Mind-Body Medicine Research Update

Mind-Body Medicine Research Update

Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres. Ann N Y Acad Sci. 2009 Aug;1172:34-53. by Epel E, Daubenmier J, Moskowitz JT, Folkman S, Blackburn E. from University of California San Francisco, Department of Psychiatry, San Francisco, California 94143, USA. eepel@lppi.ucsf.edu

Abstract:  Understanding the malleable determinants of cellular aging is critical to understanding human longevity. Telomeres may provide a pathway for exploring this question. Telomeres are the protective caps at the ends of chromosomes. The length of telomeres offers insight into mitotic cell and possibly organismal longevity. Telomere length has now been linked to chronic stress exposure and depression. This raises the question of mechanism: How might cellular aging be modulated by psychological functioning? We consider two psychological processes or states that are in opposition to one another-threat cognition and mindfulness-and their effects on cellular aging. Psychological stress cognitions, particularly appraisals of threat and ruminative thoughts, can lead to prolonged states of reactivity. In contrast, mindfulness meditation techniques appear to shift cognitive appraisals from threat to challenge, decrease ruminative thought, and reduce stress arousal. Mindfulness may also directly increase positive arousal states. We review data linking telomere length to cognitive stress and stress arousal and present new data linking cognitive appraisal to telomere length. Given the pattern of associations revealed so far, we propose that some forms of meditation may have salutary effects on telomere length by reducing cognitive stress and stress arousal and increasing positive states of mind and hormonal factors that may promote telomere maintenance. Aspects of this model are currently being tested in ongoing trials of mindfulness meditation.

 

A Critical Review of the Effects of Medical Qigong on Quality of Life, Immune Function, and Survival in Cancer Patients.   Integr Cancer Ther. 2011 Jun 28. by Oh B, Butow P, Mullan B, Hale A, Lee MS, Guo X, Clarke S. from  University of Sydney, Sydney, New South Wales, Australia.

Background. Due to the limitations and side effects of conventional cancer treatment, especially in relation to quality of life (QOL), patients are increasingly utilizing complementary and alternative medicine (CAM) to supplement health-related outcomes. However, evidence for the safety and efficacy of such treatments is lacking.The purpose of the current review was to investigate evidence for the role of one CAM, medical Qigong (MQ), in supportive care. METHODS:  The literature was searched for reported effects of MQ in improving QOL, immune function, and survival in cancer patients. RESULTS: Although many studies possessed methodological limitations and small sample sizes, encouraging evidence was found for the effects of MQ on these health-related outcomes. More robust evidence in the form of randomized controlled trials with larger sample sizes also reflected positive results for the role of MQ in improving QOL, mood and fatigue parameters, and reducing inflammation. CONCLUSION:  Given such encouraging results, further research is recommended in methodologically sound approaches to further delineate the action of MQ. These findings support the utilization of MQ by cancer patients and the place for such programs in comprehensive cancer care.

 

Yoga therapy as an adjunctive treatment for schizophrenia: a randomized, controlled pilot study. J Altern Complement Med. 2011 Jul;17(7):601-7. by Visceglia E, Lewis S.  evisceglia@gmail.com

OBJECTIVES: There has been limited study of therapeutic yoga as a complementary treatment for schizophrenia. This study investigates the effects of a Yoga Therapy program on symptomatology and quality of life in adults with schizophrenia in a state psychiatric facility. METHODS:  In a randomized, controlled pilot study, 18 clinically stable patients (12 men and 6 women) with schizophrenia (mean age=42±13.5) were randomized to an 8-week Yoga Therapy program (YT) and a Waitlist group (WL). YT intervention included yoga postures, breathing exercises, and relaxation. At baseline and at 8 weeks, symptomatology was measured using the Positive and Negative Syndrome Scale (PANSS). Secondary efficacy outcomes were measured with the World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF).  RESULTS:  The YT group obtained significant improvements in positive and negative symptoms of schizophrenia symptoms compared to WL, including PANSS scores on positive syndrome (t=-2.64, p=0.02), negative syndrome (t=-3.04, p<0.01), general psychopathology (t=-3.74, p<0.00), activation (t=-2.29, p<0.04), paranoia (t=-2.89, p<0.01), and depression subscales (t=-2.62, p<0.02). PANSS total scores also decreased for the YT group (t=-4.54, p<0.00). YT had improved perceived quality of life in physical (t=2.38, p<0.04) and psychologic domains (t=2.88, p<0.01). CONCLUSIONS:  Adults with schizophrenia being treated in a state psychiatric facility who participated in an 8-week therapeutic yoga program showed significant improvements in psychopathology and quality of life compared with controls. The findings of this study need to be confirmed in larger, more sufficiently powered studies with active control groups.

 

The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysisClin Psychol Rev. 2011 Aug;31(6):1032-40.  by  Piet J, Hougaard E.

BACKGROUND:  Mindfulness-based cognitive therapy (MBCT) is a group-based clinical intervention program designed to reduce relapse or recurrence of major depressive disorder (MDD) by means of systematic training in mindfulness meditation combined with cognitive-behavioral methods. OBJECTIVE:  By means of a meta-analysis to evaluate the effect of MBCT for prevention of relapse or recurrence among patients with recurrent MDD in remission. METHOD:  Electronic databases were searched and researchers were contacted for further relevant studies. Studies were coded for quality. Meta-analyses were performed by means of the Cochrane Collaboration Review Manager 5.1.  RESULTS:  Six randomized controlled trials with a total of 593 participants were included in the meta-analysis. MBCT significantly reduced the risk of relapse/recurrence with a risk ratio of 0.66 for MBCT compared to treatment as usual or placebo controls, corresponding to a relative risk reduction of 34%. In a pre-planned subgroup analysis the relative risk reduction was 43% for participants with three or more previous episodes, while no risk reduction was found for participants with only two episodes. In two studies, MBCT was at least as effective as maintenance antidepressant medication. CONCLUSION:  Results of this meta-analysis indicate that MBCT is an effective intervention for relapse prevention in patients with recurrent MDD in remission, at least in case of three or more previous MDD episodes.

 

Subjective experiences of older adults practicing taiji and qigong. J Aging Res. 2011;2011:650210. Epub 2011 Jun 26. by Yang Y, Decelle S, Reed M, Rosengren K, Schlagal R, Greene J.  from Dept of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820,

This article presents a qualitative study following a 6-month Taiji (T’ai Chi)/Qigong (Ch’i Kung) intervention for older adults. The researchers conducted in-depth interviews of eight selected participants who elected to continue practicing Taiji after the intervention ended, in order to explore their subjective experiences of Taiji’s effects and their motivations for continuing to practice. We created a Layers Model to capture the significance and meaning of the multidimensionality of their reported experiences. Participants not only reported simple benefits along five dimensions of experience (physical, mental, emotional, social and spiritual) but also described complex multidimensional experiences. Overall findings indicate that participants derived a very wide variety of perceived benefits, the most meaningful being a felt sense of body-mind-spirit integration. Our results support the important role of qualitative studies in researching the effects of Taiji and Qigong. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134827

 

Mindfulness-based cognitive therapy: an efficacious community-based group intervention for depression and anxiety in a sample of cancer patientsMed J Aust. 2010 Sep 6;193(5 Suppl):S79-82. by Sharplin GR, Jones SB, Hancock B, Knott VE, Bowden JA, Whitford HS. From Cancer Council South Australia, Adelaide, SA.

OBJECTIVE: To assess the impact of an 8-week structured mindfulness-based cognitive therapy (MBCT) program on individuals experiencing distress as a consequence of cancer. DESIGN, SETTING AND PARTICIPANTS:  Prospective study of 16 participants with a history of cancer and five carers of people with cancer recruited from August 2008 to February 2009 through calls to the Cancer Council South Australia Helpline. Participants were assessed for anxiety and depression before and after undergoing a course in MBCT between 30 September and 18 November 2008 and 20 February and 10 April 2009. MAIN OUTCOME MEASURES: Depression, anxiety and mindfulness as measured by the Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI), and Freiburg Mindfulness Inventory (FMI), respectively, and a consumer-centred evaluation. RESULTS:  There were significant reductions in depression (F[1,24] = 6.37; P = 0.012; partial-eta2 = 0.27) and anxiety (F[2,34] = 9.43; P = 0.001, partial-eta2 = 0.36) and mindfulness (F[2,32] = 8.36; P = 0.001; partial-eta2 = 0.34) following the intervention, and these effects were sustained at the 3-month follow-up. Reliable change indices further support these findings. Participants’ scores on measures of depression and anxiety decreased as a function of increased mindfulness, as reflected by significant (P < 0.05) negative correlations between FMI scores and BDI-II scores (ranging from r = -0.46 to r = -0.79) and STAI scores (ranging from r = -0.46 to r = -0.50) scores at all time points.  CONCLUSION:  The MBCT program appears to be an efficacious intervention for use among people affected by cancer who also experience symptoms of depression and anxiety.

 

Changes in physician costs among high-cost transcendental meditation practitioners compared with high-cost nonpractitioners over 5 yearsAm J Health Promot. 2011 Sep-Oct;26(1):56-60. By Herron RE.

Abstract: Purpose: To determine whether the Transcendental Meditation (TM) technique can affect the physician costs of consistently high-cost people. Design . Quasi-experimental, longitudinal, cost-minimization evaluation. This 14-year, preintervention-postintervention study retrospectively assessed government payments to physicians for treating the TM and no-treatment (NT) groups. Setting . Province of Quebec, Canada. Participants . The highest-spending 10% of 1418 Quebec health insurance enrollees who practiced the TM technique were compared with the highest 10% of 1418 subjects who were randomly selected from enrollees of the same age, sex, and region. TM participants had chosen to begin the technique prior to choosing to enter the study. Measures . Annual payments to private physicians in all treatment settings. The Quebec government health insurance agency provided the total physician payments for each of the 2836 subjects from 1981 to 1994. Other medical expense data for individuals were unavailable. Data were adjusted for medical cost inflation. Analysis . For each subject, least-squares regression slopes were calculated to estimate preintervention and postintervention annual rates of change in payments. The groups’ means, slopes, and medians were compared using both parametric and nonparametric tests. Results . Before starting meditation, the yearly rate of increase in payments to physicians between groups was not significantly different. After commencing meditation, the TM group’s mean payments declined $44.93 annually (p  =  .004), whereas the NT comparison group’s payments exhibited nonsignificant changes. After 1 year, the TM group decreased 11%, and after 5 years their cumulative reduction was 28% (p  =  .001). Conclusions . The results suggest the intervention may be an effective method for reducing physician costs. Randomized studies are recommended. http://ajhpcontents.org/doi/abs/10.4278/ajhp.100729-ARB-258

 

Effect of Qigong on quality of life: a cross-sectional population-based comparison study in TaiwanBMC Public Health. 2011 Jul 9;11:546. by  Ho TJ, Christiani DC, Ma TC, Jang TR, Lieng CH, Yeh YC, Lin SZ, Lin JG, Lai JS, Lan TY. From  School of Public Health, China Medical University, No, 91, Hsueh-Shih Road, Taichung 404, Taiwan. tylan@nhri.org.tw.

BACKGROUND:  Qigong, similar to Tai Chi Chuan, is beneficial to health. In Taiwan, Waitankung, a type of Qigong, is as popular as Tai Chi Chuan. This population-based comparison study compares the health-related quality of life between people practicing Waitankung and their comparable community residents.  METHODS:  A total of 165 individuals practicing Waitankung were matched by age and sex with 660 general individuals for comparison. Information about health-related quality of life, measured by the SF-36, and other basic and health conditions was obtained from the questionnaires. This study used the linear mixed-effect regression model to examine the association between health-related quality of life and the practice of Waitankung. RESULTS:  Compared with either sedentary individuals or individuals practicing other types of exercise, the Waitankung group scored higher for eight and five out of ten SF-36 components, respectively. The Waitankung group scored better in general health, vitality, and physical component summary compared to individuals participating in other types of exercise, even when considering the energy expended by exercise.  CONCLUSION:  The results suggest that Waitankung exercising is significantly associated with health-related quality of life. Waitankung may serve as an exercise choice for middle-aged and older people to improve overall quality of life. http://www.biomedcentral.com/1471-2458/11/546

 

Meditation training increases brain efficiency in an attention task. Neuroimage. 2011 Jul 7.  by Kozasa EH, Sato JR, Lacerda SS, Barreiros MA, Radvany J, Russell TA, Sanches LG, Mello LE, Amaro E Jr. From Instituto do Cérebro, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil; Department of Psychobiology, Universidade Federal De São Paulo, São Paulo, Brazil.

Abstract:  Meditation is a mental training, which involves attention and the ability to maintain focus on a particular object. In this study we have applied a specific attentional task to simply measure the performance of the participants with different levels of meditation experience, rather than evaluating meditation practice per se or task performance during meditation. Our objective was to evaluate the performance of regular meditators and non-meditators during an fMRI adapted Stroop Word-Colour Task (SWCT), which requires attention and impulse control, using a block design paradigm. We selected 20 right-handed regular meditators and 19 non-meditators matched for age, years of education and gender. Participants had to choose the colour (red, blue or green) of single words presented visually in three conditions: congruent, neutral and incongruent. Non-meditators showed greater activity than meditators in the right medial frontal, middle temporal, precentral and postcentral gyri and the lentiform nucleus during the incongruent conditions. No regions were more activated in meditators relative to non-meditators in the same comparison. Non-meditators showed an increased pattern of brain activation relative to regular meditators under the same behavioural performance level. This suggests that meditation training improves efficiency, possibly via improved sustained attention and impulse control.

 

Buddhist group therapy for diabetes patients with depressive symptoms. Arch Psychiatr Nurs. 2011 Jun;25(3):195-205. by Rungreangkulkij S, Wongtakee W, Thongyot S. from Center of Research and Training on Genderand Women Health Khon Kaen University, Thailand. somrun@kku.ac.th

Abstract:  The objective of this study was to assess the effect of Buddhist group therapy on patients with type 2 diabetes who had depressive symptoms. A quasi-experimental design study using a control group with matching technique was conducted. After informed consent was obtained, the “Nine questions for assessing depressive disorder symptom” (Isan language) was used to determine the patient’s condition. A total of 62 patients with type 2 diabetes who had depressive symptoms were assigned to either the experimental group (n = 32) or the control group (n = 32). Patients in the experimental group were divided further into four groups (8 patients per group) and attended the Buddhist group therapy. The intervention consisted of a weekly Buddhist group gathering lasting 2 hours for 6 weeks plus home meditation practices. Patients in the control group received treatment as usual. Both groups received standard physician treatment, including medication. Physicians did not know who was in either the control or experimental groups. Results show that 6 months after the intervention, 65.6% and 100% of patients in the control group and experimental group, respectively, returned to normal level. The intention-to-treat analysis, which included two participants in the experimental group lost follow-up, yielded a small reduction in the number of patients who returned to normal level (93.8%). With intention-to-treat analysis, the relative risk on depressive symptoms between the experimental and control groups was 6.5 (95% confidence interval, 1.4-30.6). Qualitative data from the experimental group supported that there were therapeutic group factors involved. However, patients realized the truth of being oneself and also accepted their current living condition. In conclusion, this program is effective in reducing depressive symptoms.

 

Mechanisms of yogic practices in health, aging, and disease. Mt Sinai J Med. 2010 Sep-Oct;77(5):559-69. By Kuntsevich V, Bushell WC, Theise ND. From Beth Israel Medical Center of Albert Einstein College of Medicine, New York, NY 10003, USA. vkuntsev@chpnet.org

Abstract: Mechanisms underlying the modulating effects of yogic cognitive-behavioral practices (eg, meditation, yoga asanas, pranayama breathing, caloric restriction) on human physiology can be classified into 4 transduction pathways: humoral factors, nervous system activity, cell trafficking, and bioelectromagnetism. Here we give examples of these transduction pathways and how, through them, yogic practices might optimize health, delay aging, and ameliorate chronic illness and stress from disability. We also recognize that most studies of these mechanisms remain embedded in a reductionist paradigm, investigating small numbers of elements of only 1 or 2 pathways. Moreover, often, subjects are not long-term practitioners, but recently trained. The models generated from such data are, in turn, often limited, top-down, without the explanatory power to describe beneficial effects of long-term practice or to provide foundations for comparing one practice to another. More flexible and useful models require a systems-biology approach to gathering and analysis of data. Such a paradigm is needed to fully appreciate the deeper mechanisms underlying the ability of yogic practice to optimize health, delay aging, and speed efficient recovery from injury or disease. In this regard, 3 different, not necessarily competing, hypotheses are presented to guide design of future investigations, namely, that yogic practices may: (1) promote restoration of physiologic setpoints to normal after derangements secondary to disease or injury, (2) promote homeostatic negative feedback loops over nonhomeostatic positive feedback loops in molecular and cellular interactions, and (3) quench abnormal “noise” in cellular and molecular signaling networks arising from environmental or internal stresses.

 

(Compiled by Kevin W Chen)

 

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