Meditation: a modulator of the immune response to physical stress? A brief report

Effects of Mindfulness Practice on Performance and Factors Related to Performance in Long-Distance Running: A Systematic Review

Fatigue, boredom, pain, performance anxiety, and negative thoughts are challenges characteristic of competitive running. One psychological technique that is gaining support and has been successfully implemented in sport is the practice of mindfulness. Where conventional psychological skills training interventions aim to change dysfunctional thoughts and emotions, mindfulness focuses on altering the relationship to physiological and psychological states. This could help in dealing with the demands of distance running but this has yet to be examined. This article was focused on reviewing mindfulness interventions on performance and performance-based factors in long distance running, assessing (a) mindfulness scores, (b) physiological performance-related factors, (c) psychological performance-related factors, and (d) performance outcomes. A search of relevant electronic databases yielded seven studies which met the inclusion criteria. The review provided some tentative support for the use of mindfulness interventions regarding: reducing competitive anxiety, attenuating immune responses to high-intensity running, and increasing state mindfulness. However, due to the methodological weaknesses of studies more research is required using high-quality randomized controlled trial designs.

The effect of willow fodder feeding on immune cell populations in the blood and milk of late-lactating dairy goats

In a previous study, we showed that access to willow fodder decreased somatic cell counts (SCC) in the milk of local Mamber goats grazing in brushland at the end of lactation. To test whether the consumption of willow affects the cells of the immune system, Alpine crossbred dairy goats grazing in the same environment were either offered free access to freshly cut willow fodder (W, n = 24) or not (C, n = 24) for 2 weeks. The willow fodder contained 7.5 g/kg DM of salicin. The other major secondary compounds were catechin, myricitrin, hyperin and chlorogenic acid (2.2, 2.6, 1.0 and 0.75 g/kg DM, respectively). Udder health status was determined before the experiment, and each of the two groups included five (W) or six (C) goats defined as infected, as established by microbial cfu in milk, and 19 (W) or 18 (C) non-infected goats. Goats ingested, on average, 600 g of DM from willow (25% of food intake), resulting in minor changes in dietary quality compared to the controls, as established by faecal near-IR spectrometry. Throughout the 2 weeks of experiment, differences between groups in dietary CP contents were minor and affected neither by infection nor by access to willow; the dietary percentage of neutral detergent fibre (NDF) decreased in C and increased in W; dietary acid detergent fibre (ADF) increased; and the dietary tannin contents decreased for both treatments. However, milking performance and milk quality attributes in both W and C goats were similar. Initial SCC and milk neutrophil (cluster of differentiation (CD)18⁺ and porcine granulocyte (PG)68) cell counts were higher in infected than in non-infected goats; counts decreased significantly in W but not in C uninfected goats. The percentage of CD8⁺ T-cells increased in all C goats, while in the W group, a significant increase was found only for infected goats. The consumption of willow mitigated an increase in CD8⁺ in blood and triggered an increase in CD8⁺ in milk, suggesting an immune-regulatory effect independent of udder status. To our knowledge, this is the first report of a direct nutraceutical effect of fodder ingestion on the immune status of goats.

Acceptance and Commitment Training to Promote Psychological Flexibility in Ice Hockey Performance: A Controlled Group Feasibility Study

Despite the growing popularity of mindfulness and acceptance-based performance enhancement methods in applied sport psychology, evidence for their efficacy is scarce. The purpose of the current study is to test the feasibility and effect of a psychological training program based on Acceptance and Commitment Training (ACT) developed for ice hockey players. A controlled group feasibility designed study was conducted and included 21 elite male ice hockey players. The ACT program consisted of four, once a week, sessions with homework assignments between sessions. The results showed significant increase in psychological flexibility for the players in the training group. The outcome was positive for all feasibility measures. Participants found the psychological training program important to them as ice hockey players and helpful in their ice hockey development. Desirably, future studies should include objective performance data as outcome measure to foster more valid evidence for performance enhancement methods in applied sport psychology.

Effectiveness of Stress-Reducing Interventions on the Response to Challenges to the Immune System: A Meta-Analytic Review

BACKGROUND

There is consistent evidence showing an interplay between psychological processes and immune function in health and disease processes.

OBJECTIVES

The present systematic review and meta-analysis aims to provide a concise overview of the effectiveness of stress-reducing psychological interventions on the activation of immune responses in both healthy subjects and patients.

METHODS

Included are 3 types of challenges: in vivo, in vitro, and psychophysiological. Such challenges are designed to mimic naturally occurring immune-related threats.

RESULTS

A systematic literature search was conducted using PubMed, EMBASE, and PsychInfo, resulting in 75 eligible studies. The risk of bias was assessed with the Cochrane risk-of-bias tool. Across all studies, a small-to-medium effect size was found for the effects of psychological interventions on optimization of the immune function (g = 0.33; 95% CI 0.22-0.43). While the largest effects were found for in vivo immune-related challenges (g = 0.61; 95% CI 0.34-0.88; especially on studies that incorporated skin tests and wound healing), studies incorporating psychophysiological challenges and in vitro immune-related stimulations similarly suggest more optimal immune responses among those receiving stress-reducing interventions (g = 0.28; 95% CI 0.15-0.42).

CONCLUSION

These findings showed substantial heterogeneity depending on the type of challenge, the study populations, and the intervention types. These data demonstrate support for the effectiveness of stress-reducing psychological interventions in improving immunity in studies that tested immune function by means of incorporating an in vivo,in vitro, or psychophysiological challenge. Future research should more consistently incorporate challenges into the study design to gather more insights in the mechanisms underlying the optimized immune function following a psychological intervention. This is also relevant for clinical practice, as psychological interventions can possibly supplement, or at least partially replace, current drug treatments in various somatic conditions to reduce side effects.

Effects of Mindfulness Practice on Performance-Relevant Parameters and Performance Outcomes in Sports: A Meta-Analytical Review

BACKGROUND

Mindfulness as a present-oriented form of mental training affects cognitive processes and is increasingly considered meaningful for sport psychological training approaches. However, few intervention studies have examined the effects of mindfulness practice on physiological and psychological performance surrogates or on performance outcomes in sports.

OBJECTIVE

The aim of the present meta-analytical review was to examine the effects of mindfulness practice or mindfulness-based interventions on physiological and psychological performance surrogates and on performance outcomes in sports in athletes over 15 years of age.

DATA SOURCES

A structured literature search was conducted in six electronic databases (CINAHL, EMBASE, ISI Web of Knowledge, PsycINFO, MEDLINE and SPORTDiscus). The following search terms were used with Boolean conjunction: (mindful* OR meditat* OR yoga) AND (sport* OR train* OR exercis* OR intervent* OR perform* OR capacity OR skill*) AND (health* OR adult* OR athlete*).

STUDY SELECTION

Randomized and non-randomized controlled studies that compared mindfulness practice techniques as an intervention with an inactive control or a control that followed another psychological training program in healthy sportive participants were screened for eligibility.

DATA EXTRACTION

Eligibility and study quality [Physiotherapy Evidence Database (PEDro)] scales were independently assessed by two researchers. A third independent researcher was consulted to achieve final consensus in case of disagreement between both researchers. Standardized mean differences (SMDs) were calculated as weighted Hedges' g and served as the main outcomes in comparing mindfulness practice versus control. Statistical analyses were conducted using a random-effects inverse-variance model.

RESULTS

Nine trials of fair study quality (mean PEDro score 5.4, standard deviation 1.1) with 290 healthy sportive participants (athletics, cyclists, dart throwers, hammer throwers, hockey players, hurdlers, judo fighters, rugby players, middle-distance runners, long-distance runners, shooters, sprinters, volleyball players) were included. Intervention time varied from 4 weeks to over 2 years. The practice frequency lasted from twice daily to just once a week, and the mean session time covered 50-60 min. In favor of mindfulness practice compared with the control condition, large effects with narrow confidence limits and low heterogeneity were found for mindfulness scores [SMD 1.03, 90% confidence interval (CI) 0.67-1.40, p < 0.001, I ² = 17%]. Physiological performance indices depicted wide confidence limits accompanied with very large heterogeneity. However, the effect sizes remained very large, with confidence limits that did not overlap zero (SMD 3.62, 90% CI 0.03-7.21, p = 0.10, I ² = 98%). Moderate to large effects were observed for both psychological performance surrogates (SMD 0.72, 90% CI 0.46-0.98, p < 0.001, I ² = 14%) and performance outcomes in shooting and dart throwing (SMD 1.35, 90% CI 0.61-2.09, p = 0.003, I ² = 82%).

CONCLUSIONS

Mindfulness practice consistently and beneficially modulates mindfulness scores. Furthermore, physiological and psychological surrogates improved to a meaningful extent following mindfulness practice, as well as performance outcomes in shooting and dart throwing. It seems reasonable to consider mindfulness practice strategies as a regular complementary mental skills training approach for athletes, at least in precision sports; however, more high-quality, randomized, controlled trials on mindfulness practice and performance improvements in diverse sport settings are needed.

Effects of an Integrated Yoga Program in Modulating Psychological Stress and Radiation-Induced Genotoxic Stress in Breast Cancer Patients Undergoing Radiotherapy

Effects of an integrated yoga program in modulating perceived stress levels, anxiety, as well as depression levels and radiation-induced DNA damage were studied in 68 breast cancer patients undergoing radiotherapy. Two psychological questionnaires—Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS)—and DNA damage assay were used in the study. There was a significant decrease in the HADS scores in the yoga intervention group, whereas the control group displayed an increase in these scores. Mean PSS was decreased in the yoga group, whereas the control group did not show any change pre- and postradiotherapy. Radiation-induced DNA damage was significantly elevated in both the yoga and control groups after radiotherapy, but the postradiotherapy DNA damage in the yoga group was slightly less when compared to the control group. An integrated approach of yoga intervention modulates the stress and DNA damage levels in breast cancer patients during radiotherapy.

Effect of integrated Yoga module on positive and negative emotions in Home Guards in Bengaluru: A wait list randomized control trial

BACKGROUND

The beneficial aspect of positive emotions on the process of learning and the harmful affect of negative emotions on coping with stress and health are well-documented through studies. The Home Guards (HGs) are working in a very stressful situation during election, managing traffic and other crowded places. It is quite essential in present day circumstances that they have to manage their emotions and cope up with different stressful situations.

OBJECTIVE

To study the efficacy of integrated Yoga module (IYM) on emotions (positive and negative affect [PA and NA]) of HGs.

METHODS

A total of 148 HGs both males and females who qualified the inclusion and exclusion criteria were randomly divided into Yoga group (YG) and control groups (CG). The YG had supervised practice sessions (by trained experts) for 1 h daily, 6 days a week for 8 weeks along with their regular routine work whereas CG performing their routine work. Positive affect negative affect scale (PANAS) was assessed before and after 8 weeks using a modified version of PANAS.

RESULTS

PA in YG had significantly increased (P < 0.05) whereas it had decreased significantly (P < 0.05) in CG. Other positive effect in YG had significantly increased (P < 0.001), whereas it had decreased significantly (P < 0.001) in CG. NA in YG had significantly decreased (P < 0.001), whereas it had significantly increased (P < 0.001) in CG. Other NA in YG had significantly decreased (P < 0.001), whereas it had significantly increased (P < 0.01) in CG.

CONCLUSIONS

The results suggested that IYM can be useful for HGs to improve the PA and to decrease NA score. Moreover, IYM is cost-effective and helps HGs for coping up with emotions in stressful situations.

A pilot feasibility and acceptability study of yoga/meditation on the quality of life and markers of stress in persons living with HIV who also use crack cocaine

BACKGROUND

Persons living with HIV (PLWH) who also use crack cocaine may have stressful, chaotic lives and typically do not engage in standard medical care that addresses a multitude of extenuating life circumstances. Yoga/meditation (YM) improves quality of life (QOL) and biomarkers of stress, but the effect of this intervention is almost unknown in PLWH, particularly those who use crack cocaine.

OBJECTIVES

This pilot study sought to compare the feasibility and acceptability of 60-minute, twice-per-week sessions of YM for 2 months with those of no-contact control and to evaluate the effects of the intervention on QOL (according to the Short Form-36, Perceived Stress Scale [PSS], and Impact of Events Scale [IES]) and salivary cortisol and dehydroepiandrosterone sulfate (DHEA-S) among PLWH who use crack cocaine.

DESIGN

Participants were randomly assigned to YM or no-contact control and were assessed at baseline, 2 months after the intervention, and 4 months' follow-up.

RESULTS

The YM program was acceptable and feasible, with high overall attendance (89%) and individual participation in yoga sessions (83%). YM participants showed modest improvements on QOL. The PSS total score and the IES intrusion score improved significantly 2 months after the intervention, but cortisol and DHEA-S did not change.

CONCLUSIONS

This pilot study showed a high level of feasibility and acceptability and modest effects on measures of QOL among PLWH who use crack cocaine. The results suggest utility of YM as a simple, safe, and inexpensive format to improve QOL in a population that has many medical difficulties and extenuating stressors.

The effects of mind-body therapies on the immune system: meta-analysis

Importance

Psychological and health-restorative benefits of mind-body therapies have been investigated, but their impact on the immune system remain less defined.

Objective

To conduct the first comprehensive review of available controlled trial evidence to evaluate the effects of mind-body therapies on the immune system, focusing on markers of inflammation and anti-viral related immune responses.

Methods

Data sources included MEDLINE, CINAHL, SPORTDiscus, and PsycINFO through September 1, 2013. Randomized controlled trials published in English evaluating at least four weeks of Tai Chi, Qi Gong, meditation, or Yoga that reported immune outcome measures were selected. Studies were synthesized separately by inflammatory (n = 18), anti-viral related immunity (n = 7), and enumerative (n = 14) outcomes measures. We performed random-effects meta-analyses using standardized mean difference when appropriate.

Results

Thirty-four studies published in 39 articles (total 2, 219 participants) met inclusion criteria. For inflammatory measures, after 7 to 16 weeks of mind-body intervention, there was a moderate effect on reduction of C-reactive protein (effect size [ES], 0.58; 95% confidence interval [CI], 0.04 to 1.12), a small but not statistically significant reduction of interleukin-6 (ES, 0.35; 95% CI, −0.04 to 0.75), and negligible effect on tumor necrosis factor-α (ES, 0.21; 95% CI, −0.15 to 0.58). For anti-viral related immune and enumerative measures, there were negligible effects on CD4 counts (ES, 0.15; 95% CI, −0.04 to 0.34) and natural killer cell counts (ES, 0.12, 95% CI −0.21 to 0.45). Some evidence indicated mind-body therapies increase immune responses to vaccination.

Conclusions

Mind-body therapies reduce markers of inflammation and influence virus-specific immune responses to vaccination despite minimal evidence suggesting effects on resting anti-viral or enumerative measures. These immunomodulatory effects, albeit incomplete, warrant further methodologically rigorous studies to determine the clinical implications of these findings for inflammatory and infectious disease outcomes.

Influence of yoga on mood states, distress, quality of life and immune outcomes in early stage breast cancer patients undergoing surgery

Context:

Breast cancer patients awaiting surgery experience heightened distress that could affect postoperative outcomes.

Aims:

The aim of our study was to evaluate the effects of yoga intervention on mood states, treatment-related symptoms, quality of life and immune outcomes in breast cancer patients undergoing surgery.

Settings and Design:

Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited for a randomized controlled trial comparing the effects of a yoga program with supportive therapy plus exercise rehabilitation on postoperative outcomes following surgery.

Materials and Methods:

Subjects were assessed prior to surgery and four weeks thereafter. Psychometric instruments were used to assess self-reported anxiety, depression, treatment-related distress and quality of life. Blood samples were collected for enumeration of T lymphocyte subsets (CD4 %, CD8 % and natural killer (NK) cell % counts) and serum immunoglobulins (IgG, IgA and IgM).

Statistical Analysis Used:

We used analysis of covariance to compare interventions postoperatively.

Results:

Sixty-nine patients contributed data to the current analysis (yoga n = 33, control n = 36). The results suggest a significant decrease in the state (P = 0.04) and trait (P = 0.004) of anxiety, depression (P = 0.01), symptom severity (P = 0.01), distress (P < 0.01) and improvement in quality of life (P = 0.01) in the yoga group as compared to the controls. There was also a significantly lesser decrease in CD 56% (P = 0.02) and lower levels of serum IgA (P = 0.001) in the yoga group as compared to controls following surgery.

Conclusions:

The results suggest possible benefits for yoga in reducing postoperative distress and preventing immune suppression following surgery.

Influence of yoga on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery

CONTEXT

Pre- and postoperative distress in breast cancer patients can cause complications and delay recovery from surgery.

OBJECTIVE

The aim of our study was to evaluate the effects of yoga intervention on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery.

METHODS

Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited in a randomized controlled trial comparing the effects of a yoga program with supportive therapy and exercise rehabilitation on postoperative outcomes and wound healing following surgery. Subjects were assessed at the baseline prior to surgery and four weeks later. Sociodemographic, clinical and investigative notes were ascertained in the beginning of the study. Blood samples were collected for estimation of plasma cytokines-soluble Interleukin (IL)-2 receptor (IL-2R), tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma. Postoperative outcomes such as the duration of hospital stay and drain retention, time of suture removal and postoperative complications were ascertained. We used independent samples t test and nonparametric Mann Whitney U tests to compare groups for postoperative outcomes and plasma cytokines. Regression analysis was done to determine predictors for postoperative outcomes.

RESULTS

Sixty-nine patients contributed data to the current analysis (yoga: n = 33, control: n = 36). The results suggest a significant decrease in the duration of hospital stay (P = 0.003), days of drain retention (P = 0.001) and days for suture removal (P = 0.03) in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF alpha levels following surgery in the yoga group (P < 0.001), as compared to the controls. Regression analysis on postoperative outcomes showed that the yoga intervention affected the duration of drain retention and hospital stay as well as TNF alpha levels.

CONCLUSION

The results suggest possible benefits of yoga in reducing postoperative complications in breast cancer patients.

Effect of integrated yogic practices on positive and negative emotions in healthy adults

BACKGROUND

Studies on affective wellbeing have shown the beneficial role of positive emotions on cognitive processing and the harmful role of negative emotions on coping, stress and health status. Studies have shown that yoga practices reduce anxiety and depression and improve wellbeing.

OBJECTIVE

The aims of the study were to, (i) examine the safety and feasibility of conducting a weeklong free yoga camp, and (ii) assess its impact on the negative and positive affect in normal healthy volunteers.

MATERIALS AND METHODS

In this open-arm study450 participants were taught integrated yoga module. It included asanas, pranayama, relaxation, notional correction and devotional sessions. Assessment was carried out on the first and last day of the camp, using a modified version of Positive Affect Negative Affect Scale (PANAS). It has ten questions each to measure positive (PA) and negative affect (NA). Nine questions have been added which are referred as other positive affect (OPA) and other negative affect (ONA) domains.

RESULTS

Three hundred and twelve sets of pre-post data were analyzed. There was an increase in PA of PANAS by 13% (P<0.001, Wilcoxon's signed rank test) and OPA by 17% (P<0.001). The NA reduced by 47% (P<0.001) and ONA by 48% (P<0.001).

CONCLUSION

It is feasible and safe to conduct a weeklong yoga camp in an urban setting, and integrated yoga practices can reduce the negative affect and increase the positive affect within one week.

Meditation-specific prefrontal cortical activation during acem meditation: an fMRI study

Some of the most popular meditation practices emphasize a relaxed focus of attention in which thoughts, images, sensations, and emotions may emerge and pass freely without actively controlling or pursuing them. Several recent studies show that meditation activates frontal brain areas associated with attention focusing and physical relaxation. The objective of the present study was to assess whether brain activation during relaxed focusing on a meditation sound could be distinguished from similar, concentrative control tasks. Brain activation was measured with functional magnetic resonance imaging (fMRI) in experienced practitioners of Acem meditation. Bilateral areas of the inferior frontal gyrus (BA47) were significantly more activated during repetition of a meditation sound than during concentrative meditation-like cognitive tasks. Meditation-specific brain activation did not habituate over time, but increased in strength with continuous meditation bouts. These observations suggest that meditation with a relaxed focus of attention may activate distinct areas of the prefrontal cortex, with implications for the understanding of neurobiological correlates of meditation.

The effect of meditation on physical and mental health in junior college students: a quasi-experimental study

BACKGROUND

Physical stress and mental stress are increasingly common phenomena in our rapidly changing and stressful modern society. Research has found meditation to produce positive and demonstrable stress reduction effects on brain and immune functions. This study is grounded in traditional Chinese philosophical mores that teach a process summarized by the keynote activities of "calm, still, quiet, consider, and get" and the potential of this process to reduce stress in adolescents.

PURPOSE

The purpose of this study was to examine the effects of meditation on the physical and mental health of junior college students.

METHODS

This research employed a quasi-experimental design. Participants included 242 freshmen from a junior college in Taiwan selected using a convenience sampling technique. Participants were then randomly separated into experimental (n = 119) and control (n = 123) groups. The project duration was 18 weeks, during which the experimental group received 2 hours of meditation treatment per week, for a total of 36 hours. Both groups completed pretest and posttest Life Adaptation Scale forms, which included questionnaires addressing information on physical and mental distress and positive and negative coping strategies. Data were analyzed using analysis of covariance.

RESULTS

Findings showed that the effect of the experiment treatment was significant when student physical and mental distress pretest scores were controlled. Physical and mental symptoms in the experimental group were lower than those in the control group.

CONCLUSIONS

Meditation can help students to adapt to life stressors. This study also provides support for traditional Chinese wisdom, which promotes meditation as one way to improve health.

Mind-Body Medicine and Immune System Outcomes: A Systematic Review

This study is a systematic review of mind-body interventions that used immune outcomes in order to: 1) characterize mind-body medicine studies that assessed immune outcomes, 2) evaluate the quality of mind-body medicine studies measuring immune system effects, and 3) systematically evaluate the evidence for mind-body interventions effect on immune system outcomes using existing formal tools. 111 studies with 4,777 subjects were reviewed. The three largest intervention type categories were Relaxation Training (n=25), Cognitive Based Stress Management (n=22), and Hypnosis (n=21). Half the studies were conducted with healthy subjects (n=51). HIV (n=18), cancer (n=13) and allergies (n=7) were the most prominent conditions examined in the studies comprising of non-healthy subjects. Natural killer cell and CD4 T lymphocyte measures were the most commonly studied outcomes. Most outcome and modality categories had limited or inconclusive evidence. Relaxation training had the strongest scientific evidence of a mind-body medicine affecting immune outcomes. Immunoglobulin A had the strongest scientific evidence for positive effects from mind-body medicine. Issues for mind-body medicine studies with immune outcomes are discussed and recommendations are made to help improve future clinical trials.

[Does meditation improve the quality of life for patients living with cancer?]

OBJECTIVE

To determine whether interventions that promote meditation improve quality of life in cancer patients.

DATA SOURCES

MEDLINE data bank (1966 to 2004) using the terms "spiritual well-being" and the MeSH terms "meditation", "neoplasm", "cancer", and "spiritual therapies".

STUDY SELECTION

Clinical trials evaluating the effect of meditation on cancer patients. SYNTHESIS Five studies were retained; none were designed in a way that made it possible to evaluate the effect of meditation exclusively or its effect on quality of life compared with a neutral intervention. Only 1 evaluated spiritual well-being. Four reported a significant improvement in symptoms of depression and anxiety when the study group's preintervention and post-intervention scores were compared. In the 2 studies that included a control intervention, participants preferred the meditation intervention.

CONCLUSION

The design of studies to evaluate the effect of meditation on cancer patients did not make it possible to clearly identify the effect of meditation alone. These studies did show, however, that mood and anxiety parameters tend to improve--something that has been documented in other populations--and that spiritual well-being tends to improve as well. The main biases preventing a generalization of the effects of meditation are simultaneous evaluation of several interventions, "diluting" the effect of meditation; the lack of control groups receiving a comparable intervention; and the selection of study populations favourable to the intervention. There is increasing recognition of the effect of improved spiritual well-being on quality of life, even though most tools for measuring quality of life do not have a section for measuring spiritual well-being. Failing to take this aspect into account could be causing us to miss certain effects of meditation. In order to determine whether meditation should be offered to terminally ill patients, we need studies that do not contain these biases--studies designed to measure spiritual well-being.

The Effects of Meditation and Visual Imagery on an Immune System Disorder: Dermatomyositis

OBJECTIVE

To analyze the relationship between a patient's "spontaneous recovery" from dermatomyositis and her practice of transcendental meditation and visual imagery without confounding effects of conventional therapies.

DESIGN

Study of time-varying relationships between (1) measures of arm strength and skin condition (rash and pain) and (2) mind-body interventions-controlling for psychologic stress-in a patient with dermatomyositis, using regression analysis to determine half-lives of treatments and stress.

SETTING

Institutional referral center.

INTERVENTION

Transcendental meditation and visual imagery (no drugs).

OUTCOME MEASURES

Daily measurements of arm strength and skin condition over 294 days. Events producing psychologic stress were also rated using a numerical scale.

RESULTS

The patient recovered, which is a low-probability event without conventional therapy. Regression analysis of time dependence between measures of arm strength, rash, and pain and application of mind-body treatments revealed statistically significant relationships for both meditation (p values 0.02 to 0.001) and visual imagery (p values 0.02 to 0.002). Stress had a significant negative impact on skin symptoms but not arm strength. Beneficial effects of meditation had half-lives of 48-59 days for skin condition and no detectable decay for arm strength. Benefits of visual imagery were more transient (half-lives 4-18 days). The effects of stress had half-lives of only 1-3 days.

CONCLUSIONS

The results demonstrate a statistically significant relationship between mind-body therapies and the patient's recovery from dermatomyositis, possibly mediated by influences on the humoral immune system. A key factor in the recovery was the slower decay rate of meditation and visual imagery compared to stress. As dermatomyositis is a humorally mediated immune microvasculopathy, the benefits of meditation and imagery in our patient comport with a growing body of evidence showing that these techniques influence immune system function.

Alterations in brain and immune function produced by mindfulness meditation

OBJECTIVE

The underlying changes in biological processes that are associated with reported changes in mental and physical health in response to meditation have not been systematically explored. We performed a randomized, controlled study on the effects on brain and immune function of a well-known and widely used 8-week clinical training program in mindfulness meditation applied in a work environment with healthy employees.

METHODS

We measured brain electrical activity before and immediately after, and then 4 months after an 8-week training program in mindfulness meditation. Twenty-five subjects were tested in the meditation group. A wait-list control group (N = 16) was tested at the same points in time as the meditators. At the end of the 8-week period, subjects in both groups were vaccinated with influenza vaccine.

RESULTS

We report for the first time significant increases in left-sided anterior activation, a pattern previously associated with positive affect, in the meditators compared with the nonmeditators. We also found significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait-list control group. Finally, the magnitude of increase in left-sided activation predicted the magnitude of antibody titer rise to the vaccine.

CONCLUSIONS

These findings demonstrate that a short program in mindfulness meditation produces demonstrable effects on brain and immune function. These findings suggest that meditation may change brain and immune function in positive ways and underscore the need for additional research.

Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients

OBJECTIVES

This study investigated the relationships between a mindfulness-based stress reduction meditation program for early stage breast and prostate cancer patients and quality of life, mood states, stress symptoms, lymphocyte counts, and cytokine production.

METHODS

Forty-nine patients with breast cancer and 10 with prostate cancer participated in an 8-week MBSR program that incorporated relaxation, meditation, gentle yoga, and daily home practice. Demographic and health behavior variables, quality of life (EORTC QLQ C-30), mood (POMS), stress (SOSI), and counts of NK, NKT, B, T total, T helper, and T cytotoxic cells, as well as NK and T cell production of TNF, IFN-gamma, IL-4, and IL-10 were assessed pre- and postintervention.

RESULTS

Fifty-nine and 42 patients were assessed pre- and postintervention, respectively. Significant improvements were seen in overall quality of life, symptoms of stress, and sleep quality. Although there were no significant changes in the overall number of lymphocytes or cell subsets, T cell production of IL-4 increased and IFN-gamma decreased, whereas NK cell production of IL-10 decreased. These results are consistent with a shift in immune profile from one associated with depressive symptoms to a more normal profile.

CONCLUSIONS

MBSR participation was associated with enhanced quality of life and decreased stress symptoms in breast and prostate cancer patients. This study is also the first to show changes in cancer-related cytokine production associated with program participation.

A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients

OBJECTIVE

The objective of this study was to assess the effects of participation in a mindfulness meditation-based stress reduction program on mood disturbance and symptoms of stress in cancer outpatients.

METHODS

A randomized, wait-list controlled design was used. A convenience sample of eligible cancer patients enrolled after giving informed consent and were randomly assigned to either an immediate treatment condition or a wait-list control condition. Patients completed the Profile of Mood States and the Symptoms of Stress Inventory both before and after the intervention. The intervention consisted of a weekly meditation group lasting 1.5 hours for 7 weeks plus home meditation practice.

RESULTS

Ninety patients (mean age, 51 years) completed the study. The group was heterogeneous in type and stage of cancer. Patients' mean preintervention scores on dependent measures were equivalent between groups. After the intervention, patients in the treatment group had significantly lower scores on Total Mood Disturbance and subscales of Depression, Anxiety, Anger, and Confusion and more Vigor than control subjects. The treatment group also had fewer overall Symptoms of Stress; fewer Cardiopulmonary and Gastrointestinal symptoms; less Emotional Irritability, Depression, and Cognitive Disorganization; and fewer Habitual Patterns of stress. Overall reduction in Total Mood Disturbance was 65%, with a 31% reduction in Symptoms of Stress.

CONCLUSIONS

This program was effective in decreasing mood disturbance and stress symptoms in both male and female patients with a wide variety of cancer diagnoses, stages of illness, and ages. cancer, stress, mood, intervention, mindfulness.

Stress reactivity to and recovery from a standardised exercise bout: a study of 31 runners practising relaxation techniques

OBJECTIVE

To compare the efficacy in runners of two relaxation techniques with regard to exercise reactivity and recovery after exercise.

METHODS

Thirty one adult male runners were studied prospectively for six months in three groups practising either meditation (n = 11) or autogenic training (n = 11) or serving as controls (n = 10). Before and after the six months relaxation intervention, indicators of reactivity to exercise and metabolism after exercise (blood lactate concentration, heart rate (HR), and oxygen consumption (VO2)), were tested immediately after and 10 minutes after exercise. Resting HR was also assessed weekly at home during the trial. State anxiety was measured before and after the intervention.

RESULTS

After the relaxation training, blood lactate concentration after exercise was significantly (p<0.01) decreased in the meditation group compared with the control group. No difference was observed in lactate responses between the autogenic training group and the control group. There were no significant differences among the groups with regard to HR, VO2, or levels of anxiety.

CONCLUSION

Meditation training may reduce the lactate response to a standardised exercise bout.

Acute increases in night-time plasma melatonin levels following a period of meditation

To determine whether a period of meditation could influence melatonin levels, two groups of meditators were tested in a repeated measures design for changes in plasma melatonin levels at midnight. Experienced meditators practising either TM-Sidhi or another internationally well known form of yoga showed significantly higher plasma melatonin levels in the period immediately following meditation compared with the same period at the same time on a control night. It is concluded that meditation, at least in the two forms studied here, can affect plasma melatonin levels. It remains to be determined whether this is achieved through decreased hepatic metabolism of the hormone or via a direct effect on pineal physiology. Either way, facilitation of higher physiological melatonin levels at appropriate times of day might be one avenue through which the claimed health promoting effects of meditation occur.

Mind-body therapy in the management and prevention of coronary disease

Conventional mind-body therapy has been proven a valuable noninvasive way to manage coronary disease. Yoga practice, especially, has been found to be valuable in preventing adverse outcomes of coronary disease by improving resistance to stress.

The effect of meditation on shooting performance

OBJECTIVE

To study effects of meditation on the shooting performance.

METHODS

25 elite shooters were investigated in an independent groups design. The results in standardised test shootings indoors and in ordinary competitions outdoors were assessed before and after regular meditation training for the experimental group. The experience of tension during the test shootings was self recorded on a visual analogue scale (VAS).

RESULTS

The competition results in the outdoor season (1993), just after the meditation training period, compared with the results the previous season (1992), were better in the meditation group (P < 0.05). No significant difference between the groups was observed in the test shootings before and after the relaxation intervention. A significant association was shown between low tension and the results in the test shootings (correlation r = 0.42, P < 0.0001; Wilcoxon rank sum test, z = -3.36, P < 0.001); 18% (= r2) of the variance in performance was explained by tension.

CONCLUSIONS

Meditation may enhance competitive shooting performance.