Neurology in practice: Yoga and mindfulness as beneficial allies in treating neurologic disorders

Holistic practices such as yoga and mindfulness are increasingly being acknowledged in neurology for their promising role in managing various neurologic disorders. Integrating these practices with conventional treatments offers a promising avenue for improving patient care.

The science behind yoga and mindfulness

Yoga, an ancient practice combining physical postures, breath control, and meditation, is known for its stress-reducing and relaxation-inducing effects. Mindfulness, a form of mental training that develops one's attention to the present moment, has been shown to reduce anxiety and improve cognitive function. Both practices promote neurologic and psychological well-being by modulating the stress response, which can be particularly beneficial in neurologic conditions where stress exacerbates symptoms.

Impact on neurologic disorders

1. Multiple sclerosis. Studies have suggested that yoga can improve balance, fatigue, and quality of life in patients with multiple sclerosis. It enhances physical function and emotional well-being, making it a valuable adjunct to conventional therapies. (Further reading: PMID 32379628, PMID 31248778, PMID 35060096.)
2. Parkinson disease. Yoga and mindfulness can help improve motor function, flexibility, and balance in patients with Parkinson disease. These practices also reduce stress and anxiety, which are common in Parkinson disease, thereby potentially slowing disease progression (PMID 30958514).
3. Epilepsy. Stress is a well-known trigger for epileptic seizures. Mindfulness and yoga can help in managing stress, and a study of 50 subjects with epilepsy from two trials reveals a possible beneficial effect in control of seizures (PMID 28982217).
4. Stroke rehabilitation. Post-stroke recovery can be enhanced through yoga, which improves motor function, balance, and coordination. Additionally, mindfulness practices can aid in coping with the psychological impact of stroke, like depression and anxiety (PMID 38011022).
5. Migraine and headache disorders. Regular yoga practice has been associated with a decrease in the frequency and intensity of migraines. Mindfulness can also help patients develop better coping mechanisms for pain management (PMID 35444373).
6. Alzheimer disease and cognitive decline. Although research is still emerging, there is growing evidence that mindfulness can improve cognitive function and might slow the progression of cognitive decline in conditions like Alzheimer disease. (Further reading: PMID 35275541, PMID 31588880.)

Mechanisms of action

The benefits of yoga and mindfulness in neurologic conditions can be attributed to several mechanisms. These include the reduction of stress hormones, improvement in sleep quality, enhancement of neuroplasticity, and a positive impact on mood and anxiety levels. Additionally, the physical aspect of yoga improves strength, flexibility, and circulation, which are crucial for neurologic health.

Implementing in clinical practice

Neurologists can recommend yoga and mindfulness as complementary therapies for patients with neurologic disorders. It is important, however, to tailor these practices to the individual’s capabilities, especially in conditions that affect physical mobility. Collaboration with trained yoga therapists and mindfulness practitioners can ensure that patients receive safe and effective guidance.

Is the evidence conclusive?

Many studies collectively suggest that yoga and mindfulness have potential benefits in various neurologic and neuropsychiatric conditions, particularly in improving physiological and psychological well-being. However, it is important to note that some of these studies noted above had limitations in their design, and further research is needed for more conclusive evidence. Several reviews have been conducted assessing the current literature for conclusive evidence:

• Evidence-based effects of yoga in neurological disorders. A comprehensive review of PubMed/Medline articles using keywords “yoga” and specific neurologic disorders, concluding that yoga might be considered an effective adjuvant for patients with various neurologic disorders.
• Effect of yoga on health-related quality of life in central nervous system disorders: a systematic review. Review of randomized control trials in the literature comparing yoga to another intervention group or control group, measuring health-related quality of life. The authors concluded that there was low to moderate evidence that yoga improves health-related quality of life in patients with Parkinson disease, but insufficient evidence to conclude that yoga improved health-related quality of life for patients with multiple sclerosis, stroke, dementia, or epilepsy and brain tumor.
• The therapeutic value of yoga in neurological disorders. Review article analyzing the efficacy of various aspects of yoga in disease prevention and health promotion, specifically focusing on its effects in neurologic disorders such as epilepsy, stroke, multiple sclerosis, Alzheimer disease, peripheral nervous system disease, and fibromyalgia. The study highlighted statistically encouraging physiological and psychological improvements in these conditions.

Yoga and mindfulness as complementary therapies offer a holistic approach to patient care, addressing both physical and psychological aspects of neurologic disorders. By incorporating these practices into treatment plans, neurologists can provide a more comprehensive and person-centered approach to care, potentially enhancing outcomes and improving the quality of life for their patients.

MedLink acknowledges the use of GPT-4 in drafting this blog entry.

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