Mind-Body Medicine

Sandra Utz et al. (2025) · Biomedicines

This prospective observational study followed 101 adults with long-standing fibromyalgia syndrome (FMS) through a two-week integrative inpatient stay in Bamberg, Germany, with no control group. FMS is a chronic condition marked by widespread pain, fatigue, sleep problems, anxiety and depression, and the authors describe it as the third most common rheumatic disease. The program was built on classical European naturopathy: water-based therapies and heat, exercise, plant-based nutrition or medical fasting, herbal remedies and mind-body practices such as relaxation. The question was whether such a combined approach would ease symptoms at discharge and six months later. Of 134 patients who joined (127 women, ages 22 to 80), 101 returned questionnaires on admission, at discharge and after six months. During the stay they took part in meditative movement, physical therapy, hydrotherapy, lectures and cooking classes, and some had whole-body heat sessions or a 5-day fast on under 300 kcal a day. Pain, fatigue, anxiety, depression, stress and quality of life were measured with standard questionnaires (such as the HADS for anxiety and depression and the MFI-20 for fatigue) and compared over time with repeated-measures statistics. Overall pain intensity dropped from 71.5 to 63.0 on a 0-100 scale at discharge (a moderate effect, dz = 0.62) and was still lower at six months (64.4). Current pain fell sharply during the stay (6.56 to 4.37 out of 10) but crept back to 5.96 at six months. Fatigue improved from 71.1 to 63.3 and then partly returned (68.0). Anxiety and depression scores each fell by roughly 2.5 points at discharge and were still lower than baseline at six months. Stress and feelings of helplessness improved mainly after discharge, and mental quality of life rose between discharge and follow-up. Patients who fasted kept their pain gains at six months (p = 0.006), whereas non-fasters did not (p = 0.062), although this difference was borderline (interaction p = 0.050) and not randomised. The results come from an uncontrolled, single-centre sample in which a quarter of the participants did not complete the six-month questionnaire, so the changes cannot be attributed to the program alone. More than half the patients reported obstacles to continuing the methods at home, such as lack of time and exhaustion. The authors call for randomised trials with long-term follow-up and propose a follow-up day-clinic programme to help consolidate the learned self-management skills and everyday routines.

Manobala V R et al. (2026) · Bioinformation

This single-arm pilot trial with 30 participants explored whether a 90-day Siddhar yogam programme could reduce the symptom burden of varicose veins, which are dilated, twisted veins of 3 mm or more in the legs. Siddhar yogam belongs to the Siddha system of medicine, a South Indian tradition that explains illness through three humors, Vatham (air), Pitham (fire) and Kabham (water), and counts Siddhar yogam among its Kayakarpam (rejuvenation science) methods. The practice combines yoga postures, controlled breathing and meditation. The authors note that no standardized, non-invasive therapy exists for varicose veins, a condition they say affects about 5% of people in India. The 30 patients (10 men and 20 women, aged 30 to 55) were recruited at the National Institute of Siddha's Ayothidoss Pandithar Hospital. All practised the same 35-minute routine for 90 days: a few minutes of relaxation, 21 minutes of postures such as raised-leg pose, half plough, inverted pose and cycling pose, and 5 minutes of Thirumoolar breathing practice. Symptoms and quality of life were scored with the Aberdeen Varicose Vein Questionnaire (AVVQ), where a lower score means less impact, before and after the programme. There was no comparison group. Average AVVQ scores dropped from 16.2 to 12.0 (a fall of 4.2 points; reported as significant at p < 0.05 by Wilcoxon signed rank test). Most participants (over 85%) reported long periods of standing, and the Siddha assessments, which grade humors, body constituents and an eight-fold examination, showed derangement mainly in Vatham and Pitham before treatment and a reduction in these findings afterwards, though the paper gives no figures for that change. The authors suggest the postures lower pressure in the leg veins and help blood return to the heart by working the calf muscles, but they did not measure this. Because the trial had one arm, no follow-up and only one outcome measure, and excluded severe cases, the authors say the efficacy of the regimen cannot be established. They recommend larger randomized trials.

Zheping Quan et al. (2026) · Frontiers in immunology

This systematic review and network meta-analysis of 16 randomized controlled trials (943 participants) explored which forms of exercise are linked to better outcomes in irritable bowel syndrome (IBS). IBS is a functional gut disorder, meaning the bowel looks normal on testing but causes recurring abdominal pain and altered bowel habits, and it often occurs alongside anxiety and depression. The authors framed the gut and brain as communicating through the brain-gut axis, with the immune system, intestinal barrier and gut microbiota also involved. A network meta-analysis is a statistical method that compares several treatments at once, even when some were never tested head to head, and ranks them using SUCRA, a percentage score where higher values mean a greater chance of being best. The included trials, published between 2004 and 2025, tested yoga, Pilates, Baduanjin (a traditional Chinese gentle movement routine), running and moderate-intensity aerobic exercise for 4 to 24 weeks. Participants were adults with constipation-predominant, diarrhea-predominant or mixed IBS, mostly in Asia, Europe and North America. Comparison groups received conventional treatment, dietary advice, probiotics or education. Researchers measured symptom severity with the IBS Symptom Severity Scale, quality of life with the IBS Quality of Life scale, and mood with anxiety and depression scores. Exercise improved several outcomes. Depression scores fell overall (SMD -0.56, a moderate-sized benefit), though heterogeneity was very high (I2 = 95%, meaning results varied widely between trials), and yoga alone was not significant. Anxiety dropped with yoga (SMD -1.82), Pilates (SMD -3.84) and aerobic exercise (SMD -6.31). Symptom severity improved with running (MD -72.68 points), Pilates (-71.32), aerobic exercise (-46.50) and Baduanjin (-16.94), with running ranked first (SUCRA 90.3%). Quality of life ranked Baduanjin first (99.9%) and yoga second (80.1%), while aerobic exercise showed no significant difference from conventional treatment. In subscale analyses, Pilates cut pain severity (MD -17.90) and aerobic exercise improved dysphoria, activity interference, body image, health worries and relationships, while yoga helped only bowel satisfaction and interference with life. Rankings differed by outcome, which the authors describe as functional specificity. The authors describe exercise as a safe, low-cost non-pharmacological option that may hold value in comprehensive IBS management, but the evidence carries clear limits. Heterogeneity was high, many trials did not clearly blind participants or assessors, and some effect sizes were unusually large, which the authors attribute to small samples. Study counts were reported inconsistently across sections, and safety was not analysed. Too few trials came from outside East Asia to judge differences across ethnic groups. The immune mechanisms remain unproven, and the authors call for trials that add immune markers, biomarkers and gut microbiome measures.

Ilse N Ganzevoort et al. (2026) · The British journal of general practice : the journal of the Royal College of General Practitioners

This randomised controlled trial with 152 Dutch children explored whether home-based guided hypnotherapy, added to usual care from a general practitioner (GP), helps children with functional abdominal pain (recurring stomach pain with no underlying disease found) or irritable bowel syndrome (IBS, abdominal pain linked to bowel habit changes). Both conditions are disorders of gut-brain interaction, meaning the gut and the nervous system influence one another, and in children they are linked with anxiety, school absence and lower quality of life. Hypnotherapy is a state of focused attention in which therapeutic suggestions are used to influence sensation, emotion and thought. It is already available in secondary care, but its effect in primary care had not been tested. Children aged 7 to 17 with a GP diagnosis were randomly assigned to usual care alone (education, reassurance and symptom monitoring) or usual care plus hypnotherapy. Of the 152 children, 46 came through GPs and 106 through social media; median age was 9.4 years. The hypnotherapy group listened to five audio exercises on a website, one for breathing and relaxation and four visualisation exercises, for 15 to 20 minutes on at least five days a week for three months. The main outcome was adequate relief of abdominal pain at 12 months; pain severity was rated from 0 to 10. At 12 months the main result was not statistically significant: 79.5% of the hypnotherapy group reported adequate relief versus 74.3% of the usual care group (adjusted odds ratio 1.47, 90% confidence interval 0.74 to 2.93; the interval includes no difference). Earlier, differences were larger. At 3 months 73.2% versus 56.8% reported relief (odds ratio 2.74, meaning higher odds of relief), and at 6 months 77.6% versus 58.6% (odds ratio 4.26). Pain severity scores were lower in the hypnotherapy group by 1.38 points at 6 months and 0.89 points at 12 months, but not significantly at 3 months. Pain threat beliefs were lower and more children fell asleep within 20 minutes. Anxiety, depression, quality of life and school absence were similar between groups. No adverse events were spontaneously reported, but children were not asked about them directly. The authors suggest that hypnotherapy added to usual care may bring earlier relief and lower pain at low cost, and note that relief at 12 months was high in both groups. The trial had limits: it recruited fewer children than planned, so the significance threshold was relaxed to 10%, which raises the chance of false positives. Participants and clinicians knew who received hypnotherapy, and most families preferred it, so placebo effects are possible. More than 40% of pain diary data were missing. The authors call for research on which children benefit most and on possible adverse effects.

Neil P Roberts et al. (2019) · European journal of psychotraumatology

This systematic review and meta-analysis explored which early psychological treatments, started within three months of a traumatic event, reduce post-traumatic stress symptoms. Post-traumatic stress disorder (PTSD) involves intrusive memories, avoidance and heightened alertness that persist after trauma, and acute stress disorder (ASD) is a similar early reaction in the first month. The authors updated an earlier 2009 review, pooled 61 randomized controlled trials, and prepared it as part of the International Society for Traumatic Stress Studies treatment guidelines. Trials were split into three groups: help offered to everyone exposed to a trauma, help for people already showing symptoms, and help for people diagnosed with ASD or PTSD. Included trials tested a wide range of approaches, including trauma-focused cognitive behavioural therapy (CBT-T, which uses written, imagined or real-life exposure to the trauma), cognitive therapy without exposure, brief EMDR (eye movement desensitization and reprocessing, a therapy in which a person recalls a trauma while following guided eye movements), cognitive processing therapy, internet-based self-help and stepped collaborative care. Most participants were adults recruited after accidents, assaults, injury or intensive care. Symptom severity was compared using standardized mean differences (SMD, where negative favors treatment), and the authors rated evidence quality with GRADE. For people not screened for symptoms, no intervention was clinically better than usual care. For people with symptoms, CBT-T outperformed waitlist (SMD -0.63) and supportive counselling (SMD -0.61) after treatment, and the gap was larger in diagnosed ASD or PTSD (SMD -0.89 and -0.75). Cognitive therapy versus waitlist reached SMD -0.68, and brief EMDR reached SMD -2.50, though that result came from four small trials with only 84 participants and very low quality evidence. CBT-T and cognitive therapy performed similarly (SMD -0.19). Benefits were less consistent at 7 to 12 months, and cognitive processing therapy showed no effect in two trials. The authors judged the CBT-T, cognitive therapy and EMDR findings clinically important, whereas significant effects for collaborative care, brief dyadic therapy and a self-guided internet program in unscreened individuals were not judged clinically important. Most ratings were low or very low quality, and few trials reported adverse events. The authors suggest that CBT-T, cognitive therapy and brief EMDR are supported for symptomatic people and that routine intervention for everyone exposed is not supported. They note limits: diverse studies, many small trials, high attrition, inconsistent follow-up and thin safety data. They also caution that the large EMDR effect rests on very few participants, that pooled estimates are uncertain because most GRADE ratings were low or very low, and that non-publication of negative results cannot be excluded.

Barbara Olasov Rothbaum et al. (2012) · Biological psychiatry

This randomized pilot study with 137 civilian trauma patients explored whether starting psychotherapy within hours of a traumatic event, before the memory of the event fully consolidates (the process by which an experience becomes a stable, long-term memory), could prevent posttraumatic stress disorder (PTSD) from developing. The intervention was a modified version of prolonged exposure (PE), a therapy that reduces conditioned fear responses by having a person repeatedly revisit a feared memory in a safe setting until the fear response diminishes, a process known as fear extinction. Because most PTSD treatments begin only after symptoms are already established, this trial tested the therapy as prevention rather than as treatment of chronic illness. Participants were adults aged 18 to 65 who arrived at a Level One trauma center emergency department within 72 hours of a qualifying trauma; 137 were randomly assigned to three one-hour sessions of modified PE, delivered one week apart and beginning in the emergency department, or to assessment only. The modified PE sessions involved guided recounting of the trauma memory, discussion of the traumatic experience, and take-home exposure exercises. Blinded evaluators measured posttraumatic stress severity with a structured clinical interview (the PSS-I) and depression with a standard self-report questionnaire (the BDI-II) at 4 and 12 weeks after enrollment. Participants who received the intervention reported significantly lower posttraumatic stress severity than the assessment-only group at 4 weeks (19.09 vs. 24.54 points, p = 0.02 for the overall treatment effect) and 12 weeks (15.47 vs. 20.33 points), representing a medium-sized benefit (Cohen's d of 0.34 to 0.38, a standard measure of effect strength where 0.2 is considered small and 0.8 is considered large). By 12 weeks, significantly more intervention participants no longer met PTSD criteria than controls (74% vs. 53%, p = 0.04). Depression scores at 4 weeks were also significantly lower in the intervention group (p < 0.01, d = 0.35). The benefit was largest among rape victims, who showed a large effect (d = 0.70) at 4 weeks, notable because sexual assault carries among the highest known risk of developing PTSD. The intervention did not significantly reduce symptoms tied to participants' earlier, unrelated traumas, suggesting its effect was specific to the event that brought them to the emergency department. The findings suggest that exposure-based psychotherapy can be safely delivered within hours of trauma, in an emergency department, before a traumatic memory becomes consolidated. The authors note important limitations: no baseline PTSD measure was collected, since assessing symptoms so soon after trauma was judged invalid, so only between-group comparisons were possible; the sample was pilot-sized and not powered for smaller effects; and roughly a quarter to a third of participants did not complete follow-up assessments. The authors describe the results as establishing feasibility and call for larger replication trials.

Veerle Oosterbaan et al. (2019) · European journal of psychotraumatology

This systematic review and meta-analysis explored whether psychological help offered within 3 months of a sexual assault can reduce or prevent posttraumatic stress disorder (PTSD), a condition in which distressing memories, avoidance and heightened alertness persist after trauma. The authors searched six databases for studies from 1980 to April 2018, and excluded psychological debriefing because earlier work found it harmful. They report that this narrow question had not been reviewed before. Seven studies with 350 participants met the criteria and tested five different early interventions, a small evidence base that the authors describe as diverse in design and timing. The included studies were mostly of women in high-income countries, with average ages of 22 to 34, recruited through hospitals, forensic examinations or counselling centres. Interventions ranged from a single 9- or 17-minute educational video to a 113-minute EMDR session (eye movement desensitization and reprocessing, in which a person recalls a trauma while following guided eye movements), a modified prolonged exposure session (structured, repeated recalling of the trauma), cognitive restructuring with relaxation, and six weeks of cognitive processing therapy. Two authors independently screened studies and rated risk of bias; four studies compared with standard care were pooled. Pooling four studies, early intervention did not clearly reduce PTSD severity at 1 to 6 weeks (g = -0.28, 95% CI -0.57 to 0.02; g is a standardized effect size, where negative favors intervention), though all four leaned that way. At 2 to 12 months, a small effect just reached significance (g = -0.23, 95% CI -0.46 to 0.00), with no measured heterogeneity. Two studies that compared PTSD diagnoses found no difference between groups. Safety data were thin: only two studies reported adverse events, and none used an active strategy to detect harm, though author contact turned up no serious events. All seven studies were judged at high risk of bias, and true randomization occurred in only two of the five studies that compared treatment groups, which the authors link to a high risk of selection bias. The authors suggest that early interventions may lead to lasting reductions in PTSD severity after sexual assault, but state that definite conclusions about safety, efficacy and PTSD prevention are impossible with so few, heterogeneous, high-risk-of-bias studies. They also note that the studies used older PTSD definitions from DSM-III-R and DSM-IV. They call for trials that actively track harm, report PTSD diagnoses as well as symptom scores, compare early with later treatment, and consider cost and access for survivors.

Milou L V Covers et al. (2021) · European journal of psychotraumatology

This randomized controlled trial with 57 recent rape victims explored whether early eye movement desensitization and reprocessing (EMDR) therapy reduces post-traumatic stress more effectively than watchful waiting, the standard wait-and-monitor approach used at Dutch sexual assault centres. EMDR is a trauma-focused psychotherapy in which a therapist guides bilateral eye movements while the person recalls a distressing memory, aiming to reduce the memory's vividness and emotional charge. Watchful waiting, by contrast, involves brief check-ins, psychoeducation, and emotional support without active trauma processing. About 40% of rape victims develop post-traumatic stress disorder (PTSD) within three months, making the timing and content of early support clinically significant. Fifty-seven participants (56 women, one man; average age about 26) were randomly assigned, between two and four weeks after a rape, to either two sessions of EMDR therapy (3.5 hours total, using a protocol adapted for very recent trauma) or two brief supportive phone calls with a case manager. Symptoms were measured before treatment, right after treatment, and again at 8 and 12 weeks using clinician-rated and self-report scales covering post-traumatic stress (CAPS-5, PCL-5), anxiety and depression (HADS), dissociation (DTS), general psychological symptoms (BSI), and sexual functioning (FSFI, AOPFS). Both groups improved substantially over the 12 weeks (large effect sizes, Cohen's d around 1.5, meaning both approaches were followed by a large drop in symptoms), but EMDR was not more effective than watchful waiting for post-traumatic stress symptoms at any time point (no statistically significant difference, p > .05 throughout). EMDR did show a short-lived edge over watchful waiting on anxiety (a 2.25-point lower score on the Hospital Anxiety and Depression Scale immediately after treatment, p = .023) and on dissociative symptoms (p = .013), but both advantages faded by the 12-week follow-up. No meaningful differences emerged between the two approaches for depression, general psychological symptoms, sexual functioning, or feelings of guilt and shame. By 12 weeks, fewer EMDR participants still met PTSD diagnostic criteria than watchful-waiting participants (16% versus 35%), though this difference was not formally tested for significance. One EMDR participant left the study after an increase in suicidal thoughts and received care; the treatment was otherwise well tolerated. The authors conclude that two sessions of early EMDR conferred no lasting advantage over watchful waiting for recent rape victims and, given its lower cost, state that the findings support existing guidance favoring watchful waiting as the default early response. The comparison involved an active watchful-waiting condition rather than no treatment, so the trial cannot show whether either approach outperforms natural recovery. The sample was small, mostly female, and experienced considerable dropout (21 of 57 participants), limiting how far the results generalize to other populations. The authors call for further research into watchful waiting's own effectiveness as an early intervention.

Lei Yi et al. (2022) · Journal of translational medicine

This randomized controlled trial with 94 women explored whether a 12-week yoga program could ease symptoms of post-traumatic stress disorder (PTSD, a condition marked by intrusive memories, avoidance of reminders, and heightened arousal following a traumatic event) after a motor vehicle accident. All participants had PTSD tied specifically to a car, motorcycle, or pedestrian accident that occurred at least three months earlier. The intervention used Kripalu yoga, a style emphasizing gentle self-observation and the connection between mind and body rather than intensive physical exertion, compared against an active control condition built around social conversation and board games. Ninety-four women were randomly assigned to a yoga group (47) or control group (47); 37 and 39, respectively, completed the trial through a 3-month follow-up. The yoga group attended six 45-minute sessions across 12 weeks, practicing breath awareness, body-focused attention during postures, and tolerance of physical discomfort under a yoga instructor's guidance. The control group met on the same schedule for daily-life conversation and games. Psychological distress was measured with two self-report instruments, the Depression Anxiety Stress Scales (DASS-21) and the Impact of Event Scale-Revised (IES-R), completed at baseline, immediately after the program, and three months later. After the program, the yoga group's total IES-R score, covering intrusion, avoidance, and hyperarousal symptoms, was significantly lower than the control group's (p = 0.01, meaning the difference was unlikely due to chance), with the difference concentrated in intrusion (p = 0.002) and avoidance (p < 0.001) rather than hyperarousal, which did not differ significantly. Intrusion and avoidance remained significantly lower in the yoga group three months later (p = 0.037 and p = 0.005). On the DASS-21, total distress scores were significantly lower in the yoga group both immediately after the program (p = 0.043) and at three-month follow-up (p = 0.024), with depression (p = 0.033, then p = 0.004) and anxiety (p < 0.001, then p = 0.035) each significantly reduced compared with control. The stress subscale of the DASS-21 showed no significant difference between groups at either timepoint. Both groups improved somewhat over time, including the control group, which the authors attribute partly to the social contact built into the comparison condition. The authors describe the results as preliminary evidence that a structured yoga program reduced depression, anxiety, and the intrusion and avoidance symptoms of PTSD in women following a motor vehicle accident, while finding no measurable effect on stress or hyperarousal. The trial enrolled a relatively small, single-site sample of Chinese women, tested only one yoga style, and relied entirely on self-report questionnaires rather than clinician-rated diagnostic measures. The authors point to comparing yoga styles and isolating which specific session components drive symptom change as directions for future research.

Peter J Bayley et al. (2022) · BMJ open

This parallel-group, randomised non-inferiority trial with 85 military veterans explored whether Sudarshan Kriya Yoga (SKY) -- a structured program of breathing exercises (pranayama) and meditation -- works as well as cognitive processing therapy (CPT), a standard trauma-focused psychotherapy, for reducing post-traumatic stress disorder (PTSD) symptoms. PTSD is a condition that can develop after a traumatic event, involving re-experiencing, avoidance, and heightened arousal. A non-inferiority design tests whether a new approach is not meaningfully worse than an established one, rather than whether it is better, which is appropriate when the existing treatment is already known to be effective. Veterans (88% men, average age 57) with elevated PTSD symptom scores were randomly assigned to SKY (n=41) or CPT (n=44) at a Veterans Affairs outpatient clinic. SKY was taught in small groups over a five-day intensive workshop plus ten weekly sessions (25 hours total), combining five distinct breathing techniques with meditation. CPT consisted of twelve individual sessions over six weeks (12 hours), focused on shifting trauma-related thinking patterns. Symptom severity was measured with the PTSD Checklist-Civilian Version (PCL-C), alongside depression (Beck Depression Inventory-II) and mood (Positive and Negative Affect Schedule). Both treatments reduced PTSD symptoms by the end of six weeks (CPT: -6.8 points, effect size d=0.58; SKY: -5.6 points, d=0.41), and the small gap between them (-1.2 points, 95% CI -5.7 to 3.3) fell safely within the study's 10-point margin for calling SKY "not meaningfully worse" -- a pattern that held at 1 month and 1 year. SKY also matched CPT on depression and mood scores through the 1-month mark, though CPT pulled ahead on both by 1 year. Dropout was similar overall (SKY 27% vs CPT 34%), and among veterans who attended at least one session, fewer left SKY (9%) than CPT (29%). Two adverse events occurred in the CPT group (treatment-related distress; a hospital admission for suicidal ideation); none were reported in the SKY group. The authors describe these results as preliminary support for SKY as a non-trauma-focused option for veterans with PTSD symptoms, comparable in the short term to an established first-line therapy. They note SKY involved roughly twice the contact time of CPT, the trial ran at a single site with a moderate sample of 85 participants, and CPT's own effect size was smaller here than in some earlier veteran studies. The authors state that SKY warrants further clinical and research attention.

Waqar Husain et al. (2026) · Brain and behavior

This systematic review of 105 studies examined how religious and spiritual practices -- meditation, prayer, chanting, ritual, and mystical experience -- show up in brain scans. It pooled evidence across eight traditions (Buddhism, Christianity, Islam, Hinduism, Santo Daime, Spiritism, Sant Mat, and mixed traditions) and seven brain-imaging methods, filling a gap left by earlier reviews that each covered only one practice or one faith. Neurotheology, the scientific study of how spiritual experience relates to brain function, asks whether these ancient practices leave a measurable, functional signature on the nervous system. Researchers searched three major databases from their earliest records through mid-2026 and found 450 candidate studies; after removing duplicates and screening for eligibility, 105 studies remained. Each had to study real human participants using an objective brain-measurement tool -- functional or structural MRI, EEG, MEG, PET, SPECT, or similar -- during an actual religious, spiritual, or contemplative practice, not passive exposure to religious words or images. Because the studies varied enormously in tradition, practice, and method, the team combined findings narratively rather than statistically averaging them. Meditation studies (the largest group, 35 studies) consistently found quieter activity in the brain's default mode network, the circuit active during mind-wandering and self-focused thought, alongside more efficient attention-related brain activity in long-term practitioners. Prayer (21 studies) activated brain regions used for understanding other people's minds when prayer was personal and improvised, suggesting the brain treats sincere prayer like a real conversation, and activated reward circuitry during peak spiritual feelings among some worshippers. Chanting and recitation (25 studies) calmed emotional brain circuits -- OM chanting, for example, reduced activity along the same pathway targeted by an approved medical nerve-stimulation therapy. Mental-health-relevant findings (14 studies) included a randomized trial in which loving-kindness meditation eased depression symptoms in diagnosed patients, and a mindfulness program that lowered stress-hormone levels months later. Eleven studies of unusual states -- near-death imagery, ayahuasca ceremonies, and trance -- showed the most widespread brain-network changes of any practice type. The review's authors state plainly that religious and spiritual practices are neurologically real, measurable behaviors, not just subjective reports, and that the brain circuits they engage overlap with those disrupted in depression, anxiety, and addiction. They stop short of claiming these practices treat any diagnosed condition, since most studies involved healthy volunteers rather than patients. The search covered only English-language, peer-reviewed studies, and the wide variety of traditions and methods meant the team could describe patterns but not calculate a single combined effect size.

Uttam Kumar et al. (2021) · Scientific reports

This cross-sectional study with 50 male participants explored whether decades of intensive oral memorization can leave a lasting signature on brain structure. It compared 25 Hindu Vedic pandits -- priests and scholars trained from childhood to recite over 20,000 Sanskrit mantras and verses from memory -- against 25 closely matched non-pandit controls. Vedic recitation follows a strict oral tradition (shruti-parampara): hymns are learned entirely by ear, using several formal recitation methods that reorder and repeat words to lock in exact pronunciation and sequence. The study asked which brain regions differ after such training -- regions governing memory, breath control, and precise speech articulation. Fifty right-handed men aged 21-28 took part: 25 pandits who began Vedic schooling around age ten and had logged nearly 17,750 hours of recitation training, and 25 controls matched for age, Sanskrit fluency, and general intelligence. All participants completed a 3-Tesla structural MRI brain scan, analyzed for grey- and white-matter volume, cortical thickness, and the folding pattern (gyrification) of the brain's surface. Memory was measured with the PGI-Memory Scale, a tool standardized for Indian populations covering immediate recall, attention, and retention. Pandits recalled significantly more information immediately after learning it than controls (a score of 11.2 versus 8.7, a large and statistically reliable gap), and this recall advantage tracked closely with the volume of grey matter in the thalamus (more volume, better recall). Brain scans showed pandits had more grey matter in the midbrain, pons, thalamus, and right frontal and pallidum regions -- areas tied to auditory processing, breath regulation, and sustained attention. They also had more white matter near the hippocampus and in frontal and temporal regions supporting memory consolidation, a thicker cortex in areas linked to emotional processing (temporal pole) and memory retrieval (caudate), and more surface folding in regions that coordinate speech articulation (insula, supplementary motor area). The longer a pandit had spent teaching Vedic recitation after training, the more grey matter he had in the angular gyrus, a region tied to retrieving well-learned verbal material. The authors interpret these differences as reflecting the specific mental and physical demands of Vedic training -- precise auditory memory, controlled breathing, and articulate speech -- rather than a single, generic meditation effect. Because the study compared existing groups at one point in time rather than tracking pandits before and after training, it cannot rule out that people with certain brain traits were more likely to complete Vedic schooling in the first place. The sample was small, male-only, and drawn from one religious and linguistic community, limiting how broadly the findings apply.

Jonathan Greenberg et al. (2025) · JAMA network open

This feasibility randomized clinical trial with 92 sedentary adults experiencing chronic musculoskeletal pain explored whether a mind-body walking program could be delivered successfully across three geographically and racially diverse U.S. academic medical centers, compared with a health education program. The mind-body walking program combined quota-based pacing — increasing step-count goals gradually based on what participants could sustain, rather than tying goals to whether pain was present — with mind-body skills such as breathing exercises and body scans, and cognitive skills aimed at identifying and reframing unhelpful pain-related thoughts. The trial measured physical function in three complementary ways (self-reported, performance-based, and step-count-based), addressing a gap identified in pain-trial reporting guidelines. Participants were randomized 1:1 to the 10-week, 60-minute weekly group mind-body walking program (47 participants) or a matched health-education control (45 participants), recruited between April 2023 and January 2024. The mind-body group received a Fitbit Inspire 3 tracker with individualized weekly step goals. Physical function was measured with the 6-Minute Walk Test, a wrist-worn accelerometer worn for one week, and the World Health Organization Disability Assessment Schedule. Pain, mood, and psychological mechanisms — pain catastrophizing, fear of movement, adaptive coping, and mindfulness — were measured with validated questionnaires before and after the program. Both programs met most feasibility benchmarks, including attendance (95.7% mind-body walking vs 82.2% health education), delivery fidelity, and participant retention (93.6% vs 86.7%). Racial and ethnic diversity exceeded its target (54.3% of participants from minority groups, against a 38% benchmark), though overall recruitment fell short (69.7% of eligible patients enrolled, against an 80% target). Within the mind-body walking group, participants showed large pre-to-post improvements in walking distance (48.6 meters over six minutes, P<.001), self-reported physical function (P<.001), and pain catastrophizing (P<.001), plus medium improvements in pain intensity (P=.002) and fear of movement (P<.001), and smaller but significant improvements in adaptive coping and mindfulness (both P<.05). The health education group improved only on walking distance and pain intensity. Because the trial was not statistically powered to compare the two programs against each other, these within-group changes describe what happened in each arm rather than a demonstrated advantage of one program over the other. The trial establishes that a mind-body walking program can be delivered with strong attendance and participant satisfaction across diverse academic medical centers, supporting a future, fully powered efficacy trial. The findings do not establish that the mind-body walking program produces greater benefit than health education, since the study was designed to test feasibility rather than comparative outcomes. The gap between eligible and enrolled participants (69.7% versus an 80% target) points to recruitment timing as an area for refinement in future trial designs.

Hong Xu et al. (2024) · Menopause (New York, N.Y.)

This meta-analysis pooled 11 randomized trials testing whether mind-body exercise programs, including tai chi, yoga, Pilates, qigong, and mindfulness-based stress reduction (MBSR, an 8-week meditation and gentle-movement program), help women going through perimenopause or postmenopause, a life stage marked by declining estrogen that can weaken bones, disrupt sleep, and affect mood. These practices pair physical movement with controlled breathing and present-moment attention, offering a non-drug alternative for women wary of hormone therapy's cancer-risk profile. The review combined 11 trials from six countries, involving just over 1,000 women, comparing mind-body exercise groups against women who continued their normal daily activities without a structured exercise program. The trials varied widely, from 6-week programs to a full year, and used five different practices, so results were combined statistically using methods that account for this variety. Across the pooled data, mind-body exercise meaningfully helped on every measure studied: bone density improved (drawing on Pilates and tai chi trials), sleep quality improved (drawing on Pilates, yoga, qigong, and MBSR trials), and both anxiety and depression symptoms dropped substantially (also drawing on that same four-practice group), while fatigue eased too. The anxiety and depression improvements were the largest effects seen, though the studies contributing to them varied considerably in their findings (a statistical marker called heterogeneity was high), meaning some trials showed much bigger benefits than others. Taken together, the findings support mind-body exercise as a safe, reasonable option for managing the physical and emotional challenges of the menopause transition, giving women another evidence-based choice beyond hormone therapy. Because the analysis pooled several different practices together rather than testing each one separately with its own effect size, it shows that mind-body exercise as a category helps, without pinpointing exactly how much benefit comes from any one specific practice like yoga versus tai chi. The individual trials were also generally small and only partially blinded, since exercise programs are hard to disguise from participants.

Daniel C Cherkin et al. · JAMA

This randomized clinical trial with 342 adults explored whether an eight-week mindfulness-based stress reduction (MBSR) program — training in meditation, body awareness, and yoga — could ease chronic low back pain as effectively as cognitive behavioral therapy (CBT), a well-established talk-therapy approach that helps people change pain-related thoughts and behaviors. Both interventions govern how the nervous system processes and responds to persistent pain signals, but through different mechanisms: MBSR through non-judgmental present-moment awareness, CBT through restructuring unhelpful thought patterns. Participants had lived with low back pain for an average of over seven years. Adults aged 20 to 70 (mean 49, two-thirds women) with pain lasting at least three months were randomly assigned to MBSR, CBT, or usual care. Both active groups met weekly for eight two-hour sessions — MBSR practiced body scans, sitting and walking meditation, and gentle yoga, while CBT focused on identifying unhelpful thoughts, relaxation training, and pacing daily activities. Improvement was measured with the Roland Disability Questionnaire (a 23-item scale of pain-related function) and a 0-10 pain-bothersomeness rating, checked by blinded interviewers at 8, 26, and 52 weeks. At the six-month mark, 61% of the MBSR group and 58% of the CBT group showed clinically meaningful improvement in function, compared with 44% of the usual-care group (a statistically significant difference, p=0.04, meaning the pattern was unlikely to occur by chance). Pain bothersomeness improved meaningfully for 44% of MBSR participants and 45% of CBT participants, versus 27% on usual care (p=0.01). MBSR was about 1.4 times more likely than usual care to produce meaningful functional improvement, and both active treatments held their advantage a full year later. On mood measures, CBT edged out MBSR at some points, though both beat usual care through six months. Roughly 3 in 10 MBSR participants and 1 in 10 CBT participants reported a temporary increase in discomfort — most often stiffness or soreness from yoga or relaxation exercises — with no serious safety concerns in either group. The trial suggests MBSR works about as well as CBT for chronic low back pain, giving people a second evidence-based option beyond conventional pain therapies. Only about half of participants attended six or more of the eight sessions, hinting the benefits may not require full completion. The study was conducted at a single US healthcare system among a fairly well-educated population, so how the findings translate to other settings, or to CBT delivered one-on-one rather than in groups, is not yet known. The authors call for further work on cost-effectiveness and long-term durability beyond one year.

Aibo Li et al. (2025) · Frontiers in public health

This study tested whether spending three days in a forest could help lower blood pressure in older adults who already have essential hypertension (high blood pressure with no single identifiable cause). Thirty-six adults aged 60 to 80 with diagnosed hypertension took part: 24 went to a subtropical forest national park in China for a 3-day retreat, while 12 stayed in the city of Hangzhou following the same daily schedule, so researchers could compare the two settings directly. The forest group took part in daily gentle activities designed to immerse them in nature: eight trigrams boxing (a slow, breath-focused Qigong practice), a few hours of guided forest walking, a traditional tea ceremony, and a meditation session. Both groups ate the same meals and kept the same schedule. Before and after the trip, researchers measured blood pressure, heart rate, blood oxygen, heart-rate variability (a marker of nervous-system balance), several inflammation and stress-hormone markers in the blood, and mood using a standard questionnaire. After the trip, the forest group's blood pressure was significantly lower than the city group's, both the top number (systolic, ~134 vs. 147) and bottom number (diastolic, ~78 vs. 85). Inflammation, measured by a sensitive CRP blood test, was also significantly lower in the forest group. Heart-rate variability shifted in a pattern the researchers interpreted as a healthy autonomic-nervous-system adjustment for this population. On mood, the forest group reported significantly less tension and anxiety and significantly more energy and vitality than the city group; other mood measures trended better but weren't statistically significant. Heart rate, blood oxygen, and most other blood markers (IL-6, cortisol, oxidative-stress markers) didn't differ significantly between the groups. These results suggest a short forest retreat combining gentle nature-based activities may meaningfully help lower blood pressure, ease inflammation, and improve mood in older adults with hypertension, as a complement to standard care. Because the forest program bundled several practices together (forest walking, qigong, meditation, tea ceremony) and compared a larger forest group to a much smaller city group in a different location, it's hard to know how much came from the forest setting itself versus the other activities. The trial only lasted three days, so it can't say whether the benefits last, and larger, longer studies are needed before forest bathing becomes a standard recommendation for hypertension.

Galib Ruknuddin et al. (2026) · JMIR research protocols

This paper is not a study of a treatment — it is a detailed, PROSPERO-registered plan (protocol) for a future systematic review that will evaluate India's AYUSH traditional medicine systems (Ayurveda, yoga and naturopathy, Unani, Siddha, Sowa Rigpa/Tibetan medicine, and homeopathy — governing prevention and personalized care) for managing prediabetes and type 2 diabetes. Diabetes affects roughly 537 million people worldwide, a number expected to more than double by 2050, and India alone had over 74 million cases in 2021 — with about half going undiagnosed — making a clear-eyed evidence review of its traditional treatment options a genuine public-health priority. Once underway, two independent researchers will search major databases (PubMed, Scopus, Web of Science, Embase) plus AYUSH-specific sources, screening for studies conducted in India that test any of these six systems — whether used alone or alongside standard diabetes care — measuring outcomes like blood sugar levels (fasting and after meals), long-term blood sugar control (HbA1c), and insulin resistance, alongside safety data. As of this publication, there are no results to report (the review had not yet started; database searching was planned for September 2025). What the protocol does establish is exactly how quality will be judged: each study will be scored with standard tools (from the NIH, and the Cochrane risk-of-bias tool for randomized trials) and then sorted into a visual "evidence map" — graded green, yellow, or red by the World Health Organization's A/B/C evidence-quality scale — showing at a glance where each traditional system has strong support and where the gaps are. The completed review and its findings are expected around December 2026, with publication in early 2027. For now, the practical takeaway is that this protocol tells us what will be studied and how carefully, not what was found. Until the finished evidence map is published, none of the six systems named here has established evidence for diabetes management; the protocol itself states upfront limitations even for the eventual review: English-language sources only, India-based studies only, and no pooled statistical meta-analysis planned.

Nima Javadzade et al. (2024) · BMC public health

This randomized controlled trial with 60 depressed older adults living in nursing homes in Isfahan, Iran, explored whether an 8-week Mindfulness-Based Stress Reduction (MBSR) program could ease depression, improve emotion regulation, and reduce sleep problems. MBSR is a structured group program, originally developed for stress and chronic illness, that trains people to notice thoughts, emotions, and body sensations without judgment through practices like body scanning and gentle movement. Emotion regulation here covers two distinct skills the study measured separately: cognitive reappraisal (reinterpreting a situation to change its emotional impact) and expressive suppression (holding back outward emotional expression), the latter generally considered a less adaptive coping strategy. Participants, referred by geriatricians and screened with the Geriatric Depression Scale, were randomly split into an MBSR group (30 people, average age 66) and a no-treatment control group (30 people, average age 67); 60% of each group were women. The MBSR group attended eight weekly 90-minute sessions with a certified instructor, practicing body scans, mindful movement, loving-kindness meditation, walking meditation, and mindful eating, plus home practice between sessions. Before the program and one week after it ended, both groups completed the Geriatric Depression Scale, the Emotion Regulation Questionnaire, and the Pittsburgh Sleep Quality Index. After 8 weeks, the MBSR group showed significantly lower depression scores than the control group (adjusted averages 6.28 vs. 8.82, p<0.001), with a large effect size (partial eta squared=0.57, meaning the intervention accounted for over half the variance in the outcome). Emotion regulation shifted favorably on both subscales: cognitive reappraisal rose (22.67 vs. 20.36, p<0.001) while expressive suppression fell (12.32 vs. 15.65, p<0.001, partial eta squared=0.56) — a pattern consistent with Gross's emotion regulation model, in which stronger reappraisal skills reshape an emotional response early, reducing reliance on effortful suppression later. Sleep quality also improved, with lower Pittsburgh Sleep Quality Index scores in the MBSR group (11.58 vs. 13.35, p<0.001), which the authors link to MBSR increasing attentional control over the automatic arousal and rumination that disrupt sleep. All four outcomes reached statistical significance with observed power near 1.00 (a near-certain ability to detect a true effect). For nursing-home psychologists and caregivers, MBSR appears to be a practical, side-effect-free complement to standard depression care for older residents, requiring only a certified instructor and a weekly 90-minute time commitment. Limitations are real: outcomes relied entirely on self-report in a population prone to inaccurate self-assessment, the control group received no intervention at all rather than an active comparison, there was no follow-up beyond one week, and the sample was limited to depressed nursing-home residents in Iran. Future research should add objective measures and longer follow-up before these findings are treated as conclusive.

Gert Bronfort et al. (2022) · Chiropractic & manual therapies

Low back pain touches an estimated 40-80% of adults at some point, and when it becomes chronic, it is a major driver of disability, missed work, and long-term opioid use. Guidelines recommend combining conventional care with complementary approaches like spinal manipulation, exercise, and acupuncture, but most back pain treatment in practice still relies on a single approach. This year-long randomized trial in Minneapolis compared standard chiropractic care against a coordinated team approach -- chiropractors, acupuncturists, massage therapists, psychologists, exercise therapists, and a physician working together -- to see whether combining disciplines beats chiropractic care alone for people with ongoing low back pain. 201 adults with long-standing back pain (on average, pain for 8 to 9 years) were randomly assigned to 12 weeks of either chiropractic-only care or the multidisciplinary team approach, with a case manager coordinating each patient's individualized plan. Both groups showed strong participation -- over 90% attended their recommended visits. Researchers tracked back pain intensity as the main outcome, alongside disability, quality of life, and patient satisfaction, checking in at 4, 12, 26, and 52 weeks after the study began. Over the full year, the team-based approach edged out chiropractic-only care on pain intensity, with the clearest advantage showing up at the one-year mark. The team approach also showed a meaningful, statistically significant advantage for disability, overall improvement, satisfaction with care, and how often people experienced back symptoms -- though pain relief itself, while favoring the team approach throughout, only reached statistical significance at certain checkpoints (mainly week 52). Things like quality of life, medication use, and fear of movement did not differ meaningfully between the two approaches. Both approaches were very safe: only five serious health events occurred over the year (mostly unrelated conditions like pneumonia or a fractured foot), and about half of participants in both groups reported mild, temporary side effects like increased soreness -- at nearly identical rates whichever approach they received. In people with chronic low back pain, this trial found that a coordinated team of practitioners — rather than chiropractic care alone — gave a modest edge, mainly on disability and overall satisfaction, without added safety risk. That said, the study's participants were not very racially or economically diverse, and the exact process used to decide each patient's treatment plan had not itself been formally validated, so the results may not translate perfectly to every clinic. Still, the findings support integrated, team-based care as a reasonable option on the evidence here.

Dilara Onan et al. (2025) · Journal of oral & facial pain and headache

Chronic tension-type headache (CTTH) -- headaches on 15 or more days a month for at least three months -- is thought to involve tight, tender muscles in the head, neck, and face, though scientists are not fully certain why it happens. This systematic review and meta-analysis pulled together randomized trials testing physiotherapy-style treatments -- things like massage, exercise, acupuncture, and relaxation training -- to see whether they actually ease CTTH symptoms. The researchers followed a pre-registered research plan and searched two major databases through mid-2024, aiming to answer a focused question: do these hands-on and movement-based approaches beat sham treatment, no treatment, or medication alone? Two physiotherapist researchers with PhD degrees independently screened 237 studies and settled on nine randomized trials -- ranging from 25 to 169 patients each, mostly women, treated for 3 to 12 weeks. The approaches tested included trigger point massage, electroacupuncture, relaxation with muscle-tension biofeedback, yoga, and neck-and-shoulder strengthening exercises, among others. Seven of the nine trials had comparable enough data to combine mathematically (meta-analysis), and each study's methodological rigor was scored using a standard 11-item checklist. When the researchers pooled the numbers, physiotherapy approaches meaningfully reduced headache intensity compared to control (a large, statistically significant effect), cut the number of headache days per month by more than one day on average, and shortened how long headaches lasted -- all statistically significant improvements. A fourth measure, day-to-day headache impact on daily life, trended in favor of physiotherapy but did not reach statistical significance. Looking at individual studies: electroacupuncture beat sham treatment for headache intensity; combining a hands-on release technique with ibuprofen worked better than ibuprofen alone; and yoga added to standard medical care outperformed medical care by itself on several measures. Importantly, though, the researchers rated their overall confidence in these pooled results as low to very low -- the studies were small, methods varied a lot between them, and most carried some risk of bias. No serious side effects were reported in any trial. The takeaway is cautiously encouraging: physiotherapy-based approaches -- especially those combining exercise, hands-on techniques, or relaxation training with standard care -- show a real signal for easing CTTH symptoms, and they appear safe. But because the underlying evidence is still thin and inconsistent, these findings should not be read as proof that any one specific technique is the best choice. The authors call for larger, more consistently designed trials before physiotherapy can be confidently recommended as a primary CTTH treatment, though the current evidence supports trying it as a reasonable, low-risk complement to standard care.