Archive for the ‘Mind Body’ Category

Home-based Training Program Improves Memory Function in Epilepsy

Everyone has moments of memory lapses — you forget someone’s name or telephone number, or to take your medication.

These types of memory problems can be part of the normal aging process.

But about half of those with seizures report more than average memory difficulties.

Now a simple self-management intervention may improve the cognitive performance of patients who have epilepsy, according to the results of a new study.

“About half of the 2 million people in the US living with epilepsy have cognitive problems.

Despite the significant impact cognitive functioning has on quality of life, there are limited treatment modalities with which to intervene.

This program teaches epilepsy patients self-efficacy and strategies on how to manage memory problems.

It also helps ease anxiety about memory problems and enhances the ability to cope with memory deficits,” Tracie Caller, MD, Neurophysiology Fellow at Dartmouth Hitchcock Medical Center in Hanover, New Hampshire, said in an interview before her presentation at the American Academy of Neurology annual meeting in Philadelphia.hobscotch_logo

Epileptic seizures typically interrupt cognitive functioning.

“Small epileptic discharges impair cognition.

Eventually, this interrupts the encoding process for new memories.

Also, many epileptic patients have overlying anxiety and depression, which can affect concentration, which in turn affects memory,” said Dr. Caller.

In addition, certain epilepsy medications, such as topiramate, can cause fatigue and affect memory and concentration.

The underlying brain abnormality that causes seizures, for example, scarring in the temporal lobe, also may affect memory, she said.

Dr. Caller and colleagues conducted a pilot study of a self-management intervention for cognitive impairment in epilepsy.

TEACHING PROBLEM-SOLVING STRATEGIES

HOBSCOTCH (HOme Based Self-management and COgnitive Training CHanges lives) is an 8-week, telephone-based intervention developed to teach problem-solving strategies and compensatory memory strategies.

Dr. Caller reported on the results of 16 adult patients with epilepsy and subjective cognitive complaints who were randomized to receive HOBSCOTCH, HOBSCOTCH+ (which adds working memory training), or usual care.

“We found that the 9 HOBSCOTCH participants had significantly improved quality of life scores as compared to 7 controls, and significant changes in depression, as well as improvement in executive function,” said Dr. Caller.

“As a pleasant surprise, we also found improvement in objective memory function.”

The program is “designed to teach memory strategies, to work around deficits, and improve memory confidence,” Dr. Caller said.

“People with epilepsy often lose confidence in their memory, and this becomes a vicious cycle.”

The structure of the program is similar to problem-solving therapy now used by primary care doctors and applied to depression and chronic diseases, such as heart disease and diabetes.

“We teach patients how to solve their own problems, for example, how to remember to take their medication by setting a reminder alarm on a cell phone or putting the medication next to their tooth brush or coffee machine,” Dr. Caller stated.

She said the program would be easy to implement in a doctor’s office.

“We have nurse practitioners deliver HOBSCOTCH.

A variety of practitioners, including psychologists and social workers, can deliver the intervention,” she said.

So far, the researchers have enrolled 50 of a planned 60 patients with epilepsy in a clinical trial to test the effectiveness of HOBSCOTCH.

The patients in the pilot study “are satisfied with the program.

We have a low drop-out rate compared to similar interventions,” said Dr. Caller.

She thinks the program also would be helpful in other neurological disorders, such as multiple sclerosis, in which patients often have memory difficulties and depression, as well as for chemotherapy patients who suffer so-called “chemobrain” post-therapy.

Relaxation Followed by Stress Triggers Migraines

If you have migraine headaches, they may increase significantly after you relax and then experience heightened stress, according to the results of a new study.

“People with migraine are thought to inherit a predisposition to headaches.

Attacks of migraine headache are initiated in vulnerable individuals when they are exposed to a broad range of triggers,” said study co-author Dawn C. Buse, PhD, Director of Behavioral Medicine, Montefiore Headache Center, and Associate Professor, Clinical Neurology, at the Albert Einstein College of Medicine in New York.

“Our study results support the ‘letdown phenomenon,’” she said.

“That is, relaxation following high perceived stress is a powerful predictor of migraine onset.”

The researchers published their results online on March 26, 2014 in the journal Neurology.

MIGRAINE DIARIES COLLECT TRIGGERS

Dr. Buse and colleagues asked 17 patients with migraine to keep electronic diaries for 3 months to examine the relationship of perceptions of stress and relaxation after stress with increased probability of a migraine attack, yielding more than 2000 diary entries, including 110 eligible migraine attacks.

Data were collected using a custom-programmed electronic diary.

Each day patients recorded information about migraine attacks, 2 types of stress ratings, and common migraine triggers.

Triggers included hours of sleep; certain foods, drinks, and alcohol consumed; and menstrual cycle.

They also recorded their mood each day, including feeling happy, sad, relaxed, nervous, lively, and bored.

“We found that a reduction in stress from one day to the next was associated with a nearly 5-fold increased risk of migraine onset within 6 hours,” Dr. Buse said.

The biology of stress is complex, including activation of both neuroendocrine and sympathetic mechanisms, she noted.

“Cortisol rises during times of stress.

If cortisol falls in periods of relaxation after stress that may contribute to the triggering of a migraine attack,” said lead author Richard B. Lipton, MD, Director, Montefiore Headache Center, and Professor and Vice Chair of Neurology and the Edwin S. Lowe Chair in Neurology at Einstein.

STRATEGIES TO REDUCE STRESS

“This study highlights the importance of stress management and healthy lifestyle habits for people who live with migraine,” Dr Buse stated.

“It is very important for people to be aware of rising stress levels and attempt to relax during periods of stress rather than allow a major buildup to occur.

Strategies to relax could include exercising, attending a yoga class, taking a walk with your dog, or simply focusing on your breath for a few minutes.”

Behavioral interventions that protect against rising levels of stress also may prevent the peak followed by the valley that leads to an increased risk of migraine attack.

“There are several approaches to stress management with strong scientific support, including cognitive behavioral therapy (CBT), biofeedback, and relaxation therapies,” Dr. Buse said.

“An additional bonus is that these techniques also have scientific evidence for migraine prevention.”

Some approaches require the guidance of a mental health care professional, such as biofeedback and CBT, and some can be self-learned, such as diaphragmatic breathing and guided visual imagery.

“Once learned these techniques can be practiced practically anywhere at any time for the rest of someone’s life,” Dr. Buse noted.

“Based on these findings, we suggest that health care professionals caring for individuals with migraine should incorporating stress management interventions into treatment plans, especially for patients for whom changes in stress levels are triggers for migraine attacks.”

Tai Chi Good for the Heart

If you have heart failure and practice Tai Chi, you’ll feel better about your life, your mood will lift, and you’ll be more likely to keep on exercising.

Those are the results of the largest study of the effects of Tai Chi on heart failure, reported this week in the Journal of the American Medical Association.

“The multi-component nature of Tai Chi – the combination of physical exercise, stress reduction, and social support – along with its integration of multiple body systems makes it an ideal way to prevent and rehabilitate heart disease,” says one of the co-authors of the study, Peter Wayne, PhD. Director of Tai Chi and Mind-Body Research Programs, Harvard Medical School’s Osher Research Center.

“Tai Chi can potentially prevent and aid the management of heart disease by providing a form of aerobic exercise, more efficient breathing, improved circulation, greater muscle strength, stress reduction, mood elevation, and encouragement of behavior changes.”

Heart failure is a particularly hard disease to live with due to the shortness of breath and low energy that results from the heart’s inability to pump enough blood. “Historically, patients with chronic systolic heart failure were considered too frail to exercise and, through the late 1980s, avoidance of physical activity was a standard recommendation,” writes the authors, led by Harvard’s Gloria Yeh, MD, MPH.

The Harvard researchers recruited 100 people with chronic heart failure and randomly assigned half of them to receive a 12-week Tai Chi program designed specifically for heart failure. The other half got a heart health education program.

The Tai Chi program involved some traditional warm-up exercises, including arm swinging, gentle stretches, breathing, and visualization techniques.

Then patients learned five simple movements adapted from Master Cheng Man-Ch’ing’s Yang-style Tai Chi, which the Harvard researchers have subsequently used in other clinical trials, all funded by the National Institutes of Health.

The patients also received an instructional videotape, and were encouraged to practice Tai Chi at home at least 3 times a week.

After 12 weeks, the patients in the Tai Chi group showed greater improvements in quality of life, in feelings of well-being, and in the confidence to perform exercise-related activities, compared with the education group.

Importantly, more than three-quarters of the participants came to the Tai Chi classes and many continued to practice Tai Chi at home when the researchers checked up on them 6 months later.

“This tells us that Tai Chi is enjoyable and can be safely incorporated into regular activities, even if you have chronic heart disease,” says Wayne.

Notes on Qi for a Nurturing Life

I just received the April 2011 issue of Yang-Sheng (Nurturing Life), an e-magazine put out monthly by a network for all Qigong, Tai Chi, Yoga, Reiki, mindfulness and meditation practitioners, health seekers, and spiritual cultivators.

The mission of the network is to promote philosophy and methods of self-healing, positive mind and health preservation, and to share knowledge and experiences with those who are interested in the subjects and their applications in everyday life.

The e-magazine always has interesting personalized articles, as well as abstracts from the latest medical journals.

I was struck by some of the wry, funny, contemplative poetry in the latest issue:

What Is Qigong? by Solala Tower

“What is this thing you do?” he asks hesitantly over the phone.

This quee gong? Is it martial arts or is some kind of health practice?”

“Well, I answer, it’s a health practice and a meditation practice, as well as a spiritual practice.”

“Wow,” he says, “all in one package, huh? What a deal!”

If a Daoist had composed the error messages that appear on a computer screen…. by Anonymous

Stay the patient course
Of little worth is your ire
The network is down.

A crash reduces
your expensive computer
to a simple stone.

Yesterday it worked
Today it is not working
Windows is like that.

You step in the stream,
but the water has moved on.
This page is not here.

Selected Poetry by Jacob Newell

Letting go of all my concerns
I settle deeply into the serenity of nature
It’s already there
I don’t have to do a darn thing
Greater than anything
Anyone could ever contrive

I hope these poems help you cultivate your Qi for Body, Mind & Spirit, as Yang-Sheng says at the end of every issue.

Your Brain on Exercise, and with Meditation

I’ve got exercise on the brain as I try to get in shape for the upcoming golf season, and two new studies caught me eye, one about the effects of exercise on the brain and the other about how meditation reduces pain-related activation of the brain.

Exercise increases the growth of brain cells and improves brain function, says Terry Eckmann, Ph.D, professor in the teacher education and performance department at Minot State University in Minot, ND.

“Exercise balances brain chemicals, hormones, and system functions,” says Eckmann.

“Research suggests that every system of the body functions more efficiently with regular exercise. Exercise is medicine and can make a difference in disease prevention and management.”

A protein known as brain-derived neurotrophic factor (BDNF) is “like Miracle-Gro for the brain,” she told the American College of Sports Medicine’s 15th-annual Health & Fitness Summit & Exposition in Anaheim, CA, on April 14, 2011. The protein helps to grow new neurons in the hippocampus area of the brain, which plays important roles in the consolidation of information from short-term memory to long-term memory and spatial navigation. The protein also aids transmission of information across the synapses of neurons.

Recent studies show that students with higher fitness levels score higher on academic tests and show an improved ability to focus.

Scientists have also documented the ability of exercise to help prevent dementia and Alzheimer’s disease.

The hippocampus is one of the first regions of the brain to suffer damage in Alzheimer’s disease.

The second study reported in the April 6 issue of the The Journal of Neuroscience shows that a little more than an hour of meditation training can dramatically reduce both the experience of pain and pain-related brain activation.

In this small study, 18 healthy volunteers who were new to meditation were taught a meditation technique known as focused attention, which involves paying close attention to breathing patterns while acknowledging and letting go of distracting thoughts, says first author Fadel Zeidan, PhD, who is a postdoctoral fellow at Wake Forest University School of Medicine.

The volunteers were subjected to heat on the skin of their thigh to induce pain during brain imaging, both before and after they had practiced meditation.

The imaging showed that, after just 4 20-minute sessions of meditation, pain intensity ratings were reduced by an average of 40%, and the pain unpleasantness rating was reduced by 57%.

Meditation engages multiple brain mechanisms to reduce activity in key pain-processing regions of the brain, concluded the researchers.

These studies have emboldened me to ride my bike and speed walk more often and continue my Tai Chi classes (which is like meditation in motion). It should make me feel better, if not smarter, and maybe I’ll feel less pain the next time I knock a golf ball into the woods.

Arthritis: Keeping Your Joints Healthy

Exercise is one of the best ways to help people with arthritis control their disease and improve their health.

Yet, some people still abide by the old myth that exercise hurts your joints.

A generation ago arthritis sufferers were sent to bed to “save their joints.”

That only did more harm than good because inactivity causes arthritic joints to stiffen and unused muscles to atrophy.

Now multiple studies have shown that exercise helps strengthen muscles to support and protect joints, even those affected by arthritis.

If you have arthritis and exercise regularly you’re likely to have less pain and joint swelling, improved function, and increased strength, endurance, and flexibility. And without harming your joints.

Several forms of structured exercise programs can help arthritis sufferers, according to a newly updated report from Harvard Medical School entitled “Arthritis: Keeping your joints healthy”:

Water-based programs. Also known as aquatic or pool therapy, these group classes are done in water that’s nearly 90° F and feature a variety of exercises, including range-of-motion exercises and aerobics.

Water helps support your body so there is less stress on the hips, knees, and spine. These programs can lead to improved knee and hip flexibility, as well as strength and aerobic fitness.

Strength and resistance training. Using equipment such as weight machines, free weights, and resistance bands or tubing strengthens not only muscles but also your bones and your cardiovascular system.

Studies show that resistance training improves muscle strength, physical functioning, and pain in most people with knee osteoarthritis.

Tai Chi. This low-impact, slow-motion exercise, based on ancient martial arts, emphasizes breathing and mental focus.

Tai Chi may have a positive effect on physiological processes important in arthritis, such as physical function, flexibility, pain, and psychological well-being.

A number of small studies suggest Tai Chi helps people with different forms of arthritis, mainly by increasing flexibility and improving muscle strength in the lower body, as well as aiding gait and balance.

A systematic review of 7 randomized controlled studies of Tai Chi for chronic musculoskeletal pain conditions found that Tai Chi had a small positive effect on pain and disability in people with arthritis.

What’s more, systematic reviews and individual studies show that Tai Chi can reduce the pain of knee osteoarthritis.

The message is simple for those with arthritis: get up and go!

Tai Chi and Green Tea Boost Bone Health, and More

Low-impact exercises such as walking can reduce rates of bone loss in women with low bone density (osteopenia) or the bone-wasting disease osteoporosis, and regular exercise can induce changes in bone mineral density (BMD) within a few months.

But many post-menopausal women just don’t do conventional exercises, either due to health factors or a lack of sustained interest, among other reasons.

A novel low-impact weight-bearing exercise like Tai Chi, along with drinking green tea, may be their answer.

A new study of 171 women with osteopenia found that doing Tai Chi three times a week and consuming the equivalent of 4-6 cups of green tea a day significantly enhanced bone health and muscle strength after 6 months.

What’s more, Tai Chi and green tea seem to work in synergy to reduce oxidative stress, which is one of the precursors to inflammation and may be an underlying cause of osteoporosis as well as other inflammatory diseases, such as arthritis, reported Dr. Chwan-Li (Leslie) Shen, associate professor at the Laura W. Bush Institute for Women’s Health at the Texas Tech University Health Sciences Center, at the Experimental Biology 2011 meeting in Washington, DC on April 10.

Dr. Shen led a double-blind, placebo-controlled trial – the gold standard of medical studies – that divided the women into 4 groups.

One group took 500 mg a day of green tea polyphenols, which is the active ingredient in green tea, and did no Tai Chi.

A second group took Tai Chi classes 3 times a week and a sugar pill daily.

A third group took Tai Chi classes and the green tea pills.

A fourth, control group did no Tai Chi and took sugar pills.

In addition to benefits to bones, Dr. Shen said those who took Tai Chi classes also reported significant improvements in their emotional and mental health.

Preliminary studies from Asia suggest Tai Chi can reduce rates of BMD decline in post-menopausal women.

Tai Chi has also been shown to improve balance, reduce falls in older women, and increase bone strength – all important ways to prevent fractures from low bone density.

Tai Chi doesn’t require any equipment, it’s relatively inexpensive, and it’s easily incorporated into daily life. Add in some cups of green tea each day and you may just stave off the effects of low bone density.

Weight Training for Whole Health

In the April 2011 issue of American Legion magazine, I wrote about how a well-rounded physical activity program that combines strength training with aerobic activity is good for your heart and overall health.

Strength training gets results fast – do it twice a week for a few weeks and you’ll start to see and feel your body change, compared with three times a week with aerobics.

Working out with weights can also reduce your blood pressure, improve your insulin sensitivity, protect you against bone loss, and reduce your risk of falls. And your quality of life will improve and you will be able to live independently for longer.

You can increase your strength by 25-30% and put on nearly 2.5 pounds of muscle in just 18-20 weeks of progressive resistance training, according to a new study on resistance training for aging adults by University of Michigan researchers published in The American Journal of Medicine.

“Resistance exercise is a great way to increase lean muscle tissue and strength capacity so that people can function more readily in daily life,” says Mark Peterson, Ph.D., a research fellow in the University of Michigan Physical Activity and Exercise Intervention Research Laboratory at the Department of Physical Medicine and Rehabilitation.

Progressive resistance training means that the amount of weight used, and the frequency and duration of training sessions, is altered over time to accommodate your improvement. You need to increase the resistance and intensity of your training to continue building muscle mass and strength.

Peterson says that anyone over age 50 should strongly consider participating in resistance exercise. To start out, particularly if you are relatively sedentary, he recommends beginning with exercises that use your own body weight, such as squats, modified push-ups, and lying hip bridges, as well as non-traditional exercises that progress through a full range of motion, such as Tai Chi, Pilates, or Yoga.

In the American Legion article, I mention that to maintain your health, exercise guidelines suggest you do two days of strength training each week in addition to moderate aerobic activity for 30 minutes, five days a week.

A regular regimen of 8-10 resistance exercises using the major muscle groups on two non-consecutive days allows time for your muscles to adapt, which reduces the potential for excessive muscle soreness and injury.

Kerry Stewart, Ed.D., Director of Clinical/Research Exercise Physiology at Johns Hopkins University, told me once you start lifting weights, you will gain self-confidence and be able – and want – to do even more.

Know Your Chi Flow 24/7 with iPhone App

Like a 21st Century version of the mood ring, an iPhone app can give you a reading on your chi (qi) throughout the day.

What’s more, the 24/7 Chi application will lead you through a series of pressure point manipulations, meditation exercises, and stretches to help you wind down the day and try to connect with your natural rhythms and cycles, says inventor Matt Harrigan in a recent community blog post.

An inventor and student of alternative therapies, Harrigan had created a Chi Watch that enabled people to observe their 24-hour Chi cycle on the watch’s face. This apparently was based on the traditional Chinese medicine concept that we all have a diurnal clock inside us that regulates body rhythms to allow our bodies to function more efficiently and to defend against illness.

When the iPhone came along, Harrigan decided to take advantage of the new technology to update his concept, and his 24/7 app first appeared last fall.

The application can be downloaded at MEDL Mobile’s website or on iTunes for $2.99.

As described on the MEDL Mobile website, chi keeps the rhythm and sets the pace of our daily lives by traveling throughout our bodies along energy channels known as meridians. Chi flows through each of the twelve major meridians during a specific 2-hour period of the day.

The spleen meridian (between 9-11 a.m) is the best time for hard work, intellectual challenges or handling emotionally burdening tasks. The heart meridian (between 11 a.m. and 1 p.m.) is the time to pursue your most meaningful and enjoyable activities. The kidney meridian (between 5-7 p.m.) is the best time to relax, unwind, and decompress.

The 24/7 Chi application includes three therapy options to improve your chi flow.

The first is acupressure used to relieve anxiety by manipulating the body’s pressure points with the fingers.

The second is Chi Kung (qigong), which involves standing still, breathing, and slowly moving the body.

The third is meridian stretching, 6 stretches that focus on the body’s 12 meridians.

The app also allows you to add any meridian, therapy treatment, or specialist to your favorites, and has a GPS Google Maps locator for the nearest alternative health specialists.

It sounds like a lot of fun, and probably works better than the old mood ring I’ve got stashed somewhere in a junk drawer.

Tai Chi Helps Ease Depression in the Elderly

The ancient Chinese mind-body exercise of Tai Chi can help relieve the symptoms of depression in older people.

More than 18 million American adults suffer from depression, and 2 million of them are age 65 or older. A new study from the University of California at Los Angeles shows that 10 weeks of Tai Chi classes for 2 hours per week helped to relieve depressive symptoms, as well as improve quality of life, memory, and cognition, and provide more overall energy, among 112 adults age 60 or older with major depression who were also treated with an antidepressant drug.

The study in the current online edition of the American Journal of Geriatric Psychiatry is the first study to demonstrate the benefits of Tai Chi in the management of late-life depression, said lead author Dr. Helen Lavretsky, a UCLA professor-in-residence of psychiatry.

Any kind of exercise may seem the last thing you want to do if you are depressed, but exercise may help relieve your symptoms. The links between anxiety, depression, and exercise is quite robust. There’s good evidence to suggest that exercise can improve depression and anxiety, and exercise may be just as good as drugs in treating depression.

Exercise probably helps in a number of ways, including releasing feel-good brain chemicals (neurotransmitters and endorphins) and reducing immune system chemicals that can worsen depression. Exercise has many psychological and emotional benefits as well. These include gains in self-confidence, feeling better about your appearance, relaxation of the mind, and enhancement of social interactions.

A number of Tai Chi studies have reported improvement in mood, decreases in anxiety, and enhancement in vigor. A recent meta-analysis of 40 Tai Chi studies including more than 3,800 subjects conducted by Dr. Chenchen Wang from the Division of Rheumatology at Tufts University School of Medicine found that Tai Chi reduced stress, anxiety, depression, and mood disturbance, and increased self-esteem.

“Tai Chi provides a perfect combination of exercise, mood enhancement, stress reduction, and social support,” says Dr. Peter Wayne, Director of Tai Chi and Mind-Body Research Programs at Harvard Medical School’s Osher Research Center. “Being part of a group has therapeutic value for a variety of medical conditions, including depression and anxiety. In ongoing Tai Chi classes, students develop a strong sense of community, and with rich interactions and support from teachers and peers, often undergo a profound journey of self-discovery.”

Tai Chi may just be a natural way for our aging population to handle the psychological aspects of depression and improve their physical health at the same time.