Event-Related Potential Changes Following 12-week Yoga Practice in T2DM Patients: A Randomized Controlled Trial.

Introduction. Type 2 diabetes patients are more likely to experience cognitive decline (1.5%) and dementia (1.6%) than healthy individuals. Although cognitive impairment adversely affects Type 2 diabetes mellitus (T2DM) patients, it is the least addressed complication of T2DM patients. Objective. The present study attempts to examine the changes in cognitive performance of T2DM patients and the probable factors contributing to the changes following 12-week yoga practice. Methods. The current study is a parallel group randomized controlled trial that compared the outcomes of the participants randomized to a yoga group (YG) (n = 25) and to a wait-list control group (n = 29). The study assessed N200 and N450 event-related potential (ERP) components following the Stroop task, heart rate variability (HRV) and HbA1c before and after the intervention. Results. The mean amplitude of the N200 ERP component showed a significant group difference after the intervention, demonstrating an improved neural efficiency in the process of conflict monitoring and response inhibition. No differences were present for the N450 component. T2DM patients showed reduced heart rate and increased mean RR following yoga practice without any corresponding changes in other HRV parameters, demonstrating an overall improvement in cardiac activity. Along with that yoga practice also reduced HbA1c levels in T2DM patients, indicating improved glycemic control. Moreover, HbA1c levels were negatively correlated with reaction time after the intervention, indicating an impact of glycemic control on cognitive performance. Conclusion. The 12-week yoga practice improved cognitive performance by enhancing the processes of conflict monitoring and response inhibition. Further, improved cognitive performance postintervention was facilitated by improved glycemic control.

Cerebral Haemodynamic Changes in Type 2 Diabetes Mellitus Following a Three-Month Yoga Intervention: A Randomized Controlled Trial.

Background and purpose Cerebral haemodynamics and cognitive performance may be adversely affected in type 2 diabetes mellitus (T2DM). Previous studies reported reduced cerebral blood flow (CBF) and altered cerebrovascular reactivity (CVR) in T2DM. Yoga, an ancient holistic health approach, is known to be beneficial for T2DM. We hypothesized that yoga practice may alter CBF and the flow resistance in the middle cerebral artery (MCA) and improve cognition in T2DM. Our secondary objective was to explore the relationship between changes in cerebral haemodynamics and cognition in T2DM. Materials and methods Participants were randomly allotted into the yoga and control groups based on the eligibility criteria. One hour of yoga intervention specific to type 2 diabetes was provided to the yoga group for three months, while conventional treatment was provided to the control group. A transcranial Doppler was used to evaluate longitudinal changes in cerebral haemodynamics in MCA. A Corsi block tapping test was used to assess visio-spatial working memory. Results There were 75 participants recruited, of whom 38 participated in yoga and 37 participated in a control group. Both intention to treat and per protocol analysis showed significant results. At day 90, intention-to-treat analysis showed significant changes in CBF velocities (mean difference -10.85%, 95% CI (-13.26, -6.15), p<0.001), cerebral vasodilatory reserve (mean difference -0.23%, 95% CI (-0.43, -0.03), p=0.02) and cognition (mean difference -12.13%, 95% CI (-17.48, -6.78), p≤0.001). There was no between-group effect. Also, the correlation between the CBF and cognition did not show any significant results. Conclusion The three-month yoga intervention was associated with an improvement in cerebral hemodynamics. The study also revealed an improvement in visio-spatial working memory among patients with T2DM. The study did not show any correlation between the improvement in cerebral haemodynamics and working memory. We recommend larger and longer studies on yoga intervention for T2DM patients to evaluate whether such benefits are sustained and improve their quality of life.

Yoga Practice Facilitates Prefrontal Oxygenation and Working Memory in Type 2 Diabetes Mellitus Patients: A Pilot Study.

Background: Type 2 diabetes mellitus (T2DM) is associated with cognitive decline. Lifestyle behaviors such as yoga practices play a significant role in preventing cognitive decline. Purpose: The goal of this study was to assess the effect of yoga intervention on working memory and prefrontal cortex (PFC) oxygenation in T2DM patients. Methods: Twenty T2DM participants, aged between 40 and 60 years, volunteered for a 6-week study. Participants were randomized into a yoga practice (n = 10) and a waitlist control group (n = 10). The n-back task was administered to evaluate working memory before and after the intervention. While performing the working memory task, PFC oxygenation was monitored using functional near-infrared spectroscopy. Results: The yoga group showed a significant improvement in working memory performance. The accuracy improved in 1-back (mean difference of 4.73%, 95% CI[0.69,8.77], P = .026) and 2-back (8.0%, 95% CI[1.89,14.1], P = .016) task conditions. The reaction time improved in 0-back (mean difference of -79.07 milliseconds, 95% CI[-128.3,-29.8]), 1-back (mean difference of -119.17 milliseconds, 95% CI[-217.5,-20.8] ) and 2-back (-76.06 milliseconds, 95% CI[-148.8,-3.3]) task conditions. In the yoga group, at post-intervention, higher oxygenation was observed during 0-back and 1-back task conditions (Beta coefficient mean difference of 211.3, 95% CI[2.8, 420.0], P = .048 and 80.5, 95% CI [3.7,157.2], P = .042 respectively) in the left PFC region compared to the pre-intervention values. The control group showed no significant change in working memory performance and PFC oxygenation. Conclusions: The study suggests that yoga practice may improve working memory performance and facilitate higher PFC oxygenation in T2DM patients. Further studies with a larger sample and a longer intervention period are required to strengthen the findings.

Prefrontal oxygenation and working memory in patients with type 2 diabetes mellitus following integrated yoga: a randomized controlled trial.

AIMS: Type 2 diabetes mellitus (T2DM) alters brain functional and structural connectivity leading to cognitive dysfunction. This study examined the effect of a 12-week yoga intervention on prefrontal cortex (PFC) oxygenation and working memory in patients with T2DM. METHODS: Fifty participants were randomized into yoga and waitlist control groups. The yoga protocol specific to T2DM was followed. The pre- (day 1), mid- (6 weeks) and post-intervention (12 weeks) assessments included measurement of PFC oxygenation while performing working memory tasks (n-back) using functional near-infrared spectroscopy. RESULTS: Following a 12-week intervention, the yoga group showed improved performance in working memory [accuracy (geometric mean difference of 3.15%, 95% CI [2.33,3.96], p = 0.001) and reaction time (mean difference of 100.8 milliseconds,95% CI [- 166.6, - 35.1], p = 0.002] in the high task load (2-back) associated with higher oxygenation in dorsolateral PFC (ß coefficient mean difference of 95.6, 95% CI [0.23,191], p = 0.049) and ventrolateral PFC (ß coefficient mean difference of 53.4, 95% CI [7.8,98.9], p = 0.018) regions. Higher oxygenation in dorsolateral PFC during 2-back task was positively correlated with accuracy (r(23) = 0.65, p < 0.001) and negatively correlated with reaction time (r(23) = - 0.47,p = 0.017). CONCLUSION: Integrated yoga practice may improve working memory performance associated with higher PFC oxygenation in patients with T2DM. As 12 weeks of yoga intervention improved working memory performance, the regular practice of yoga may have the potential to prevent decline of cognitive functions in clinical conditions.

Changes in Heart Rate Variability and Executive Functions Following Yoga Practice in Type 2 Diabetes Patients: A Pilot Study.

Context: Type 2 diabetes mellitus (T2DM) patients are at increased risk of cognitive impairment and dementia compared to healthy individuals. Lifestyle practices such as yoga can have a vital role in preventing and managing T2DM. Some studies have found that yoga can positively impact cognitive function in T2DM. Objective: The study aimed to investigate the benefits of short-term yoga practice on heart rate variability (HRV) and cognitive function for T2DM patients, without a matched control group, to address the paucity of data on the effectiveness of yoga practice on cognitive health on T2DM individuals. Design: Current study is a single group pre post design. Setting: The study took place in the Department of Yoga and Life Sciences at Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA) in Bangalore, India. Participants: Participants were 21 T2DM patients from various hospitals, clinics and community setups, in different parts of Bengaluru city in India. Intervention: The participants took part in one month of yoga practice. Outcome Measures: The research team used the Madrid card sorting test (MCST) to assess participants' executive function (EF) at baseline and postintervention. In addition, the team monitored participants' heart rate variability (HRV) in a resting phase and during task performance. Results: Between baseline and postintervention: (1) participants' reaction time for the MCST decreased for overall task performance (P = .01) and during rule shifting (P = .03); (2) a significant reduction occurred in participants' random errors (REs) and incorrect responses, at P = .02 for both, whereas a significant increase occurred in correct responses and efficient errors (EEs), at P = .03 and P = .01, respectively; (3) the low frequency (LF) and LF/high frequency (HF ) ratio for the HRV decreased; HF increased but the difference wasn't statistically significant; and (4) a statistically significant decrease occurred in LF and LF/HF and an increase in HF occurred during task performance. Conclusion: Yoga therapy had beneficial effects on cognitive performance for the T2DM participants. The yoga practice also positively affected autonomic functions during task performance and suggesting that it can reduce task-induced stress. It's important for the future studies to validate the current findings with a randomized controlled trial.

Effect of Heartfulness Meditation Among Long-Term, Short-Term and Non-meditators on Prefrontal Cortex Activity of Brain Using Machine Learning Classification: A Cross-Sectional Study.

Background Meditation is a mental practice with health benefits and may increase activity in the prefrontal cortex of the brain. Heartfulness meditation (HM) is a modified form of rajyoga meditation supported by a unique feature called "yogic transmission." This feasibility study aimed to explore the effect of HM on electroencephalogram (EEG) connectivity parameters of long-term meditators (LTM), short-term meditators (STM), and non-meditators (NM) with an application of machine learning models and determining classifier methods that can effectively discriminate between the groups. Materials and methods EEG data were collected from 34 participants. The functional connectivity parameters, correlation coefficient, clustering coefficient, shortest path, and phase locking value were utilized as a feature vector for classification. To evaluate the various states of HM practice, the categorization was done between (LTM, NM) and (STM, NM) using a multitude of machine learning classifiers. Results The classifier's performances were evaluated based on accuracy using 10-fold cross-validation. The results showed that the accuracy of machine learning models ranges from 84% to 100% while classifying LTM and NM, and accuracy from 80% to 93% while classifying STM and NM. It was found that decision trees, support vector machines, k-nearest neighbors, and ensemble classifiers performed better than linear discriminant analysis and logistic regression. Conclusion This is the first study to our knowledge employing machine learning for the classification among HM meditators and NM The results indicated that machine learning classifiers with EEG functional connectivity as a feature vector could be a viable marker for accessing meditation ability.

Heart-brain Rhythmic Synchronization during Meditation: A Nonlinear Signal Analysis.

Background: Heart-brain synchronization is the integration of mind, body, and spirit. It occurs when the electrical activity of the heart and brain is synchronized. In recent years, there has been mounting curiosity to investigate the effects of meditation on heart-brain synchronization with respect to mental and emotional health and well-being. The current investigation aims to explore the rhythmic synchronicity between the brain and the heart during heartfulness meditation (HM) practice. Materials and Methods: The study was performed on 45 healthy volunteers who were categorized into three equal groups: long-term meditators (LTMs), short-term meditators (STMs), and nonmeditators (NMs). The electroencephalogram (EEG) signals were recorded to measure the prefrontal activity, and electrocardiogram (ECG) signals were recorded to measure the cardiac activity. The data were recorded in four states: baseline, meditation, transmission, and posttransmission. The detrended fluctuation analysis (DFA) method was used for the analysis of EEG and ECG signals. Results: The result indicates that DFA values of EEG and ECG declined during meditation and transmission states as compared to pre- and postmeditation states. Significant results were obtained for the LTM group in all the states. A positive correlation was also observed between DFA of the heart and brain for the LTM group and no significant correlations were observed for the STM and NM groups. Conclusion: The shreds of evidence suggest that heart-brain synchronization facilitates mental and emotional stability. HM practice has the potential to regulate the fluctuation of the mind. Regular meditation practice may result in physiological synchrony between cardiac and neural behavior, which can be considered a quality index for meditation practice.

Heartfulness Meditation Alters Electroencephalogram Oscillations: An Electroencephalogram Study.

Background: Heartfulness meditation (HM) has been shown to have positive impacts on cognition and well-being, which makes it important to look into the neurophysiological mechanisms underlying the phenomenon. Aim: A cross-sectional study was conducted on HM meditators and nonmeditators to assess frontal electrical activities of the brain and self-reported anxiety and mindfulness. Settings and Design: The present study employed a cross-sectional design. Methods: Sixty-one participants were recruited, 28 heartfulness meditators (average age male: 31.54 ± 4.2 years and female: 30.04 ± 7.1 years) and 33 nonmeditators (average age male: 25 ± 8.5 years and female: 23.45 ± 6.5 years). An electroencephalogram (EEG) was employed to assess brain activity during baseline (5 min), meditation (10 min), transmission (10 min) and post (5 min). Self-reported mindfulness and anxiety were also collected in the present study. The EEG power spectral density (PSD) and coherence were processed using MATLAB. The statistical analysis was performed using an independent sample t-test for trait mindfulness and anxiety, repeated measures analysis of variance (ANOVA) for state mindfulness and anxiety, and Two-way multivariate ANOVA for EEG spectral frequency and coherence. Results: The results showed higher state and trait mindfulness, P < 0.05 and P < 0.01, respectively, and lower state and trait anxiety, P < 0.05 and P < 0.05, respectively. The PSD outcomes showed higher theta (P < 0.001) and alpha (P < 0.01); lower beta (P < 0.001) and delta (P < 0.05) power in HM meditators compared to nonmeditators. Similarly, higher coherence was found in the theta (P < 0.01), alpha (P < 0.05), and beta (P < 0.01) bands in HM meditators. Conclusions: These findings suggest that HM practice may result in wakeful relaxation and internalized attention that can influence cognition and behavior.

Yoga-Based Relaxation Technique Facilitates Sustained Attention in Patients with Low Back Pain: A Pilot Study.

CONTEXT: The experience of pain strongly influences sustained attention, which is important for neurocognitive performance. Yoga-based relaxation techniques may be effective in improving sustained attention by attenuating pain in patients with low back pain. Hence, we aimed to investigate the effect of a yoga-based relaxation technique on sustained attention and self-reported pain disability in patients with low back pain. METHODS: A total of 22 men aged 30 to 50 years with low back pain were recruited for the study. They were randomly assigned to either the yoga (n = 11) or control (n = 11) groups. The yoga group practiced a yoga-based relaxation technique (YBRT) 1 hour a day for 4 weeks and the control group maintained their usual physical activity regimen. Assessments included the Sustained Attention to Response Task (SART) and the Oswestry Low Back Pain Disability Questionnaire (OLBPDQ) measured before and after the 4-week intervention. RESULTS: The study showed a significant reduction in all self-reported OLBPDQ domains and improvement in sustained attention in a before and after comparison 4 weeks following the yoga intervention. Pearson's correlation also showed a positive correlation between sustained attention and pain reduction following the yoga intervention. CONCLUSION: The findings indicate that yoga practice reduces pain and simultaneously improves information processing speed with impulse control during the performance of a sustained attention task.