Practice and proficiency of Isha Yoga for better mental health outcomes: insights from a COVID-19 survey.

Introduction: The COVID-19 pandemic has brought about unparalleled suffering on a global scale, affecting both physical and mental well-being. In such challenging times, it becomes crucial to identify interventions that can alleviate negative mental health outcomes, such as stress, while promoting positive mental health outcomes, like well-being. We report the effectiveness of a mind-body practise, Isha Yoga, in promoting well-being. Methods: We conducted an online survey, during the COVID-19 pandemic, with Yoga practitioners (n = 1,352) from the Isha Yoga tradition in Karnataka, India. We evaluated stress and well-being attributes using conventional psychometric questionnaires. Subsequently, we requested the Isha Yoga practitioners to share another survey with their friends and family members, assessing similar outcomes. From the respondents of this shared survey (n = 221), we identified individuals who currently did not engage in any form of Yoga or meditation, constituting the non-Yoga control group (n = 110). To enhance the reliability and validity of our study and minimize the limitations commonly associated with online surveys, we adhered to the CHERRIES guidelines for reporting survey studies. Results: Isha Yoga practitioners had significantly lower levels of stress (p < 0.001, gHedges = 0.94) and mental distress (p < 0.001, gHedges = 0.75) while reporting significantly higher levels of well-being (p < 0.001, gHedges = 0.78) and affective balance (p < 0.001, gHedges = 0.80) compared to the control group. Furthermore, expertise-related improvements were observed in these outcomes, and a dose-response relationship was found between regularity of Isha Yoga practice and outcome changes. A minimum 3-4 days of weekly practice showed significant differences with the control group. In addition, we investigated the effect of Isha Yoga on stress and well-being among the healthcare workers (HCWs) in our sample and observed better mental health outcomes. Discussion: These findings collectively underscore the benefits of Mind and Body practices like Isha Yoga on various aspects of mental health and well-being, emphasizing its potential as an effective and holistic approach for promoting a healthy lifestyle among diverse populations, including healthcare workers, even in difficult circumstances such as the COVID-19 pandemic.

Development and validation of Ayurveda based assessment scale for anxiety.

BACKGROUND: Anxiety scale based on Ayurveda would help Ayurveda physicians to measure and initiate appropriate treatment strategies. OBJECTIVES: The objective of the study was to develop a clinical assessment scale for anxiety based on Ayurveda science. MATERIALS AND METHODS: Ayurveda assessment scale for anxiety (AAA) was developed and subjected to various psychometric evaluations. Patients of generalized anxiety disorder with social phobia (GAD with SP) (n = 31) meeting DSM-IV-TR criteria and age, sex-matched healthy subjects (n = 31) were enrolled from NIMHANS Psychiatry OPD. Two independent Ayurveda experts evaluated both patients and healthy subjects using AAA, Hamilton Anxiety Rating Scale (HARS), and Beck Anxiety Inventory (BAI). Reliability and validity assessments were carried out. The sensitivity to treatment-induced change was evaluated in a randomized controlled clinical trial. 72 patients of GAD with SP meeting DSM-IV-TR criteria, aged between 20 and 55 years, and either sex participated in the study. The duration of intervention was 30 days. The assessments were done through HARS, BAI, Beck Depression Inventory (BDI), AAA and Clinical Global Impression scales (Severity, Improvement, and Efficacy). RESULTS: The Interrater reliability was between - good to very good score. Validity of AAA with HARS and BAI was significant (p < 0.001). Scales recorded significant differences when compared between patients and healthy subjects (p < 0.001). AAA also recorded the sensitivity to treatment-induced changes in a randomized controlled study and noted a large effect size (>0.60). CONCLUSIONS: The psychometric properties such as interrater reliability, validity (criteria, convergent, divergent, face) and sensitivity to change of AAA were promising.

Differences in brain connectivity of meditators during assessing neurocognition via gamified experimental logic task: A machine learning approach.

Meditation practices increase attention, memory, and self-awareness. The neuroscientific study of meditation has helped gain useful insights into the functional changes in the brain. In this study, we have assessed the performance of meditators with different years of practice while performing an engaging task rather than studying the meditation practice itself. This task helps assess many neural processes simultaneously and represents task performance in presence of multiple audio-visual distractors as in a real-life scenario. The long-term practice of meditation could bring neuroplastic changes in the way cognitive processing is carried out. It could be conscious and effortful in short-term practitioners and relatively unconscious and effortless in long-term practitioners. Our goal is to understand if it is possible to differentiate between long-term and short-term meditators solely based on their cognitive processing. A group of proficient Rajayoga meditators from the Brahma Kumaris were recruited based on their meditation experience-Long-Term Practitioners (n = 12, mean 13,596 h) and Short-Term Practitioners (n = 10, mean 1095 h). A task-based functional Magnetic Resonance Imaging was acquired while the subjects performed the task. Functional Connectivity Analysis was performed to derive the correlation measures to be used as features for classification. Five supervised Machine Learning algorithms Logistic Regression, Support Vector Machine, Decision Tree, Random Forest, and Gradient Boosted Tree were used for classification. Among all the classifiers Gradient Boosted Tree performed the best with an accuracy of 77% when all the four Functional Connectivity Metrics were used. Connectivity in visual areas, cerebellum, left rostral prefrontal cortex, and middle frontal gyrus was found to be higher in long-term meditators. Such a classification demonstrates that long-term meditation practice brings about neuroplastic changes that influence cognitive processing.

Classification of Rajayoga Meditators Based on the Duration of Practice Using Graph Theoretical Measures of Functional Connectivity from Task-Based Functional Magnetic Resonance Imaging.

Context: Functional magnetic resonance imaging (fMRI) studies on mental training techniques such as meditation have reported benefits like increased attention and concentration, better emotional regulation, as well as reduced stress and anxiety. Although several studies have examined functional activation and connectivity in long-term as well as short-term meditators from different meditation traditions, it is unclear if long-term meditation practice brings about distinct changes in network properties of brain functional connectivity that persist during task performance. Indeed, task-based functional connectivity studies of meditators are rare. Aims: This study aimed to differentiate between long-term and short-term Rajayoga meditators based on functional connectivity between regions of interest in the brain. Task-based fMRI was captured as the meditators performed an engaging task. The graph theoretical-based functional connectivity measures of task-based fMRI were calculated using CONN toolbox and were used as features to classify the two groups using Machine Learning models. Subjects and Methods: In this study, we recruited two age and sex-matched groups of Rajayoga meditators from the Brahma Kumaris tradition that differed in the duration of their meditation experience: Long-term practitioners (n = 12, mean 13,596 h) and short-term practitioners (n = 10, mean 1095 h). fMRI data were acquired as they performed an engaging task and functional connectivity metrics were calculated from this data. These metrics were used as features in training machine learning algorithms. Specifically, we used adjacency matrices generated from graph measures, global efficiency, and local efficiency, as features. We computed functional connectivity with 132 ROIs as well as 32 network ROIs. Statistical Analysis Used: Five machine learning models, such as logistic regression, SVM, decision tree, random forest, and gradient boosted tree, were trained to classify the two groups. Accuracy, precision, sensitivity, selectivity, area under the curve receiver operating characteristics curve were used as performance measures. Results: The graph measures were effective features, and tree-based algorithms such as decision tree, random forest, and gradient boosted tree yielded the best performance (test accuracy >84% with 132 ROIs) in classifying the two groups of meditators. Conclusions: Our results support the hypothesis that long-term meditative practices alter brain functional connectivity networks even in nonmeditative contexts. Further, the use of adjacency matrices from graph theoretical measures of high-dimensional fMRI data yields a promising feature set for machine learning classifiers.

Enhanced dehydroepiandrosterone levels are positively correlated with N3 sleep stage in long-term mindfulness meditation practitioners.

Objectives: Meditation practices positively influence the neural, hormonal and autonomic systems. We have demonstrated that long-term practice of mindfulness meditation increases N3 and rapid eye movement (REM) sleep stages and bring efficient autonomic modulation during sleep. In the present study, the probable humoral correlation that could bring about these changes is evaluated. Material and Methods: Long-term Vipassana meditators (n=41) and controls (n=24) (males, 30-60 years of age) underwent a two-day consecutive whole night polysomnography recording. During the second day, with exposure to 100Lux brightness, blood was sampled from the antecubital vein between 8-9 PM and in subsequent early morning. Sleep stage was scored as per American Society of Sleep Medicine (ASSM) guidelines for the second-day recording. Sleep-related hormones were estimated - melatonin by radioimmunoassay; dehydroepiandrosterone (DHEA), cortisol, growth hormone (GH) and prolactin with enzyme-linked immunosorbent assay (ELISA); DHEA/cortisol ratio was calculated. Percentage of sleep stages and hormonal levels were compared between both groups using independent 't' test and Pearson's correlation was estimated between sleep stages and hormonal levels. Results: Meditators showed increased N3, REM sleep stages. Though evening cortisol was comparable between the two groups; early morning cortisol, diurnal DHEA and melatonin were significantly higher in meditators. Diurnal DHEA correlated significantly with the N3 sleep stage in meditators. Discussion: Higher diurnal DHEA despite variations in corresponding cortisol in meditators demonstrates that long-term Vipassana meditation practice modulates the hypothalamicpituitary-adrenal (HPA) axis and thereby influences sleep. Thus, the study provides evidence to explore the mechanism most likely involved with mindfulness meditation intervention in insomnia.

Exposure to Short Photoperiod Regime Restores Spatial Cognition in Ventral Subicular Lesioned Rats: Potential Role of Hippocampal Plasticity, Glucocorticoid Receptors, and Neurogenesis.

Ambient light influences our mood, behavior, and cognition. Phototherapy has been considered as an effective non-pharmacological intervention strategy in the restoration of cognitive functions following central nervous system insults. However, the cellular and molecular underpinnings of phototherapy-mediated functional recovery are yet to be studied. The present study examines the effectiveness of short photoperiod regime (SPR; 6:18-h light:dark cycle) in restoring the cognitive functions in ventral subicular lesioned rats. Bilateral ventral subicular lesion (VSL) resulted in significant impairment of spatial navigational abilities when tested in the Morris water maze (MWM) task. Further, VSL resulted in reduced expression of glucocorticoid receptors (GRs) and activity-regulated cytoskeletal (Arc) protein and suppression of neurogenesis in the hippocampus. VSL also suppressed the magnitude of long-term potentiation (LTP) in the hippocampal Schaffer collateral-CA1 synapses. However, exposure to SPR for 21 days showed significant restoration of spatial performance in the MWM task as the ventral subicular lesioned rats could deploy higher cognitive allocentric navigational strategies to reach the hidden platform. Further, SPR resulted in enhanced expression of hippocampal GR and Arc protein and neurogenesis but not hippocampal LTP suggestive of appropriate need-based SPR intervention. In conclusion, the study demonstrates the effectiveness of SPR in establishing functional recovery as well as the possible molecular and cellular basis of cognitive recovery in a rat model of neurodegeneration. Such studies provide a framework in understanding the efficacy of non-pharmacological strategies in establishing functional recovery in neurodegenerative conditions.

Meditation, well-being and cognition in heartfulness meditators - A pilot study.

Meditative practices can vary considerably in technique as well as their effects. Heartfulness is a popular meditation technique that includes in its repertoire, a unique passive form of meditation. We carried out a pilot study recruiting male heartfulness meditators (proficient n = 24, with 6-28 years of meditation experience; novice n = 24, 5 to 16 months of experience) and subsequently recruited matched controls (n = 15). We examined well-being, and carried out high-density EEG recordings to examine indices of meditation and cognition in these groups. Well-being scores were significantly higher for the proficient meditators as compared to novice and intermediate for the controls. We did not find any group differences in cognitive processing. During meditation, enhanced occipital gamma was found in proficient meditators as compared to controls. We discuss the findings from this pilot study and suggest avenues for future research.

State-trait influences of Vipassana meditation practice on P3 EEG dynamics.

Several studies have demonstrated that meditation naïve subjects can, in just a few weeks, become proficient enough in meditation to show cognitive improvements accompanied with functional and structural changes in the brain. Would long-term exposure to qualitatively different levels of meditative training bring about differences in cognitive processing? Would meditation prior to task performance help separate out these differences? Could the nature of the task influence the findings related to cognitive enhancements? To address these questions, we evaluated cognitive functions in three groups of experienced Vipassana practitioners (Novices: n=22, Mean±SD meditation experience=989±595h; Senior practitioners: 21, 10,510±5313; Teachers: 16, 14,648±9623) who differed in terms of duration and quality of meditative practice. Specifically, we employed "ANGEL" a gamified multilevel oddball paradigm, to assess P3 event-related potentials (ERPs) and associated EEG dynamics-power spectra, event related spectral perturbations (ERSP) and inter-trial coherence (ITC). In order to elicit the state-trait influences of meditation, the cognitive task was performed after the participants had undergone an hour long traditional meditation session. All participants could perform the task well and the gross ERP waveforms were similar for the three groups. As hypothesized, we found distinct state-trait influences of meditation leading to graded differences in P3 EEG dynamics. Specifically, we found reduced theta synchrony, enhanced alpha de-synchrony and lesser theta-alpha coherence in the more proficient meditators. Post hoc analyses revealed several differences between the novice and teacher groups but not as many between novice and seniors suggesting that the senior meditators formed an intermediate group. Our study demonstrates that both quantity and quality of meditation influence EEG dynamics during cognitive processing and that meditation prior to a task can provide additional state-trait effects involved in meeting the specific cognitive demands.

Beyond Hypnograms: Assessing Sleep Stability Using Acoustic and Electrical Stimulation.

OBJECTIVE: Conventional polysomnographic recordings reflect brain dynamics associated with sleep architecture. We hypothesized that noninvasive tools like transcranial alternating current stimulation (tACS) and acoustic stimulation (for generating event related potentials [ERPs]) would help to predict sleep stability and provide a window to actively assess brain activity during sleep. MATERIALS AND METHODS: Twelve healthy male volunteers participated in the multiple whole-night polysomnography (PSG) recording protocol. Acoustic tones (100 msec duration) were presented throughout night to evaluate ERP during sleep. Furthermore, 30 sec tACS were presented during nonrapid eye movement (NREM) and rapid eye movement (REM) sleep on subsequent two nights without disturbing the subject's sleep. For ERP analysis, event-locked artifact-free epochs from each sleep stage were averaged separately. For tACS analysis, 30 sec prestimulus and poststimulus artifact-free EEG epochs were subjected to bootstrapping-based comparison of power spectral values. RESULTS: Acoustic stimulation generated sleep stage-dependent ERP components (N350, N550, and P900) in all participants. The tACS stimulation during NREM sleep (0.75 Hz) increased parietal delta power but decreased frontocentral theta and increased frontal gamma power when delivered during REM sleep (40Hz). These interventions provide details on sleep stability as larger N550-P900 ERP-complex correlated with lower NREM disruptions (Spearman's rho = -0.553; p = 0.049; n = 10) and tACS-related theta power perturbation with higher REM disruptions (Spearman's rho = 0.734; p = 0.030; n = 7). CONCLUSIONS: Noninvasive brain stimulation approaches such as sleep ERP and sleep tACS are reliable tools to evaluate sleep stability during NREM and REM sleep, respectively, but more large-sample studies are warranted.

Dissociating meditation proficiency and experience dependent EEG changes during traditional Vipassana meditation practice.

Meditation, as taught by most schools of practice, consists of a set of heterogeneous techniques. We wanted to assess if EEG profiles varied across different meditation techniques, proficiency levels and experience of the practitioners. We examined EEG dynamics in Vipassana meditators (Novice, Senior meditators and Teachers) while they engaged in their traditional meditation practice (concentration, mindfulness and loving kindness in a structured manner) as taught by S.N. Goenka. Seniors and Teachers (vs Novices) showed trait increases in delta (1-4 Hz), theta-alpha (6-10 Hz) and low-gamma power (30-40 Hz) at baseline rest; state-trait increases in low-alpha (8-10 Hz) and low-gamma power during concentrative and mindfulness meditation; and theta-alpha and low-gamma power during loving-kindness meditation. Permutation entropy and Higuchi fractal dimension measures further dissociated high proficiency from duration of experience as only Teachers showed consistent increase in network complexity from baseline rest and state transitions between the different meditation states.

Just a minute meditation: Rapid voluntary conscious state shifts in long term meditators.

Meditation induces a modified state of consciousness that remains under voluntary control. Can meditators rapidly and reversibly bring about mental state changes on demand? To check, we carried out 128 channel EEG recordings on Brahma Kumaris Rajayoga meditators (36 long term: median 14240h meditation; 25 short term: 1095h) and controls (25) while they tried to switch every minute between rest and meditation states in different conditions (eyes open and closed; before and after an engaging task). Long term meditators robustly shifted states with enhanced theta power (4-8Hz) during meditation. Short term meditators had limited ability to shift between states and showed increased lower alpha power (8-10Hz) during eyes closed meditation only when pre and post task data were combined. Controls could not shift states. Thus trained beginners can reliably meditate but it takes long term practice to exercise more refined control over meditative states.

Exposure to short photoperiod regime reduces ventral subicular lesion-induced anxiety-like behavior in Wistar rats.

Neurodegeneration of hippocampal structures is implicated in Alzheimer's disease (AD). Patients with AD exhibit 'sundown syndrome' featuring mood swings and anxiety. Although there are studies demonstrating circadian rhythm disruption associated with sundown phenomenon, the mechanisms underlying the emotional disturbances remain elusive. In the present study, we examined the relationship between subiculum (a key hippocampal output structure) and anxiety. Our study demonstrates that bilateral ventral subicular lesion (VSL) leads to anxiogenic behavior. In the elevated plus maze test, VSL rats made less number of entries into the open arms and spent significantly more time in the closed arms. Similarly, in the light-dark exploration test, VSL rats spent significantly more time in the dark chamber and made fewer entries into the light chamber. VSL also produced significant neurodegeneration in the paraventricular, suprachiasmatic and dorsomedial nuclei of the hypothalamus. Exposing VSL rats to a short photoperiod regime (SPR; 06/18h light-dark cycle) for 21days ameliorated the anxiety-like behavior. VSL rats on SPR also exhibited increased food consumption and higher core body temperature. Our study supports the hypothesis that the ventral subiculum regulates anxiety-like behavior and that SPR helps in the alleviation of such behavior. Even though the mechanisms underlying anxiolytic effects of light-dark cycle manipulation are yet to be elucidated, such non-pharmacological strategies can help to mitigate anxiety-like behavior. A proper understanding of the effectiveness of photoperiod manipulation will help in developing strategies in the management of emotional disturbances associated with affective and neurodegenerative disorders including AD.

Senior Vipassana Meditation practitioners exhibit distinct REM sleep organization from that of novice meditators and healthy controls.

The present study is aimed to ascertain whether differences in meditation proficiency alter rapid eye movement sleep (REM sleep) as well as the overall sleep-organization. Whole-night polysomnography was carried out using 32-channel digital EEG system. 20 senior Vipassana meditators, 16 novice Vipassana meditators and 19 non-meditating control subjects participated in the study. The REM sleep characteristics were analyzed from the sleep-architecture of participants with a sleep efficiency index >85%. Senior meditators showed distinct changes in sleep-organization due to enhanced slow wave sleep and REM sleep, reduced number of intermittent awakenings and reduced duration of non-REM stage 2 sleep. The REM sleep-organization was significantly different in senior meditators with more number of REM episodes and increased duration of each episode, distinct changes in rapid eye movement activity (REMA) dynamics due to increased phasic and tonic activity and enhanced burst events (sharp and slow bursts) during the second and fourth REM episodes. No significant differences in REM sleep organization was observed between novice and control groups. Changes in REM sleep-organization among the senior practitioners of meditation could be attributed to the intense brain plasticity events associated with intense meditative practices on brain functions.

Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions.

CONTEXT AND AIMS: Migraine is an episodic disabling headache requiring long-term management. Migraine management through Yoga therapy would reduce the medication cost with positive health benefits. Yoga has shown to improve the quality of life, reduce the episode of headache and medication. The aim of the present study was to evaluate the efficacy of Yoga as an adjuvant therapy in migraine patients by assessing clinical outcome and autonomic functions tests. SUBJECTS AND METHODS: Migraine patients were randomly given either conventional care (n = 30) or Yoga with conventional care (n = 30). Yoga group received Yoga practice session for 5 days a week for 6 weeks along with conventional care. Clinical assessment (frequency, intensity of headache and headache impact) and autonomic function test were done at baseline and at the end of the intervention. RESULTS: Yoga with conventional care and convention care groups showed significant improvement in clinical variables, but it was better with Yoga therapy. Improvement in the vagal tone along with reduced sympathetic activity was observed in patients with migraine receiving Yoga as adjuvant therapy. CONCLUSIONS: Intervention showed significant clinical improvement in both groups. Headache frequency and intensity were reduced more in Yoga with conventional care than the conventional care group alone. Furthermore, Yoga therapy enhanced the vagal tone and decreased the sympathetic drive, hence improving the cardiac autonomic balance. Thus, Yoga therapy can be effectively incorporated as an adjuvant therapy in migraine patients.

Clinical efficacy of Manasamitra Vataka (an Ayurveda medication) on generalized anxiety disorder with comorbid generalized social phobia: a randomized controlled study.

BACKGROUND: Studies on alternative medicines for generalized anxiety disorder (GAD) are few. Manasamitra Vataka (an Ayurveda preparation) is explored for its efficacy in patients with GAD with comorbid generalized social phobia. MATERIALS AND METHODS: Seventy-two (72) patients with GAD with comorbid social phobia meeting DSM IV TR criteria, and who were between the ages of 20 and 55 of either sex, participated in the study. They were randomly divided into three treatment groups: Group 1 (n=24) and Group II (n=24) received Manasamitra Vataka tablets (100 mg twice daily for 30 days). Group II, in addition to Manasamitra Vataka, underwent Shirodhara (therapy involving dripping of medicated oil [Brahmi tail] over the forehead) treatment for the first 7 days. Group III (n=24) received clonazepam 0.75 mg daily in divided dose for 30 days. The assessment of the study was done using the Hamilton Anxiety Rating Scale, Beck Anxiety Inventory, Beck Depression Inventory, Epworth Sleepiness Scale (ESS), World Health Organization Quality of Life BREF, and Clinical Global Impression scales (Improvement and Efficacy). RESULTS: Patients from all the groups showed significant reduction in clinical parameters evaluated. However, improvement in ESS was observed only in Group II. The treatment outcome was comparable between the three groups. CONCLUSIONS: This is the first study conducted on the efficacy of Manasamitra Vataka in anxiety disorders. The results suggest that Manasamitra Vataka is effective in the management GAD with comorbid generalized social phobia. Add-on effect of Shirodhara reduced the daytime sleepiness. Further studies on Manasamitra Vataka need to be carried out to judge its potential as a first-line treatment modality.

Meditation and its regulatory role on sleep.

Intense meditation practices help to achieve a harmony between body and mind. Meditation practices influence brain functions, induce various intrinsic neural plasticity events, modulate autonomic, metabolic, endocrine, and immune functions and thus mediate global regulatory changes in various behavioral states including sleep. This brief review focuses on the effect of meditation as a self regulatory phenomenon on sleep.