Yoga may be effective add-on therapy for psychosis in women with schizophrenia

By Rita Buckley

NEW YORK (Reuters Health) - Yoga may improve neurocognition in females with schizophrenia spectrum early psychosis, a study suggests.

Dr. H.M. Lee and colleagues at the University of Hong Kong carried out a randomized controlled trial in 124 women diagnosed with schizophrenia spectrum within five years of early onset psychosis. They ranged from 16 to 60 years of age (mean, 24.6 years).

The primary aim was to examine the different effects of yoga and aerobic exercise on neurocognition and brain functional fluctuation in early psychosis.

The women were randomized into three groups: integrated yoga therapy, aerobic exercise, and a wait-list control group. Both intervention programs were held three times weekly for 12 weeks, with each session lasting approximately an hour.

The final analysis, reported November 29 online in Schizophrenia Research, consisted of functional MRI data from 58 women (23 in the yoga group, 23 in the aerobic exercise group, and 12 controls).

Repeated measure analysis of variance (ANOVA) and post-hoc analyses showed decreased amplitude of low-frequency fluctuation (ALFF) in the precuneus (posteromedial portion of the parietal lobe) in the yoga groups compared to the control (p<0.001) and aerobic exercise groups (p<0.001).

ALFF in the visual cortex increased in the wait-list control group (p=0.0018).

In the yoga group, the ALFF changes in the precuneus were significantly correlated with changes in the Positive and Negative Syndrome Scale (PANSS) negative scores (r=0.5906, p=0.003), especially in the blunted affect subscores (r=0.551, p=0.012).

"Studies of the brain mechanisms underlying the psychological benefits of yoga are very important, and will improve the scientific credibility of this promising approach to treatment of psychiatric disorders," said Dr. Matcheri S. Keshavan, Vice-Chair of Psychiatry at Beth Israel Deaconess Medical Center in Boston, Massachusetts.

Dr. Keshavan, who was not involved in the study, said in an email to Reuters Health that yoga reduced neural responses in part of a brain circuit called the default mode network.

"This is of therapeutic relevance since the default network's activity is known from prior studies to be inappropriately increased in some psychiatric disorders, such as schizophrenia," he said.

Dr. David Henderson, Psychiatrist-in-Chief at Boston Medical Center in Massachusetts, said the findings, if replicated, could represent an important adjuvant treatment to medication for people with psychosis.

Dr. Henderson, who was also not involved in the study, noted that the sample for the neuroimaging was too small. "Although the study completion rate was reasonable, only data from 12 controls were used in the analysis. This greatly limits the findings," he said by email.

The effect of yoga, but not exercise, is interesting, said Dr. Sara Lazar, from the Department of Psychiatry at Massachusetts General Hospital in Boston. She and her MassGeneral colleague, Dr. Maren Nyer, who is Director of Yoga Studies, Depression Clinical and Research Program, told Reuters Health in a joint email that the mindfulness/mind-body component of yoga may provide a novel method for reducing negative symptoms that is distinct from the mechanisms associated with exercise alone.

Drs. Lazar and Nyer, who weren't involved in the new research, said the findings of this small preliminary study need to be replicated, evaluated for safety, and/or studied in a larger, more representative sample.

The corresponding author declined a request for comments.

SOURCE: http://bit.ly/2gDJFT2

Schizophr Res 2016

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