Study finds meditation and aerobic exercise relieves stress in medical school students

by Robin Lally, Rutgers Universi

Rutgers Robert Wood Johnson Medical School student Paul Lavadera expected his career would put him on the front lines of dealing with medical emergencies.

31 may 2020--But he never could have imagined he'd be graduating during the biggest global pandemic in a century when he joined forces two years ago with Tracey Shors, Distinguished Professor of Neuroscience and Psychology, on a study to find out whether aerobic exercise and meditation would reduce stress and improve the quality of life for medical students like him.

Now Lavadera, who begins a four-year emergency medicine residency on June 29 at a COVID-19 only hospital in Brooklyn and Shors, who thinks she may have battled a case of the coronavirus, are using the stress-reducing technique taught to RWJMS medical school students to help them each deal with the anxiety and uncertainty left in the path of the crisis.

"I am isolating alone in my apartment and keeping myself up to date on the evolving guidelines on treatments and recommendations regarding COVID19, but I'm making a conscious decision to avoid sensational and minute-by-minute news," says Lavadera who will split his time between two Brooklyn hospitals—Kings County Hospital in Flatbush and SUNY Downstate Medical Center, one of only three New York hospitals treating COVID-19 only patients. "I am working out, mediating and doing the training program that I helped to promote to medical school students. I think it keeps me afloat and helps to keep my stress level down."

The new Rutgers study in the Journal of Alternative and Complementary Medicine, Lavadera coauthored with Shors and doctoral student Emma Millon, documents the effectiveness of the technique that helped them both through this difficult time. The researchers found that meditation combined with aerobic exercise reduces stress and rumination while enhancing the quality of life for medical students.

Over an eight-week period first and second-year medical school students participated in the intervention called MAP Train My Brain, twice a week, which included 30 minutes of meditation followed by 30 minutes of aerobic exercise compared to a control group of student who did neither.

Shors—who developed the MAP (mental and physical) Training for those with depression, trauma and stress-related symptoms—has studied the effects of this training on different groups, including women who have been sexually assaulted and most recently women living with HIV, a study which has not yet been published.

When Shors began the study on medical school students with Lavadera she thought she understood how stressful treating patients could be for physicians. But she gained deeper insight during her recent illness.

For about six weeks from late February to early April, Shors suffered with coronavirus symptoms at home: trouble breathing, a persistent cough, and debilitating fatigue. She went to packed emergency departments twice, got a chest X-ray that showed no pneumonia and was sent home to isolate without getting a COVID-19 test because she didn't have a fever.

Shors remembers the doctors and nurses. "Behind their masks, I could see in their eyes the stress and anxiety that they are feeling, but I also experienced the professionalism and compassion that they bring to each person coming in for help," said Shors, vice chair/director of Graduate Studies in the department of psychology Center for Collaborative Neuroscience in the School of Arts and Sciences at Rutgers University-New Brunswick.

The study, which researchers believe is the first to document positive outcomes with such an intervention on medical students, found that the students doing the MAP Training experienced significantly less stress and were approximately 20 percent less likely to ruminate with depressive and brooding thoughts, when compared to medical students in the control group who did not participate in the program.

Most importantly, researchers say, is that those involved in the study said the training improved their quality of life, with 84 percent of the medical school students saying that they would recommend MAP Train My BrainTM to future patients as a way to alleviate anxiety and stress and improve overall health.

Shors and Lavadera say while the aim of the study was to provide a program for medical school students that would keep them physically and mentally healthy, they also hoped that it would be a program that they would want to recommend to future patients.

As the uncertainty of what lies ahead with the global COVID-19 pandemic continues, both Shors, who at the height of what she believes was her bout with coronavirus, worried that she would have to be hooked to a ventilator, and Lavadera, who has been trying to stay away from the daily drumbeat of coronavirus news before he has to deal with it firsthand, says this meditation and aerobic exercise program allows them to do it at home, alone.

"It is always important to reduce stress but especially important and difficult to do during this traumatic time," says Shors. "We are living with the threat of illness and even death for ourselves and our loved ones. There is nothing more stressful than that."

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More information: Paul Lavadera et al, MAP Train My Brain: Meditation Combined with Aerobic Exercise Reduces Stress and Rumination While Enhancing Quality of Life in Medical Students, The Journal of Alternative and Complementary Medicine (2020). DOI: 10.1089/acm.2019.0281

Journal information: Journal of Alternative and Complementary Medicine 

Provided by Rutgers University 

Meditation and music may alter blood markers of cellular aging and Alzheimer's disease

Credit: CC0 Public Domain

A research team led by Dr. Kim Innes, a professor in the West Virginia University School of Public Health, has found that a simple meditation or music listening program may alter certain biomarkers of cellular aging and Alzheimer's Disease in older adults who are experiencing memory loss. Study findings, reported in the Journal of Alzheimer's Disease, also suggest these changes may be directly related to improvements in memory and cognition, sleep, mood, and quality of life.

15 nov 2018--Sixty older adults with subjective cognitive decline (SCD), a condition that may represent a preclinical stage of Alzheimer's disease, participated in the randomized, clinical trial. While SCD has been linked to increased risk for dementia and associated with certain neuropathological changes implicated in Alzheimer's disease development, including elevated brain levels of beta amyloid, this preclinical period may also provide a critical window for therapeutic intervention.
In this trial, each participant was randomly assigned to either a beginner meditation (Kirtan Kriya) or music listening program and asked to practice 12 minutes/day for 12 weeks. At baseline and 3 months, blood samples were collected. Two markers of cellular aging were measured: telomere length and telomerase activity. (Telomeres serve as protective caps on chromosomes; telomerase is an enzyme responsible for maintaining telomere length). Blood levels of specific beta-amyloid peptides commonly linked to Alzheimer's Disease were also assessed. In addition, memory and cognitive function, stress, sleep, mood, and quality of life were measured. All participants were followed for a total of 6 months.
Following completion of the 3 month intervention period, the meditation group showed significantly greater increases in a key beta amyloid peptide (Aβ40) than did the music group. Rising beta amyloid levels were correlated with improvements in memory and cognitive function, as well as with those in mood, sleep, and quality of life at both 3 and 6 months; these positive associations were substantially more pronounced in the meditation group. Telomerase activity rose in both the meditation and music groups, although the increases were significant only among participants who had lower values at baseline (≤ 50th percentile), and who practiced more frequently over the course of the intervention. Likewise, increases in telomere length were also significantly greater among participants with lower values at the beginning of the study. Increases in telomere length and telomerase activity were also correlated with improvements in certain cognitive and psychosocial outcomes.
In addition, both groups improved significantly in memory and cognitive function, as well as in sleep and psychological status, although improvements in stress, mood, and quality of life were substantially greater in the meditation group. These improvements were maintained or further strengthened at six months, three months after the intervention ended.

More information: Kim E. Innes et al. Effects of Meditation and Music-Listening on Blood Biomarkers of Cellular Aging and Alzheimer's Disease in Adults with Subjective Cognitive Decline: An Exploratory Randomized Clinical Trial, Journal of Alzheimer's Disease (2018). DOI: 10.3233/JAD-180164


Provided by IOS Press

Study finds that yoga and meditation can help minimize cognitive impairment

Inner peace and a flexible body may not be the most valuable benefits that yoga and meditation have to offer, suggests new research by a UCLA-led team of neuroscientists.

22 may 2016--The team found that a three-month course of yoga and meditation practice helped minimize the cognitive and emotional problems that often precede Alzheimer's disease and other forms of dementia—and that it was even more effective than the memory enhancement exercises that have been considered the gold standard for managing mild cognitive impairment.
"Memory training was comparable to yoga with meditation in terms of improving memory, but yoga provided a broader benefit than memory training because it also helped with mood, anxiety and coping skills," said Helen Lavretsky, the study's senior author and a professor in residence in UCLA's department of psychiatry.
People with mild cognitive impairment are two-and-a-half times more likely to develop Alzheimer's disease and other forms of dementia.
The study, which appears May 10 in the Journal of Alzheimer's Disease, is the first to compare outcomes from yoga and meditation with those from memory training, which incorporates activities ranging from crossword puzzles to commercially available computer programs. The study of 25 participants, all over the age of 55, measured changes not just in behavior but also in brain activity.
"Historically and anecdotally, yoga has been thought to be beneficial in aging well, but this is the scientific demonstration of that benefit," said Harris Eyre, the study's lead author, a doctoral candidate at Australia's University of Adelaide and a former Fulbright scholar at UCLA's Semel Institute for Neuroscience and Human Behavior. "We're converting historical wisdom into the high level of evidence required for doctors to recommend therapy to their patients."
Lavretsky and Eyre studied participants who had reported issues with their memory, such as tendencies to forget names, faces or appointments or to misplace things. Subjects underwent memory tests and brain scans at the beginning and end of the study.
Eleven participants received one hour a week of memory enhancement training and spent 20 minutes a day performing memory exercises—verbal and visual association and other practical strategies for improving memory, based on research-backed techniques.
The other 14 participants took a one-hour class once a week in Kundalini yoga and practiced 20 Kirtan Kriya meditation at home for 20 minutes each day. Kirtan Kriya, which involves chanting, hand movements and visualization of light, has been practiced for hundreds of years in India as a way to prevent cognitive decline in older adults, Lavretsky said.
After 12 weeks, the researchers saw similar improvements among participants in both groups in verbal memory skills—which come into play for remembering names and lists of words. But those who had practiced yoga and meditation had better improvements than the other subjects in visual-spatial memory skills, which come into play for recalling locations and navigating while walking or driving.
The yoga-meditation group also had better results in terms of reducing depression and anxiety and improving coping skills and resilience to stress. That's important because coming to terms with cognitive impairment can be emotionally difficult.
"When you have memory loss, you can get quite anxious about that and it can lead to depression," said Lavretsky, who is also a researcher at the Semel Institute.
The researchers report that the participants' outward improvements in memory corresponded with perceptible changes in their brain activity. Using functional magnetic resonance imaging, they showed that subjects in both groups had changes in their brain connectivity, but the changes among the yoga group were statistically significant, whereas the changes in the memory group were not.
The researchers attribute the positive "brain fitness" effects of mindful exercise to several factors, including its abilities to reduce stress and inflammation, improve mood and resilience, and enhance production of brain-derived neurotrophic growth factor, a protein the stimulates connections between neurons and kick-start telomerase activity, a process that replaces lost or damaged genetic material.
"If you or your relatives are trying to improve your memory or offset the risk for developing memory loss or dementia, a regular practice of yoga and meditation could be a simple, safe and low-cost solution to improving your brain fitness," Lavretsky said.


Provided by University of California, Los Angeles

Study identifies genes, pathways altered during relaxation response practice

A new study from investigators at the Benson-Henry Institute for Mind/Body Medicine at Massachusetts General Hospital (MGH) and Beth Israel Deaconess Medical Center (BIDMC) finds that elicitation of the relaxation response – a physiologic state of deep rest induced by practices such as meditation, yoga, deep breathing and prayer – produces immediate changes in the expression of genes involved in immune function, energy metabolism and insulin secretion. Published in the open-access journal PLOS ONE, the study combined advanced expression profiling and systems biology analysis to both identify genes affected by relaxation response practice and determine the potential biological relevance of those changes.

24 may 2013--"Many studies have shown that mind/body interventions like the relaxation response can reduce stress and enhance wellness in healthy individuals and counteract the adverse clinical effects of stress in conditions like hypertension, anxiety, diabetes and aging," says Herbert Benson, MD, director emeritus of the Benson-Henry Institute and co-senior author of the PLOS ONE report. "Now for the first time we've identified the key physiological hubs through which these benefits might be induced."

Towia Libermann, PhD – director of the Beth Israel Deaconess Medical Center (BIDMC) Genomics, Proteomics, Bioinformatics and Systems Biology Center and co-senior author of the study – adds, "Some of the biological pathways we identify as being regulated by relaxation response practice are already known to play specific roles in stress, inflammation and human disease. For others, the connections are still speculative, but this study is generating new hypotheses for further investigation."

Benson first described the relaxation response – the physiologic opposite of the fight-or-flight response – almost 40 years ago, and his team has pioneered the application of mind/body techniques to a wide range of health problems. Studies in many peer-reviewed journals have documented how the relaxation response both alleviates symptoms of anxiety and many other disorders and also affects factors such as heart rate, blood pressure, oxygen consumption and brain activity. In 2008, Benson and Libermann led a study finding that long-term practice of the relaxation response changed the expression of genes involved with the body's response to stress. The current study examined changes produced during a single session of relaxation response practice, as well as those taking place over longer periods of time.

The study enrolled a group of 26 healthy adults with no experience in relaxation response practice, who then completed an 8-week relaxation response training course. Prior to starting their training, the participants went through what was essentially a control group session – blood samples were taken before and immediately after they listened to a 20-minute health education CD and again 15 minutes later. After completing the training course, a similar set of blood tests was taken before and after participants listened to a 20-minute CD used to elicit the relaxation response as part of daily practice.

The sets of blood tests taken before the training program were designated "novice," and those taken after training completion were categorized as from "short-term practitioners." For further comparison a similar set of blood samples was taken from a group of 25 individuals with 4 to 25 years experience regularly eliciting the relaxation response through many different techniques before and after they listened to the same relaxation response CD. Blood samples from all participants were analyzed to determine the expression of more than 22,000 genes at the different time points.

The results revealed significant changes in the expression of several important groups of genes between the novice samples and those from both the short- and long-term sets, with even more pronounced changes in the long-term practitioners. A systems biology analysis of known interactions among the proteins produced by the affected genes revealed that pathways involved with energy metabolism, particularly the function of mitochondria, were upregulated during the relaxation response. Pathways controlled by activation of a protein called NF-κB – known to have a prominent role in inflammation, stress, trauma and cancer – were suppressed after relaxation response elicitation. The expression of genes involved in insulin pathways was also significantly altered.

"The combination of genomics and systems biology in this study provided great insight into the key molecules and physiological gene interaction networks that might be involved in relaying beneficial effects of relaxation response in healthy subjects," says Manoj K. Bhasin, PhD, co-lead author of the study and co-director of the BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center. He notes that these insights should provide a framework for determining, on a genomic basis, whether the relaxation response will help alleviate symptoms of diseases triggered by stress and developing biomarkers that may suggest how individual patients will respond to interventions.

Benson stresses that the long-term practitioners in this study elicited the relaxation response through many different techniques – various forms of meditation, yoga or prayer – but those differences were not reflected in the gene expression patterns. "People have been engaging in these practices for thousands of years, and our finding of this unity of function on a basic-science, genomic level gives greater credibililty to what some have called 'new age medicine,' " he says.

Libermann says, "While this and our previous studies focused on healthy participants, we currently are studying how the genomic changes induced by mind/body interventions affect pathways involved in hypertension, inflammatory bowel disease and irritable bowel syndrome. We have also started a study – a collaborative undertaking between the Dana Farber Cancer Institute, the Massachusetts General Hospital and the Beth Israel Deaconess Medical Center – in patients with precursor forms of multiple myeloma, a condition known to involve activation of NF-κB pathways."

Provided by Massachusetts General Hospital

Study Suggests Meditation Can Help Train Attention

By SANDRA BLAKESLEE
In meditation, people sit quietly and concentrate on their breath. As air swooshes in and out of their nostrils, they attend to each sensation. As unbidden thoughts flutter to mind, they let them go. Breathe. Let go. Breathe. Let go.
According to a study published today in the online edition of the journal PloS Biology, three months of rigorous training in this kind of meditation leads to a profound shift in how the brain allocates attention.
It appears that the ability to release thoughts that pop into mind frees the brain to attend to more rapidly changing things and events in the world at large, said the study’s lead author, Richard Davidson, a professor of psychology and psychiatry at the University of Wisconsin in Madison. Expert meditators, he said, are better than other people at detecting such fast-changing stimuli, like emotional facial expressions.
Dr. Ron Mangun, director of the Center for Mind and Brain at the University of California, Davis, who was not involved in the study, called the finding exciting. “It provides neuroscience evidence for changes in the workings of the brain with mental training, in this case meditation,” he said. “We know we can learn and improve abilities of all sorts with practice, everything from driving to playing the piano. But demonstrating this in the context of meditation is interesting and novel.”
Recent research has shown that meditation is good for the brain. It appears to increase gray matter, improve the immune system, reduce stress and promote a sense of well-being. But Dr. Davidson said this was the first study to examine how meditation affects attention.
The study exploited a brain phenomenon called the attentional blink. Say pictures of a St. Bernard and a Scottish terrier are flashed before one’s eyes half a second apart, embedded in a series of 20 pictures of cats. In that sequence, most people fail to see the second dog. Their brains have “blinked.”
Scientists explain this blindness as a misallocation of attention. Things are happening too fast for the brain to detect the second stimulus. Consciousness is somehow suppressed.
But the blink is not an inevitable bottleneck, Dr. Davidson said. Most people can identify the second target some of the time. Thus it may be possible to exert some control, which need not be voluntary, over the allocation of attention.
In the study, 17 volunteers with no meditation experience spent three months at the Insight Meditation Society in Barre, Mass., meditating 10 to 12 hours a day. A novice control group meditated for 20 minutes a day over the same period.
Both groups were then given attentional blink tests with two numbers embedded in a series of letters. As both groups looked for the numbers, their brain activity was recorded with electrodes placed on the scalp.
Everyone could detect the first number, Dr. Davidson said. But the brain recordings showed that the less experienced meditators tended to grasp the first number and hang onto it, so they missed the second number. Those with more experience invested less attention to the first number, as if letting it go. This led to an increased ability to grasp the second number.
The attentional blink was thought to be a fixed property of the nervous system, Dr. Davidson said. But this study shows that it can change with practice. Attention is a flexible, trainable skill.
Just ask Daniel Levison, a staff researcher in the psychology department at the University of Wisconsin who meditated for three months as part of the study. “I’m a much better listener,” he said. “I don’t get lost in my own personal reaction to what people are saying.”