Yoga is effective in treating symptoms of Gulf War illness: A randomized clinical trial.

Many Veterans of the 1990-1991 Gulf War report symptoms of Gulf War Illness, a condition involving numerous chronic symptoms including pain, fatigue, and mood/cognition symptoms. Little is known about this condition's etiology and treatment. This study reports outcomes from a randomized controlled single-blind trial comparing yoga to cognitive behavioral therapy for chronic pain and other symptoms of Gulf War Illness. Participants were Veterans with symptoms of GWI: chronic pain, fatigue and cognition-mood symptoms. Seventy-five Veterans were randomized to treatment via selection of envelopes from a bag (39 yoga, 36 cognitive behavioral therapy), which consisted of ten weekly group sessions. The primary outcomes of pain severity and interference (Brief Pain Inventory- Short Form) improved in the yoga condition (Cohen's d = .35, p = 0.002 and d = 0.69, p < 0.001, respectively) but not in the CBT condition (d = 0.10, p = 0.59 and d = 0.25 p = 0.23). However, the differences between groups were not statistically significant (d = 0.25, p = 0.25; d = 0.43, p = 0.076), though the difference in an a-priori-defined experimental outcome variable which combines these two variables into a total pain variable (d = 0.47, p = 0.047) was significant. Fatigue, as indicated by a measure of functional exercise capacity (6-min walk test) was reduced significantly more in the yoga group than in the CBT group (between-group d = .27, p = 0.044). Other secondary outcomes of depression, wellbeing, and self-reported autonomic nervous system symptoms did not differ between groups. No adverse events due to treatment were reported. Yoga may be an effective treatment for core Gulf War Illness symptoms of pain and fatigue, making it one of few treatments with empirical support for GWI. Results support further evaluation of yoga for treating veterans with Gulf War Illness. CLINICAL TRIAL REGISTRY: clinicaltrials.gov Registration Number NCT02378025.

A Role for Complementary and Integrative Medicine in Alzheimer's Disease Prevention.

Complementary and Integrative Medicine has been maturing as a field to support treatment for a variety of medical conditions. The approaches, including yoga, meditation, acupuncture, and dietary supplements, may assist patients in a variety of ways, though clear explanations for their mechanisms of action or measurements of their possible benefit are in most cases elusive. In this issue of the Journal of Alzheimer's Disease, Khalsa examines the use of meditation as a stress-reduction technique and provides an argument that with a specific technique such stress reduction can be provided efficiently, with relatively little interference in daily activities, and might decrease Alzheimer risk. This thorough review provides some evidence of physiological benefit of meditation to brain function. While any actual effect of meditation on Alzheimer pathophysiology is only conjectural, meditation has received considerable attention as a tool that may have positive psychological and medical benefits. Consequently, this review is welcome. What is less certain is whether the recommended meditation approach is of specific benefit for Alzheimer's disease or any other condition above and beyond what might be provided by many other types of exercises (like singing in a chorus or doing cross-word puzzles) or physical activities (like swimming or yoga).

The Cost-Time Index: a new method for measuring the efficiencies of recruitment-resources in clinical trials.

Paid media are important resources used to recruit subjects in clinical trials. An index for evaluating which advertising resource has minimal cost and time requirement for patient accrual, for a given study design, has not been previously introduced. In this communication the authors present a new index, the Cost-Time Index, which represents a measure of the average amount of money and time spent, simultaneously, on a given advertising resource to recruit one analyzable subject. This index can be calculated using retrospective data and may be a useful tool for comparing recruitment efficiencies among various resources. The authors demonstrate the utility of the Cost-Time Index and recommend its use as an additional variable in future studies regarding recruitment strategies in clinical trials.