES IN PLASMA LEVELS OF TGF-BETA1 AND BDNF. IN CONTRAST, INCREASED VIGOR POSITIVELY CORRELATED WITH HVA. CONCLUSIONS: A SINGLE SESSION OF SITTING ISOMETRIC YOGA REDUCED FATIGUE AND INCREASED VIGOR IN PATIENTS WITH CFS. YOGA ALSO INCREASED VAGAL NERVE FUNCTION AND CHANGED BLOOD BIOMARKERS IN A PATTERN THAT SUGGESTED ANTI-STRESS AND ANTI-INFLAMMATORY EFFECTS. THESE CHANGES APPEAR TO BE RELATED TO THE SHORT-TERM FATIGUE-RELIEVING EFFECT OF SITTING ISOMETRIC YOGA IN PATIENTS WITH CFS. FURTHERMORE, DOPAMINERGIC NERVOUS SYSTEM ACTIVATION MIGHT ACCOUNT FOR SITTING ISOMETRIC YOGA-INDUCED INCREASES IN ENERGY IN THIS PATIENT POPULATION. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. REGISTERED DEC 27, 2012. 2018 6 1698 28 PAIN-RELATED ENCEPHALIC REGIONS INFLUENCED BY YOGA MEDITATION: AN INTEGRATIVE REVIEW. INTRODUCTION: THE MECHANISMS UNDERLYING THE USE OF YOGA IN PAIN RELIEF ARE STILL UNCLEAR. THIS STUDY REVIEWED LITERATURE REPORTS ON ENCEPHALIC ACTIVITY RELATED TO ANALGESIA INDUCED BY YOGA MEDITATION PRACTICE. METHODS: THIS INTEGRATIVE REVIEW EXAMINED STUDIES PUBLISHED IN THE PUBMED, LILACS AND MEDLINE DATABASES WITHOUT RESTRICTION OF THE YEAR OF PUBLICATION. THE RESEARCH INVOLVED 16 DESCRIPTORS RELATED TO THE WORDS: YOGA, PAIN AND NEUROIMAGING METHODS. INCLUSION CRITERIA INVOLVED ONLY THE PUBLICATIONS AVAILABLE ONLINE, WITH FREE ACCESS AND WRITTEN IN ENGLISH. RESULTS: 2 CASE STUDIES AND 1 PILOT STUDY MET THE CRITERIA. YOGA MEDITATION PRACTICE INDUCES ANALGESIA PRIMARILY THROUGH ATTENUATION OF THE MEDIAL PAIN PERCEPTION SYSTEM INCLUDING THE ANTERIOR CINGULATE CORTEX AND INSULA REGIONS, AS WELL AS THE LATERAL SYSTEM INCLUDING THE SECONDARY SENSORY CORTEX AND THALAMUS. CONCLUSION: YOGA INDUCED ANALGESIA IS A POTENTIALLY IMPORTANT ADJUNCT TO CURRENT PAIN MANAGEMENT. THIS INTEGRATIVE REVIEW REVEALED THAT THERE IS A NEED FOR FURTHER RESEARCH THAT ANALYZES THE ENCEPHALIC REGIONS RELATED TO ANALGESIA INDUCED BY YOGA PRACTICE. 2018 7 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 8 2308 36 TRANSCRANIAL DIRECT CURRENT STIMULATION AND YOGA FOR FUNCTIONAL MOVEMENT DISORDERS. BACKGROUND: FUNCTIONAL MOVEMENT DISORDER (FMD), A CONVERSION DISORDER CHARACTERIZED BY INVOLUNTARY MOVEMENTS, IS DIFFICULT TO TREAT. METHODS: WE AIMED TO ASSESS THE EFFECTS OF ANODAL TRANSCRANIAL DIRECT CURRENT STIMULATION (TDCS) AND YOGA IN FMD PATIENTS (N=5). TDCS OF THE RIGHT TEMPOROPARIETAL JUNCTION, A BRAIN REGION RELEVANT IN THE SENSE OF SELF-AGENCY, WAS CONDUCTED. SUBJECTS UNDERWENT BOTH SHAM AND ANODAL TDCS WITH A WASHOUT PERIOD OF 3 WEEKS. YOGA WAS USED AS A MODE OF EXERCISE, AS WELL AS IN CONJUNCTION WITH STIMULATION TO SUSTAIN POTENTIAL CHANGES IN NEURAL PLASTICITY. RESULTS: A TOTAL OF 5 SUBJECTS COMPLETED THE STUDY [MEAN AGE: 52 (SE: 4) Y, DISEASE DURATION: 5 (SE: 1.6) Y], UNDERGOING BOTH SHAM AND ANODAL TDCS. ANODAL TDCS DOES NOT APPEAR TO BE SUPERIOR TO SHAM TDCS IN ALLEVIATING SYMPTOMS AND DISABILITY, BUT COMBINING TDCS AND YOGA APPEARS TO LEAD TO MILD IMPROVEMENT NOTED ON CLINICAL OBSERVATION, BASED ON THE CHANGE IN THE EFFICACY INDEX OF CLINICAL GLOBAL IMPRESSION FOUND IN 4 SUBJECTS. CONCLUSION: OUR STUDY RESULTS SUGGEST THAT ANODAL TDCS IS NOT SUPERIOR TO SHAM TDCS IN ALLEVIATING SUBJECTIVE SYMPTOMS AND DISABILITY IN FMD. HOWEVER, INTERPRETATION OF THESE RESULTS IS LIMITED DUE TO THE SMALL NUMBER OF STIMULATION SESSIONS AND NUMBER OF SUBJECTS. FUTURE STUDIES USING MORE FREQUENT STIMULATION SESSIONS ARE NEEDED TO FURTHER DETERMINE WHETHER ANODAL TDCS MAY HAVE A THERAPEUTIC EFFECT IN THIS PATIENT GROUP COMPARED WITH SHAM TDCS. 2021 9 1873 32 RAPID GENE EXPRESSION CHANGES IN PERIPHERAL BLOOD LYMPHOCYTES UPON PRACTICE OF A COMPREHENSIVE YOGA PROGRAM. ONE OF THE MOST COMMON INTEGRATIVE MEDICINE (IM) MODALITIES IS YOGA AND RELATED PRACTICES. PREVIOUS WORK HAS SHOWN THAT YOGA MAY IMPROVE WELLNESS IN HEALTHY PEOPLE AND HAVE BENEFITS FOR PATIENTS. HOWEVER, THE MECHANISMS OF HOW YOGA MAY POSITIVELY AFFECT THE MIND-BODY SYSTEM ARE LARGELY UNKNOWN. HERE WE HAVE ASSESSED POSSIBLE RAPID CHANGES IN GLOBAL GENE EXPRESSION PROFILES IN THE PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMCS) IN HEALTHY PEOPLE THAT PRACTICED EITHER A COMPREHENSIVE YOGA PROGRAM OR A CONTROL REGIMEN. THE EXPERIMENTAL SESSIONS INCLUDED GENTLE YOGA POSTURES, BREATHING EXERCISES, AND MEDITATION (SUDARSHAN KRIYA AND RELATED PRACTICES--SK&P) COMPARED WITH A CONTROL REGIMEN OF A NATURE WALK AND LISTENING TO RELAXING MUSIC. WE SHOW THAT THE SK&P PROGRAM HAS A RAPID AND SIGNIFICANTLY GREATER EFFECT ON GENE EXPRESSION IN PBMCS COMPARED WITH THE CONTROL REGIMEN. THESE DATA SUGGEST THAT YOGA AND RELATED PRACTICES RESULT IN RAPID GENE EXPRESSION ALTERATIONS WHICH MAY BE THE BASIS FOR THEIR LONGER TERM CELL BIOLOGICAL AND HIGHER LEVEL HEALTH EFFECTS. 2013 10 588 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 11 2847 35 YOGA, MEDITATION AND MIND-BODY HEALTH: INCREASED BDNF, CORTISOL AWAKENING RESPONSE, AND ALTERED INFLAMMATORY MARKER EXPRESSION AFTER A 3-MONTH YOGA AND MEDITATION RETREAT. THIRTY-EIGHT INDIVIDUALS (MEAN AGE: 34.8 YEARS OLD) PARTICIPATING IN A 3-MONTH YOGA AND MEDITATION RETREAT WERE ASSESSED BEFORE AND AFTER THE INTERVENTION FOR PSYCHOMETRIC MEASURES, BRAIN DERIVED NEUROTROPHIC FACTOR (BDNF), CIRCADIAN SALIVARY CORTISOL LEVELS, AND PRO- AND ANTI-INFLAMMATORY CYTOKINES. PARTICIPATION IN THE RETREAT WAS FOUND TO BE ASSOCIATED WITH DECREASES IN SELF-REPORTED ANXIETY AND DEPRESSION AS WELL AS INCREASES IN MINDFULNESS. AS HYPOTHESIZED, INCREASES IN THE PLASMA LEVELS OF BDNF AND INCREASES IN THE MAGNITUDE OF THE CORTISOL AWAKENING RESPONSE (CAR) WERE ALSO OBSERVED. THE NORMALIZED CHANGE IN BDNF LEVELS WAS INVERSELY CORRELATED WITH BSI-18 ANXIETY SCORES AT BOTH THE PRE-RETREAT (R = 0.40, P < 0.05) AND POST-RETREAT (R = 0.52, P < 0.005) SUCH THAT THOSE WITH GREATER ANXIETY SCORES TENDED TO EXHIBIT SMALLER PRE- TO POST-RETREAT INCREASES IN PLASMA BDNF LEVELS. IN LINE WITH A HYPOTHESIZED DECREASE IN INFLAMMATORY PROCESSES RESULTING FROM THE YOGA AND MEDITATION PRACTICES, WE FOUND THAT THE PLASMA LEVEL OF THE ANTI-INFLAMMATORY CYTOKINE INTERLEUKIN-10 WAS INCREASED AND THE PRO-INFLAMMATORY CYTOKINE INTERLEUKIN-12 WAS REDUCED AFTER THE RETREAT. CONTRARY TO OUR INITIAL HYPOTHESES, PLASMA LEVELS OF OTHER PRO-INFLAMMATORY CYTOKINES, INCLUDING INTERFERON GAMMA (IFN-GAMMA), TUMOR NECROSIS FACTOR (TNF-ALPHA), INTERLEUKIN-1BETA (IL-1BETA), INTERLEUKIN-6 (IL-6), AND INTERLEUKIN-8 (IL-8) WERE INCREASED AFTER THE RETREAT. GIVEN EVIDENCE FROM PREVIOUS STUDIES OF THE POSITIVE EFFECTS OF MEDITATIVE PRACTICES ON MENTAL FITNESS, AUTONOMIC HOMEOSTASIS AND INFLAMMATORY STATUS, WE HYPOTHESIZE THAT THESE FINDINGS ARE RELATED TO THE MEDITATIVE PRACTICES THROUGHOUT THE RETREAT; HOWEVER, SOME OF THE OBSERVED CHANGES MAY ALSO BE RELATED TO OTHER ASPECTS OF THE RETREAT SUCH AS PHYSICAL EXERCISE-RELATED COMPONENTS OF THE YOGA PRACTICE AND DIET. WE HYPOTHESIZE THAT THE PATTERNS OF CHANGE OBSERVED HERE REFLECT MIND-BODY INTEGRATION AND WELL-BEING. THE INCREASED BDNF LEVELS OBSERVED IS A POTENTIAL MEDIATOR BETWEEN MEDITATIVE PRACTICES AND BRAIN HEALTH, THE INCREASED CAR IS LIKELY A REFLECTION OF INCREASED DYNAMIC PHYSIOLOGICAL AROUSAL, AND THE RELATIONSHIP OF THE DUAL ENHANCEMENT OF PRO- AND ANTI-INFLAMMATORY CYTOKINE CHANGES TO HEALTHY IMMUNOLOGIC FUNCTIONING IS DISCUSSED. 2017 12 2486 54 YOGA AS AN INTEGRATIVE APPROACH FOR PREVENTION AND TREATMENT OF ORAL CANCER. DESPITE TREMENDOUS ADVANCEMENTS IN MEDICINE, THE NUMBER OF ORAL CANCER CASES CONTINUES TO INCREASE, AND THE NEED FOR INTEGRATING ALTERNATE MEDICINE OR ADOPTING AN INTEGRATIVE APPROACH HAS BECOME A COMPELLING COST-EFFECTIVE REQUIREMENT FOR THE MANAGEMENT AND TREATMENT OF DISEASES. CONVENTIONAL TREATMENT OF ORAL CANCER INVOLVES SURGERY FOLLOWED BY RADIOTHERAPY WITH OR WITHOUT CHEMOTHERAPY WHICH CAUSES SEVERAL COMPLICATIONS INCLUDING POOR QUALITY OF LIFE AND HIGH CHANCES OF RECURRENCE OF CANCER. ORAL CANCER IS OFTEN LINKED WITH OBESITY WHICH IS MAJOR RISK FACTORS IN OTHER CANCERS. APART FROM OBESITY, ORAL CANCER IS THOUGHT TO HAVE AN INVERSE RELATION WITH NEURODEGENERATIVE DISORDERS PRESUMABLY BECAUSE CELL DEATH DECREASES IN THE FORMER CASE AND INCREASES IN THE LATTER. ANCIENT MIND-BODY TECHNIQUES SUCH AS YOGA HAVE NOT BEEN ADEQUATELY TESTED AS A TOOL TO SYNERGIZE THE CELLULAR EQUILIBRIUM PERTAINING TO THE TREATMENT OF ORAL CANCER. NERVE GROWTH FACTOR (NGF), TUMOR NECROSIS FACTOR-ALPHA (TNF-ALPHA), AND INTERLEUKIN-6 (IL-6) ARE AMONG THE EARLY EXPERIMENTAL CELLULAR BIOMARKERS THAT MAY BE USED TO PROBE THE MODULATION OF ORAL CANCER, OBESITY, AND NEURODEGENERATIVE DISORDERS. YOGA HAS BEEN REPORTED TO INFLUENCE THESE MOLECULES IN HEALTHY INDIVIDUALS BUT WHETHER THEIR EXPRESSION CAN BE ALTERED IN PATIENTS OF ORAL CANCER BY YOGA INTERVENTION IS THE SUBJECT OF THIS RESEARCH BEING DISCUSSED IN THIS REVIEW ARTICLE. THEREFORE, THE PRESENT ARTICLE NOT ONLY REVIEWS THE CURRENT STATUS OF RESEARCH STUDIES IN ORAL CANCER, OBESITY, AND NEURODEGENERATIVE DISORDERS BUT ALSO HOW THESE ARE LINKED TO EACH OTHER AND WHY THE INVESTIGATIONS OF THE PUTATIVE NGF PATHWAY, INVOLVING TNF-ALPHA AND IL-6, COULD PROVIDE USEFUL CLUES TO UNDERSTAND THE MOLECULAR EFFECTS BROUGHT ABOUT BY YOGA INTERVENTION IN SUCH PATIENTS. 2018 13 2850 41 YOGA, MINDFULNESS-BASED STRESS REDUCTION AND STRESS-RELATED PHYSIOLOGICAL MEASURES: A META-ANALYSIS. BACKGROUND AND OBJECTIVES: PRACTICES THAT INCLUDE YOGA ASANAS AND MINDFULNESS-BASED STRESS REDUCTION FOR THE MANAGEMENT OF STRESS ARE INCREASINGLY POPULAR; HOWEVER, THE NEUROBIOLOGICAL EFFECTS OF THESE PRACTICES ON STRESS REACTIVITY ARE NOT WELL UNDERSTOOD. MANY STUDIES INVESTIGATING THE EFFECTS OF SUCH PRACTICES FAIL TO INCLUDE AN ACTIVE CONTROL GROUP. GIVEN THE FREQUENCY WITH WHICH PEOPLE ARE SELECTING SUCH INTERVENTIONS AS A FORM OF SELF-MANAGEMENT, IT IS IMPORTANT TO DETERMINE THEIR EFFECTIVENESS. THUS, THIS REVIEW INVESTIGATES THE EFFECTS OF PRACTICES THAT INCLUDE YOGA ASANAS, WITH AND WITHOUT MINDFULNESS-BASED STRESS REDUCTION, COMPARED TO AN ACTIVE CONTROL, ON PHYSIOLOGICAL MARKERS OF STRESS. MATERIALS AND METHODS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED CONTROLLED TRIALS PUBLISHED IN ENGLISH COMPARED PRACTICES THAT INCLUDED YOGA ASANAS, WITH AND WITHOUT MINDFULNESS-BASED STRESS REDUCTION, TO AN ACTIVE CONTROL, ON STRESS-RELATED PHYSIOLOGICAL MEASURES. THE REVIEW FOCUSED ON STUDIES THAT MEASURED PHYSIOLOGICAL PARAMETERS SUCH AS BLOOD PRESSURE, HEART RATE, CORTISOL AND PERIPHERAL CYTOKINE EXPRESSION. MEDLINE, AMED, CINAHL, PSYCINFO, SOCINDEX, PUBMED, AND SCOPUS WERE SEARCHED IN MAY 2016 AND UPDATED IN DECEMBER 2016. RANDOMISED CONTROLLED TRIALS WERE INCLUDED IF THEY ASSESSED AT LEAST ONE OF THE FOLLOWING OUTCOMES: HEART RATE, BLOOD PRESSURE, HEART RATE VARIABILITY, MEAN ARTERIAL PRESSURE, C-REACTIVE PROTEIN, INTERLEUKINS OR CORTISOL. RISK OF BIAS ASSESSMENTS INCLUDED SEQUENCE GENERATION, ALLOCATION CONCEALMENT, BLINDING OF ASSESSORS, INCOMPLETE OUTCOME DATA, SELECTIVE OUTCOME REPORTING AND OTHER SOURCES OF BIAS. META-ANALYSIS WAS UNDERTAKEN USING COMPREHENSIVE META-ANALYSIS SOFTWARE VERSION 3. SENSITIVITY ANALYSES WERE PERFORMED USING 'ONE-STUDY-REMOVED' ANALYSIS. SUBGROUP ANALYSIS WAS CONDUCTED FOR DIFFERENT YOGA AND CONTROL GROUP TYPES, INCLUDING MINDFULNESS-BASED STRESS REDUCTION VERSUS NON-MINDFULNESS-BASED STRESS REDUCTION BASED INTERVENTIONS, DIFFERENT POPULATIONS, LENGTH OF INTERVENTION, AND METHOD OF DATA ANALYSIS. A RANDOM-EFFECTS MODEL WAS USED IN ALL ANALYSES. RESULTS: FORTY TWO STUDIES WERE INCLUDED IN THE META-ANALYSIS. INTERVENTIONS THAT INCLUDED YOGA ASANAS WERE ASSOCIATED WITH REDUCED EVENING CORTISOL, WAKING CORTISOL, AMBULATORY SYSTOLIC BLOOD PRESSURE, RESTING HEART RATE, HIGH FREQUENCY HEART RATE VARIABILITY, FASTING BLOOD GLUCOSE, CHOLESTEROL AND LOW DENSITY LIPOPROTEIN, COMPARED TO ACTIVE CONTROL. HOWEVER, THE REPORTED INTERVENTIONS WERE HETEROGENEOUS. CONCLUSIONS: PRACTICES THAT INCLUDE YOGA ASANAS APPEAR TO BE ASSOCIATED WITH IMPROVED REGULATION OF THE SYMPATHETIC NERVOUS SYSTEM AND HYPOTHALAMIC-PITUITARY-ADRENAL SYSTEM IN VARIOUS POPULATIONS. 2017 14 1523 32 ISOMETRIC YOGA IMPROVES THE FATIGUE AND PAIN OF PATIENTS WITH CHRONIC FATIGUE SYNDROME WHO ARE RESISTANT TO CONVENTIONAL THERAPY: A RANDOMIZED, CONTROLLED TRIAL. BACKGROUND: PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) OFTEN COMPLAIN OF PERSISTENT FATIGUE EVEN AFTER CONVENTIONAL THERAPIES SUCH AS PHARMACOTHERAPY, COGNITIVE BEHAVIORAL THERAPY, OR GRADED EXERCISE THERAPY. THE AIM OF THIS STUDY WAS TO INVESTIGATE IN A RANDOMIZED, CONTROLLED TRIAL THE FEASIBILITY AND EFFICACY OF ISOMETRIC YOGA IN PATIENTS WITH CFS WHO ARE RESISTANT TO CONVENTIONAL TREATMENTS. METHODS: THIS TRIAL ENROLLED 30 PATIENTS WITH CFS WHO DID NOT HAVE SATISFACTORY IMPROVEMENT AFTER RECEIVING CONVENTIONAL THERAPY FOR AT LEAST SIX MONTHS. THEY WERE RANDOMLY DIVIDED INTO TWO GROUPS AND WERE TREATED WITH EITHER CONVENTIONAL PHARMACOTHERAPY (CONTROL GROUP, N = 15) OR CONVENTIONAL THERAPY TOGETHER WITH ISOMETRIC YOGA PRACTICE THAT CONSISTED OF BIWEEKLY, 20-MINUTE SESSIONS WITH A YOGA INSTRUCTOR AND DAILY IN-HOME SESSIONS (YOGA GROUP, N = 15) FOR APPROXIMATELY TWO MONTHS. THE SHORT-TERM EFFECT OF ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY ADMINISTRATION OF THE PROFILE OF MOOD STATUS (POMS) QUESTIONNAIRE IMMEDIATELY BEFORE AND AFTER THE FINAL 20-MINUTE SESSION WITH THE INSTRUCTOR. THE LONG-TERM EFFECT OF ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY ADMINISTRATION OF THE CHALDER'S FATIGUE SCALE (FS) QUESTIONNAIRE TO BOTH GROUPS BEFORE AND AFTER THE INTERVENTION. ADVERSE EVENTS AND CHANGES IN SUBJECTIVE SYMPTOMS WERE RECORDED FOR SUBJECTS IN THE YOGA GROUP. RESULTS: ALL SUBJECTS COMPLETED THE INTERVENTION. THE MEAN POMS FATIGUE SCORE DECREASED SIGNIFICANTLY (FROM 21.9 +/- 7.7 TO 13.8 +/- 6.7, P < 0.001) AFTER A YOGA SESSION. THE CHALDER'S FS SCORE DECREASED SIGNIFICANTLY (FROM 25.9 +/- 6.1 TO 19.2 +/- 7.5, P = 0.002) IN THE YOGA GROUP, BUT NOT IN THE CONTROL GROUP. IN ADDITION TO THE IMPROVEMENT OF FATIGUE, TWO PATIENTS WITH CFS AND FIBROMYALGIA SYNDROME IN THE YOGA GROUP ALSO REPORTED PAIN RELIEF. FURTHERMORE, MANY SUBJECTS REPORTED THAT THEIR BODIES BECAME WARMER AND LIGHTER AFTER PRACTICING ISOMETRIC YOGA. ALTHOUGH THERE WERE NO SERIOUS ADVERSE EVENTS IN THE YOGA GROUP, TWO PATIENTS COMPLAINED OF TIREDNESS AND ONE OF DIZZINESS AFTER THE FIRST YOGA SESSION WITH THE INSTRUCTOR. CONCLUSIONS: ISOMETRIC YOGA AS AN ADD-ON THERAPY IS BOTH FEASIBLE AND SUCCESSFUL AT RELIEVING THE FATIGUE AND PAIN OF A SUBSET OF THERAPY-RESISTANT PATIENTS WITH CFS. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. 2014 15 683 40 EFFECT OF AN 8-WEEK YOGA-BASED LIFESTYLE INTERVENTION ON PSYCHO-NEURO-IMMUNE AXIS, DISEASE ACTIVITY, AND PERCEIVED QUALITY OF LIFE IN RHEUMATOID ARTHRITIS PATIENTS: A RANDOMIZED CONTROLLED TRIAL. VARIOUS EXTERNAL STRESSORS AND ENVIRONMENTAL CHALLENGES LEAD TO THE PROVOCATION OF THE IMMUNE SYSTEM IN AUTOIMMUNE DISEASES LIKE RHEUMATOID ARTHRITIS (RA). THE INAPPROPRIATE IMMUNE RESPONSE FURTHER TRIGGERS THE CASCADE OF INFLAMMATORY CHANGES RESULTING IN PRECIPITATION OF SYMPTOMS AND HAMPERS QUALITY OF LIFE (QOL). THE UNDERLYING PSYCHO-SOMATIC COMPONENT OF THE DISEASE REQUIRES A HOLISTIC APPROACH TO ITS TREATMENT DIMENSION RATHER THAN THE USE OF PHARMACOTHERAPY. THE APPLICABILITY OF MIND-BODY INTERVENTIONS HAS BECOME ESSENTIAL IN TODAY'S FAST-PACED LIFE. YOGA, A MIND-BODY TECHNIQUE, ALTERS THE MIND'S CAPACITY TO FACILITATE SYSTEMIC FUNCTIONING AT MULTIPLE ORGAN SYSTEM LEVELS. HENCE, WE CONDUCTED THIS STUDY TO EVALUATE THE IMPACT OF 8 WEEKS OF A YOGA-BASED LIFESTYLE INTERVENTION (YBLI) ON PSYCHO-NEURO-IMMUNE MARKERS, GENE EXPRESSION PATTERNS, AND QOL IN RA PATIENTS ON ROUTINE MEDICAL THERAPY. A TOTAL OF 66 PATIENTS WERE RANDOMIZED INTO TWO GROUPS: YOGA GROUP OR NON-YOGA GROUP AND WERE ASSESSED FOR A PANEL OF INFLAMMATORY CYTOKINES (IL-6, IL-17A, TNF-ALPHA, AND TGF-BETA), MIND-BODY COMMUNICATIVE MARKERS (BDNF, DHEAS, BETA-ENDORPHIN, AND SIRTUIN) AND TRANSCRIPT LEVELS OF VARIOUS GENES (IL-6, TNF-ALPHA, NFKB1, TGF-BETA, AND CTLA4). WE ASSESSED DISEASE ACTIVITY AND QOL USING THE DAS28-ESR AND WHOQOL-BREF QUESTIONNAIRE, RESPECTIVELY. YOGA GROUP OBSERVED SIGNIFICANT IMPROVEMENTS IN THE LEVELS OF MARKERS, WHICH INFLUENCED THE PSYCHO-NEURO-IMMUNE AXIS (P < 0.001) WITH AN ESTIMATED EFFECT SIZE FROM SMALL TO MEDIUM RANGE. IN THE YOGA GROUP, THERE WAS A SIGNIFICANT REDUCTION IN DAS28-ESR (P < 0.001) AND IMPROVEMENT SEEN IN THE PHYSICAL HEALTH, PSYCHOLOGICAL, SOCIAL RELATIONSHIPS DOMAINS (P < 0.001) OF QOL, EXCEPT ENVIRONMENTAL (P > 0.05). THE YOGA GROUP SHOWED DOWNREGULATION OF IL-6, TNF-ALPHA, AND CTLA4 AND UPREGULATION OF TGF-BETA. THESE RESULTS SUGGEST THAT A DECREASE IN DISEASE ACTIVITY AFTER YOGA PRACTICE IS ASSOCIATED WITH A SIGNIFICANT REDUCTION IN INFLAMMATORY CYTOKINES, THE ELEVATION OF MIND-BODY COMMUNICATIVE MARKERS, AND NORMALIZATION OF VARIOUS TRANSCRIPT LEVELS, WHICH IMPROVED QOL. THUS THE ADOPTION OF YBLI IMPROVES CLINICAL OUTCOME IN RA, AND DECREASES SYSTEMIC INFLAMMATION BY ITS BENEFICIAL EFFECTS ON PSYCHO-NEURO-IMMUNE AXIS AND NORMALIZATION OF DYSREGULATED TRANSCRIPTS. THUS YBLI MAY BE USED FOR RA PATIENTS AS AN ADJUNCTIVE THERAPY. 2020 16 226 35 A SYSTEMATIC REVIEW OF RANDOMISED CONTROL TRIALS ON THE EFFECTS OF YOGA ON STRESS MEASURES AND MOOD. STRESS RELATED DISORDERS SUCH AS DEPRESSION AND ANXIETY ARE LEADING SOURCES OF DISABILITY WORLDWIDE, AND CURRENT TREATMENT METHODS SUCH AS CONVENTIONAL ANTIDEPRESSANT MEDICATIONS ARE NOT BENEFICIAL FOR ALL INDIVIDUALS. THERE IS EVIDENCE THAT YOGA HAS MOOD-ENHANCING PROPERTIES POSSIBLY RELATED TO ITS INHIBITORY EFFECTS ON PHYSIOLOGICAL STRESS AND INFLAMMATION, WHICH ARE FREQUENTLY ASSOCIATED WITH AFFECTIVE DISORDERS. HOWEVER THE BIOLOGICAL MECHANISMS VIA WHICH YOGA EXERTS ITS THERAPEUTIC MOOD-MODULATING EFFECTS ARE LARGELY UNKNOWN. THIS SYSTEMATIC REVIEW INVESTIGATES THE EFFECTS OF YOGA ON SYMPATHETIC NERVOUS SYSTEM AND HYPOTHALAMIC PITUITARY ADRENAL AXIS REGULATION MEASURES. IT FOCUSES ON STUDIES COLLECTING PHYSIOLOGICAL PARAMETERS SUCH AS BLOOD PRESSURE, HEART RATE, CORTISOL, PERIPHERAL CYTOKINE EXPRESSION AND/OR STRUCTURAL AND FUNCTIONAL BRAIN MEASURES IN REGIONS INVOLVED IN STRESS AND MOOD REGULATION. OVERALL THE 25 RANDOMISED CONTROL STUDIES DISCUSSED PROVIDE PRELIMINARY EVIDENCE TO SUGGEST THAT YOGA PRACTICE LEADS TO BETTER REGULATION OF THE SYMPATHETIC NERVOUS SYSTEM AND HYPOTHALAMIC-PITUITARY-ADRENAL SYSTEM, AS WELL AS A DECREASE IN DEPRESSIVE AND ANXIOUS SYMPTOMS IN A RANGE OF POPULATIONS. FURTHER RESEARCH IS WARRANTED TO CONFIRM THESE PRELIMINARY FINDINGS AND FACILITATE IMPLEMENTATION IN CLINICAL SETTINGS. 2015 17 1789 31 PRELIMINARY INDICATIONS OF THE EFFECT OF A BRIEF YOGA INTERVENTION ON MARKERS OF INFLAMMATION AND DNA METHYLATION IN CHRONICALLY STRESSED WOMEN. YOGA IS ASSOCIATED WITH REDUCED STRESS AND INCREASED WELL-BEING, ALTHOUGH THE MOLECULAR BASIS FOR THESE BENEFITS IS NOT CLEAR. MOUNTING EVIDENCE IMPLICATES THE IMMUNE RESPONSE, WITH CURRENT STUDIES FOCUSED ON PROTEIN IMMUNE MARKERS (SUCH AS CYTOKINES) IN CLINICAL POPULATIONS. TO EXPLORE THE MOLECULAR IMPACT, THIS PILOT STUDY USES A SUBSAMPLE (N=28) FROM A RANDOMISED WAITLIST CONTROL TRIAL INVESTIGATING THE IMPACT OF AN 8-WEEK YOGA INTERVENTION IN A COMMUNITY POPULATION OF WOMEN REPORTING PSYCHOLOGICAL DISTRESS (N=116). WE MEASURED INTERLEUKIN-6 (IL-6), TUMOUR NECROSIS FACTOR (TNF) AND C-REACTIVE PROTEIN (CRP) PROTEIN LEVELS, AND THE DNA METHYLATION OF THESE GENES AND THE GLOBAL INDICATOR, LINE-1. CORRELATIONS BETWEEN THESE AND PSYCHOLOGICAL VARIABLES WERE EXPLORED, IDENTIFYING MODERATE CORRELATIONS WITH CRP PROTEIN LEVELS, AND METHYLATION OF IL-6, CRP AND LINE-1. MANY CYTOKINE SAMPLES WERE BELOW DETECTION, HOWEVER A MANN-WHITNEY U DEMONSTRATED A TREND OF MODERATE BETWEEN-GROUP EFFECT FOR ELEVATED IL-6 IN THE YOGA GROUP. METHYLATION ANALYSES APPLIED CROSS-SECTIONAL AND NON-CONTROLLED LONGITUDINAL ANALYSES. WAIST-TO-HEIGHT RATIO AND AGE WERE COVARIED. WE DEMONSTRATED REDUCED METHYLATION OF THE TNF REGION IN THE YOGA GROUP RELATIVE TO THE WAITLIST CONTROL GROUP. NO OTHER GENES DEMONSTRATED A SIGNIFICANT DIFFERENCE. LONGITUDINAL ANALYSIS FURTHER SUPPORTED THESE RESULTS. THIS STUDY IS ONE OF THE FIRST TO EXPLORE YOGA AND IMMUNOLOGICAL MARKERS IN A NON-CLINICAL POPULATION, AND IS THE FIRST STUDY TO EXPLORE DNA METHYLATION. THESE FINDINGS INDICATE THAT FURTHER RESEARCH INTO MOLECULAR IMPACT OF YOGA ON MARKERS OF IMMUNE FUNCTION IS WARRANTED, WITH LARGER STUDIES REQUIRED. 2016 18 1927 39 ROLE OF YOGA IN CARDIAC DISEASE AND REHABILITATION. PURPOSE: CARDIOVASCULAR DISEASE CONTINUES TO BE THE LEADING CAUSE OF MORBIDITY AND MORTALITY AROUND THE WORLD. YOGA, A COMBINATION OF PHYSICAL POSTURES (ASANA), BREATHING EXERCISES (PRANAYAMA), AND MEDITATION (DHYANA), HAS GAINED INCREASING RECOGNITION AS A FORM OF MIND-BODY EXERCISE. IN THIS NARRATIVE REVIEW, WE INTENDED TO REVIEW THE EMERGING EVIDENCE ASSESSING THE PHYSIOLOGIC AND CLINICAL EFFECTS OF YOGA ON THE CARDIOVASCULAR SYSTEM AND THE POTENTIAL ROLE OF YOGA AS A COMPONENT OF COMPREHENSIVE CARDIAC REHABILITATION. METHODS: WE SEARCHED PUBMED, GOOGLE SCHOLAR, EMBASE, AND COCHRANE DATABASES FOR LITERATURE RELATED TO CARDIOVASCULAR EFFECTS OF YOGA FROM INCEPTION UP UNTIL 2017. RESULTS: YOGA HAS BEEN SHOWN TO HAVE FAVORABLE EFFECTS ON SYSTEMIC INFLAMMATION, STRESS, THE CARDIAC AUTONOMIC NERVOUS SYSTEM, AND TRADITIONAL AND EMERGING CARDIOVASCULAR RISK FACTORS. CONCLUSIONS: YOGA HAS SHOWN PROMISE AS A USEFUL LIFESTYLE INTERVENTION THAT CAN BE INCORPORATED INTO CARDIOVASCULAR DISEASE MANAGEMENT ALGORITHMS. ALTHOUGH MANY INVESTIGATORS HAVE REPORTED THE CLINICAL BENEFITS OF YOGA IN REDUCING CARDIOVASCULAR EVENTS, MORBIDITY, AND MORTALITY, EVIDENCE SUPPORTING THESE CONCLUSIONS IS SOMEWHAT LIMITED, THEREBY EMPHASIZING THE NEED FOR LARGE, WELL-DESIGNED RANDOMIZED TRIALS THAT MINIMIZE BIAS AND METHODOLOGICAL DRAWBACKS. 2019 19 1149 46 ENHANCEMENT OF CANCER STEM CELL SUSCEPTIBILITY TO CONVENTIONAL TREATMENTS THROUGH COMPLEMENTARY YOGA THERAPY: POSSIBLE CELLULAR AND MOLECULAR MECHANISMS. CANCER STEM CELLS (CSCS) ARE STEM-LIKE TUMOR POPULATIONS THAT ARE REPORTED TO CONTRIBUTE TOWARDS TUMOR GROWTH, MAINTENANCE AND RECURRENCE AFTER THERAPY. HYPOXIA INCREASES CSC FRACTION AND PROMOTES ACQUISITION OF A STEM-CELL-LIKE STATE. CANCER STEM CELLS ARE CRITICALLY DEPENDANT ON THE HYPOXIA-INDUCIBLE FACTOR-1 (HIF-1) FOR SURVIVAL, SELF-RENEWAL, TUMOR GROWTH AND MAINTENANCE OF THEIR UNDIFFERENTIATED PHENOTYPE. RECENT RESEARCHES SHOW THAT STAGE OF DIFFERENTIATION OF THE TUMOR CELLS IS PREDICTIVE OF THEIR SUSCEPTIBILITY TO NATURAL KILLER CELL (NK) CELL MEDIATED CYTOTOXICITY AND CANCER STEM CELLS ARE SIGNIFICANT TARGETS OF NK CELL CYTOTOXICITY. STUDIES ALSO SHOW THAT REVERSION OF TUMOR CELLS TO A LESS-DIFFERENTIATED PHENOTYPE CAN BE ACHIEVED BY BLOCKING NFKAPPAB. YOGA THERAPY (YOGIC LIFESTYLE MODIFICATIONS ENCOMPASSING PHYSICAL POSTURES, BREATHING PRACTICES, RELAXATION TECHNIQUES AND MEDITATIONS) IS KNOWN TO MODULATE NEURAL, ENDOCRINE AND IMMUNE FUNCTIONS AT THE CELLULAR LEVEL THROUGH INFLUENCING CELL CYCLE CONTROL, AGING, OXIDATIVE STRESS, APOPTOSIS AND SEVERAL PATHWAYS OF STRESS SIGNALING MOLECULES. YOGA THERAPY HAS ALSO BEEN SHOWN TO ENHANCE NATURAL KILLER CELL ACTIVITY AND MODULATE STRESS AND DNA DAMAGE IN BREAST CANCER PATIENTS RECEIVING RADIOTHERAPY. RECENT STUDY FOUND THAT BRIEF DAILY YOGIC MEDITATION MAY REVERSE THE PATTERN OF INCREASED NFKAPPAB-RELATED TRANSCRIPTION OF PRO-INFLAMMATORY CYTOKINES IN LEUKOCYTES. THUS, YOGA THERAPY HAS THE POTENTIAL TO REDUCE CANCER STEM CELL SURVIVAL, SELF -RENEWAL AND TUMOR GROWTH BY MODIFYING THE TUMOR MICRO-ENVIRONMENT THROUGH VARIOUS MECHANISMS SUCH AS; 1) REDUCING HIF-1 ACTIVITY BY ENHANCED OXYGENATION, 2) PROMOTING NK CELL ACTIVITY DIRECTLY (OR INDIRECTLY THROUGH DOWN REGULATING NFKAPPAB EXPRESSION), THEREBY ENHANCING NK CELL MEDIATED CSC LYSIS, AND 3) BY MINIMIZING THE ABERRANT EXPRESSIONS OR ACTIVITIES OF VARIOUS HORMONES, CYTOKINES, CHEMOKINES AND TUMOR SIGNALING PATHWAYS. YOGA THERAPY MAY HAVE A SYNERGISTIC EFFECT WITH CONVENTIONAL MODALITIES OF TREATMENT IN PREVENTING CANCER PROGRESSION AND RECURRENCES. 2012 20 1640 51 MOLECULAR SIGNATURE OF THE IMMUNE RESPONSE TO YOGA THERAPY IN STRESS-RELATED CHRONIC DISEASE CONDITIONS: AN INSIGHT. THE WORLD HEALTH ORGANIZATION DEFINES HEALTH AS COMPLETE WELL-BEING IN TERMS OF PHYSICAL, MENTAL AND SOCIAL, AND NOT MERELY THE ABSENCE OF DISEASE. TO ATTAIN THIS, INDIVIDUAL SHOULD ADAPT AND SELF-MANGE THE SOCIAL, PHYSICAL AND EMOTIONAL CHALLENGES OF LIFE. EXPOSURE TO CHRONIC STRESS DUE TO URBANIZATION, WORK STRESS, NUCLEAR FAMILY, POLLUTION, UNHEALTHY FOOD HABITS, LIFESTYLE, ACCIDENTAL DEATH IN THE FAMILY, AND NATURAL CALAMITIES ARE THE TRIGGERING FACTORS, LEADING TO HORMONAL IMBALANCE AND INFLAMMATION IN THE TISSUE. THE RELATIONSHIP BETWEEN STRESS AND ILLNESS IS COMPLEX; ALL CHRONIC ILLNESSES SUCH AS CARDIOVASCULAR DISEASE AND ASTHMA HAVE THEIR ROOT IN CHRONIC STRESS ATTRIBUTED BY INFLAMMATION. IN RECENT TIMES, YOGA THERAPY HAS EMERGED AS AN IMPORTANT COMPLEMENTARY ALTERNATIVE MEDICINE FOR MANY HUMAN DISEASES. YOGA THERAPY HAS A POSITIVE IMPACT ON MIND AND BODY; IT ACTS BY INCORPORATING APPROPRIATE BREATHING TECHNIQUES AND MINDFULNESS TO ATTAIN CONSCIOUS DIRECTION OF OUR AWARENESS OF THE PRESENT MOMENT BY MEDITATION, WHICH HELPS ACHIEVE HARMONY BETWEEN THE BODY AND MIND. STUDIES HAVE ALSO DEMONSTRATED THE IMPORTANT REGULATORY EFFECTS OF YOGA THERAPY ON BRAIN STRUCTURE AND FUNCTIONS. DESPITE THESE ADVANCES, THE CELLULAR AND MOLECULAR MECHANISMS BY WHICH YOGA THERAPY RENDERS ITS BENEFICIAL EFFECTS ARE INADEQUATELY KNOWN. A GROWING BODY OF EVIDENCE SUGGESTS THAT YOGA THERAPY HAS IMMUNOMODULATORY EFFECTS. HOWEVER, THE PRECISE MECHANISTIC BASIS HAS NOT BEEN ADDRESSED EMPIRICALLY. IN THIS REVIEW, WE HAVE ATTEMPTED TO HIGHLIGHT THE EFFECT OF YOGA THERAPY ON IMMUNE SYSTEM FUNCTIONING WITH AN AIM TO IDENTIFY IMPORTANT IMMUNOLOGICAL SIGNATURES THAT INDEX THE EFFECT OF YOGA THERAPY. TOWARD THIS, WE HAVE SUMMARIZED THE AVAILABLE SCIENTIFIC EVIDENCE SHOWING POSITIVE IMPACTS OF YOGA THERAPY. FINALLY, WE HAVE EMPHASIZED THE EFFICACY OF YOGA IN IMPROVING PHYSICAL AND MENTAL WELL-BEING. YOGA HAS BEEN A PART OF INDIAN CULTURE AND TRADITION FOR LONG; NOW, THE TIME HAS COME TO SCIENTIFICALLY VALIDATE THIS AND IMPLEMENT THIS AS AN ALTERNATIVE TREATMENT METHOD FOR STRESS-RELATED CHRONIC DISEASE. 2020