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 THE  YOGA AND COGNITIVE FUNCTIONS. 

  With age, memory is more and more "dynamic": we have just taken the time to learn something, that everything is already forgotten  ”.
                                                                                               Voltaire

 

The growing number of patients with  cognitive disorders  and dementia in general, justifies the name given by the WHO  in the 21st century: “a century of cognitive problems”. [1] 

The
  cognitive function of the brain  - it is his ability to understand, learn, study, recognize, perceive and digest external information. These are the functions of the central nervous system, providing the higher nervous activity, without which the human personality would be lost [2]. There is a concept of the so-called "intelligence standard" - where everyone has their own indicators of  cognitive development, the decline of which is always individual.
 

It has been shown that a high level of intelligence and its continuous training throughout life directly determine the rate of  cognitive decline in a patient, in the case of a potentially irreversible, progressive disease. In the case of Alzheimer's disease, in the patient with a high level of  intellectual development, and the habit of exercising mental operations, we will observe over a longer period of constant flow of the disease, a reduced rate of progression, compared to patients with a low level of education and a lack of intellectual formation throughout life.

 

Presumably, this phenomenon is the result of additional formations of neuronal and synaptic connections, as well as the involvement in the learning process of a larger population of neurons in people who perform mental work. [3]
 

To determine the presence of a  cognitive dysfunction, we consider the initial level of the patient, and we question the patient and his relatives. The analysis of the mental state based on different tests is carried out by a neurologist and a psychiatrist. Attention, reproduction of information, memory, mood, following instructions, imaginative thinking, writing, arithmetic, reading are tested. 
The most common are the following tests: a short scale
  MSE  (Mini-Mental State Examination) - 30 questions for an estimated assessment of  cognitive function; the Dementia Rating Scale (Large Scale Clinical Dementia -  CDR) is based on a study of disorders of orientation, memory, interaction with others, behavior at home and at work, and being alone.

 

Also, in the presence of  cognitive deficits  acquired from the patient, it is necessary to perform laboratory tests, CT, MRI and other neuroimaging tests of the brain.

For treatment, medication is often prescribed, a diet low in cholesterol and it is advisable to eliminate tobacco and alcohol [4].

 

Finally, discussing the features of the treatment of patients with cognitive disorders, experts in modern evidence-based medicine emphasize that we should not forget about the possibilities of correction by non-pharmacological methods. These methods include intellectual activity, cognitive training, therapeutic methods of influence - the  cognitive stimulation  and cognitive behavioral therapy, as well as physical activity of course [5].

 

Modern medical science has long been involved in studying the beneficial effects of exercise on cognitive function; for example, in 2014 the American Journal of Pediatrics published the results of a study led by Professor Charles Hillman (Charles Hillman). The study concludes that 60 minutes of physical activity per day, after school, is useful not only for the physical health of children, but is also able to create a beneficial effect on their cognitive function [6].

 

Finally, I suggest that you move on to the subject that interests us - the  yoga. Let's analyze research on the impact of  Yoga  on higher mental functions.

In this article, we will study the  yoga  and the  meditation. It is noted that the  meditation  certainly plays a positive role in promoting mental well-being, as well as improving attention and other  cognitive abilities. Furthermore, the preliminary analysis showed positive effects of meditation on attention, memory, executive functions, information processing speed and general knowledge in the test age group (where it was already noted a great cognitive decline and the presence of degenerative diseases).

 

About the  yoga, it has been effective as an additional factor in reducing stress, depressive symptoms, controlling emotions, improving mood, well-being and quality of life. It was concluded that the  yoga and meditation  are safe and effective traditional methods for improving cognitive functions  and their use should be encouraged. [7]

 

Study No. 1

Here is a randomized study involving 84 people between 18 and 25 years old, who were divided into 3 groups:

  • a group performs  fast pranayama

  • a group performs  slow pranayama

  • a control group
     

It should be noted that people who have already practiced the  yoga, were not included in this study. 
This lasted 12 weeks, with 3 sessions per week, lasting an average of 30 minutes. For a week prior to the study, participants were trained in special techniques of
  pranayama  under the guidance of a qualified teacher. Classes were held in a quiet room at a comfortable temperature and included the following:


The  fast pranayama  was composed of four cycles with the following sequence: 
- 1 minute Kapalabhati - 1 minute rest
 
- 1 minute Bhastrika - 1 minute rest
 
- 1 minute of Kukkuriya ("panting breath") -
  1 minute rest
For a total of
  24 minutes.


The  slow pranayama  was composed of three cycles with the following sequence: 
- 2 minutes Nadi Sodhana - 1 minute rest
 
- 2 minutes Pranava (mantra repetition
  OM (AUM)) - 1 minute rest 
- 2 minutes Savitri (the Gayatri Mantra) - 1 minute rest
For a total of 27 minutes.
 

During the performance of the pranayamas, the participants sat in
  Sukhasana.

The results were evaluated with the following parameters:

LCT  (letter cancellation test) - crossed out letter test (a test for attention, the patient is instructed to cross out some letters: e.g. capital letters and B,N and E) in the text during 60 seconds. We take into account the number of crossed out letters and the number of omissions..);

MSDS, RDS  (direct and reverse memorization of numbers) - test on memorization of numbers, which is used as one of the tests for memory and cognitive abilities;

ART  - auditory reaction time test;

VRT-R  (visual reaction time for red) - reaction time on the appearance of red color;

TRV-G  (visual reaction time for green) - visual reaction time to the appearance of the color green (these tests also measure the level of concentration and stress response).


Having analyzed the data, we can say that the results of the rapid response on the test of  LCT  increased in the group of  slow pranayama, and the omission of letters and errors increased in the group of  quick pranayama. 
Thus, these tests can help us to conclude that the
  slow pranayama  increases our ability to concentrate.

The tests  MSDS  and  RDS  showed almost identical results in both groups.
The test results
  ART  were slightly higher in the group  slow pranayama, plus tests  VRT-R  and the  TRV-G  - their performance increased significantly in the group of  slow pranayama  compared to the fast. 

Of course, the results
  of the two groups, practicing the  Pranayama, was significantly different from  control group  by improving performance.

An interesting effect was demonstrated by the group of  rapid pranayama, dramatically reducing auditory and visual reaction time in the  RT test, and improving participants' concentration. 
The authors thus conclude that the slow and fast forms of
  pranayama  can be useful for  reduce stress  and  improve cognitive functions, but fast pranayama has better effects on sensory-motor skills [8].

 


Study No. 2

Another unusual study was conducted in India to determine the impact of the effects of Medhya (Medha)  Rasayana  and  yogic practices  on short-term memory in schoolchildren. For three months, 90 Indian students aged 10 to 16 were divided into 3 groups of 30 people each.


Group A  : a group of witnesses.


Group B  : group processed by  Medhya Rasayana. The treatment consisted of taking the following plants:  Mandukaparni  (Centella Asiatica),  Yashtimadhu  (licorice root),  Guduchi  (Tinospora) and  Shankhapushpi  (bindweed). These four raw products have been identified by experts from the Ministry  Dravyaguna. After their identification, the plants were divided into equal parts and powdered. Group B members took 2gr of Medhya Rasayana, twice a day with milk for 3 months. The preparation of Medhya Rasayana was composed of a powder of the above four herbs, powdered milk, and sugar, in a ratio of 2:1:1. This being done to increase their digestibility, and also to maximize their simple use by children of school age.  Medhya Rasayana  been taken in the morning and evening.


Group C  : this group practiced the  yoga. Daily lessons including the following practices:

- a small joint warm-up: it consisted mainly of flexion-extension and joint rotation exercises;

- from  asanas  in standing position:  Tadasana, Tiryaka Tadasana, Vrikshasana, Virabhadrasana, Trikonasana - 5 cycles;

- a practice of  pranayama  :  Anuloma-Viloma - 15 times - 10 times of Bramari, Omkar Dhyana (meditation on OM) - 15 min.;

- one shatkarma - Kapalabhati - 100 times.


To assess results and see improvements, the following criteria were used  :


1) The  short term memory test  with pictures (photos):  the subjects looked at a sheet containing 20 photos. For two minutes, they must memorize them and then the sheets were removed. Then, the participants were asked to write in two minutes, on a white sheet, the names of the photos seen.


2) The  word series test: a set of 10 words was shown to each participant who had to reproduce them in the same order as indicated. If the answer was incorrect, he pressed the ESC key (the test was automated). At the end of the test, the screen displayed the score;


3) Mental status examination. This test evaluated the mental state of the subject through a questionnaire relating to the date, the hour, the place of the event, as well as a certain number of factors, determining the level of mental stress, because this one directly affects short-term memory and academic performance.

Some questions about multiplying and dividing numbers also helped assess the ability to remember things. Some of these same questions also helped analyze the individual's writing skills.


At the end of the research and tests we concluded  :

In test 1  (short-term memory test - memorization of photos), the inter-group comparison showed that the  group B  was the most effective, since the increase in the mean values of this group was the greatest. In addition, a significant improvement was observed in the practice group of  Yoga  (group C).

In test 2  (series of words) the  group B  also showed the best results, however, test 3 (mental state assessment) was won by the  group C. This shows that the  yoga practices  help to improve the mental state and relieve the effect of stress.

The increase in mean values in group B was higher compared to group C. In addition, among the three groups, the group receiving  Medhya Rasayana  was most effective against objective outcome parameters in tests 1 and 2.

Thus, group B showed the most effective results in improving short-term memory  in children attending school.
The authors conclude that Medhya Rasayana is fast in its action and contributes to the improvement of the potency of
memory. [9]

 

Study No. 3

The following study was carried out in England with people aged 62 on average, and lasted 8 weeks; with 118 attendees. 
We selected among the criteria: a
  sedentary lifestyle, as well as the absence of a regular practice of yoga. 

The two groups formed trained 3 times a week for an hour under the direction of certified teachers. The first group was doing
  haha yoga. The program was designed for beginners and included exercises such as the Warrior Pose (Virabhadrasana),  lotus posture,  Surya Namaskar, deep breathing exercises,  Nadi Sodhana, mantras, and meditation exercises with an emphasis on thoughts and breathing. It should be noted that the participants were without shoes (during the practice) and used props - such as yoga blocks and belts.

the  second group  was the “stretch and strengthen” group. The group members met on the same days and times as the first group, but in a different room. Each class consisted of a warm-up and rest, then 8-10 different exercises for the major muscle groups, with 10-12 repetitions of each exercise. The exercise did not include elements of meditation or breathing.


At the end of the study, participants were tested with three computerized tests to assess executive memory function and reaction to changing work tasks (task switching).

The result  : after 8 weeks of  regular and structured yoga practice,  group participants  yoga  showed a clear  improved executive functions of working memory, as well as increased productivity and efficiency in mental work, as well as flexibility, compared to the second group. 
According to the authors, these results are partly due to the influence of conscious breathing and meditation (these exercises were not present in the second "control" group). On the other hand, all the results of this study, taken together, should serve as a platform for further studies on the effect of yoga on cognitive function.
  [10].

 

Study No. 4

Another experiment involved 30 young engineering graduates who were randomly selected and divided into two equal groups of 15 people each (control group and yoga group). The study focused on people who were non-practitioners of yoga and did not consume drugs, tobacco or alcohol. 
During this five-month study, subjects were asked not to delay their normal pace of life. The experimental group had a yoga session for 90 minutes a day, every day, between 7 p.m. and 6:30 a.m. The second group did not do any physical activity.

Yoga practice consisted of:  pray,  pranayama,  simple yoga postures.
Training sessions were held under the supervision of a teacher, during which the following program was adapted to the group:

 

1) Standing asanas : Surya Namaskar,  Dandasana,  Urdhva Mukha Svanasana,  Trikonasana,  Hastapadasana,  Virabhadrasana,  Vatayanasana;

 

2) Asanas in seated positions :  Kurmasana,  Ustrasana,  Ardha Matsyendrasana,  Vakrasana,  Suptanasana,  Matsyendrasana,  Mandukasana,  Bakasana,  Mayurasana, Viparita Padasana, Padma Mayurasana,  Paschimottanasana,  Purna Chakrasana,  Eka Padangusthasana;

 

3) Asanas in lying position:  Uta Padasana,  Pavanamuktasana,  Sarvangasana,  Halasana, Seth Bandha Sana and  chakrasana;

 

4) Asanas while lying on your stomach :  Shalabhasana,  Dhanurasana,  Naukasana;

 

5) Pranayamas : Anuloma-Viloma, Kapalabhati, Ujjayi, Bhramari, Sita, Shitkari, Surya Bhedana, Bhastrika, Bahya, Kaki Mudra, Mudra shanmukhi. Each day of practice ended with prayer and meditation.

At the end of the study, all participants took the test on   EKG  and  EEG.

 

The conclusion  :

Team members who regularly practice  yoga, after a period of five months, showed an increase in different  types of cognitive skills  at the end of this period. The parameters of  cognitive behavior  were evaluated on the basis of EEG indicators.

 

The increase in signal strength in a particular area of the cortex was perceived as a  strengthening of a specific type of cognitive skills. (For example, the frontal lobe is associated with reasoning, planning, problem solving, cognition; the parietal lobe - includes visual perception, recognition, information processing and spatial reasoning, the temporal lobe - includes memory and processing of verbal and sound signals, and the occipital lobe - includes visual spatial processing and object recognition).

 

Besides the  cognitive abilities,  yoga practice  has led to positive changes at the physical level, such as improved heart rate variability. There was also an increase in parasympathetic activity and, as a consequence, a decrease in sympathetic activity [11].

 

Study No. 5

The study cited here involved 98 students aged 8 to 13 years. The experiment lasted 3 months, representing  5  yoga sessions  per week, lasting 45 minutes each, during the school day. Prior to the start of the study, the students' physical condition, as well as their self-esteem, attentiveness, punctuality, and  their behavior were assessed.

The participants were divided into two groups - the first group practiced the  yoga, including pranayama, vyayamas, asanas, chanting of mantras, as well as relaxation techniques. 


The second group performed simple physical exercises with the same frequency and at the same time as the first group. They performed jogging on the spot, flexions, extensions and rotations of the body. The study authors focused on the differences between the  yoga  and physical exercise, taking into account the importance of awareness, relaxation and control of the  breathing in yoga.

After the study ended, test scores in both groups showed a noticeable difference on self-esteem outcomes in social; this was the only variable with significant changes in the exercise group. 


Both groups before and after the study also showed significant changes in the  cognitive function. 
The physical practice group also showed a drop in a few specific points on computer test scores. Additionally, both groups showed improvement in obedience, performance, punctuality, behavior with friends and teachers. The authors also linked this improvement with aerobic exercise (as observed in both groups), and suggested the inclusion of such
  yoga exercises  in the school calendar.

 

Study No. 6

This study examined the effect of yoga on cognitive function  in the elderly in a nursing home in India. The study involved 87 people aged over 60, who were divided into two groups (yoga group  = 44,  a group of witnesses  = 43).
 
The study lasted 6 months. the
  yoga program  was developed based on traditional yoga texts and included a joint warm-up,  asanas, pranayama and meditation. 
During the first month of classes, the exercises were daily (except holidays) and lasted 1 hour.
 
During the
  2 following months, under the direction of the teacher, the lessons also lasted 1 hour each, but only once a week (the rest of the time was devoted to individual practice)
The last 3 months, the participants followed only the individual practice
  (probable frequency of 3-4 times per week).

The exercise protocol was as follows  :

-  Sukshma vyayama  (exercises for the neck, shoulders, wrists and feet) - 10 minutes;

-  Asanas  (Tadasana, Katichakrasana, Konasana, Marjariasana, Pavanamuktasana, Vakrasana, Viparita Karani, Bhujangasana, Ardha Shalabhasana, Setubandhasana, Savasana) - 20 minutes

-  Pranayam  (Kapalabhati, Nadi shodhana, Bhedana Surya, Chandra Bhedana, Bhastrika, Bhramari) - 15 minutes

-  Trataka and meditation  - 15 minutes.


In addition, it should be noted that before the start of the study, all participants were aware of the importance of physical and cognitive activity.  as factors in the fight against senility. Therefore, during the study, many participants of both groups practiced walking, spiritual activities (chanting, visiting seminars and meetings on this subject).

For the evaluation we used the following tests  :

  • Rey's Auditory Verbal Learning Test (RAVLT) - Ray's test of oral and auditory memorization;

  • Rey's complex figure test (CFT) - tests on the construction of "complex figures";

  • Wechsler Memory Scale (WMS) - Wechsler's memory scale test;

  • Oral Controlled Word Association (COWA) test - a test of word associations;

  • Stroop Color Word Interference Test and Trail Making Test - Stroop's verbal color-word interference test, and a test of hand-eye coordination.

 

All these tests were carried out with the participants before the start of the study, and 6 months later, at the end of the study.

Consequently the group of  yoga  showed notable improvements in all indicators compared to the control group [13].

 

Thus, after analyzing these scientific data, it can be said that the  yoga  as a form of physical exercise, may be recommended to patients with  cognitive impairment  existing, and healthy people who want to prevent such disorders. 
There is insufficient comparative data with conventional physical activity groups to understand which techniques are most effective and should be followed.

 

The training program should be balanced, tailored to the individual characteristics of the individual, and include not only  asanas, but also a variety of  breathing techniques  (as we have seen, fast and slow pranayama had their positive impact too).  Quick pranayama  acts on the improvement of sensory-motor skills, and  slow pranayama  - on reducing stress and improving cognitive function  in general. 
With these same goals it would be helpful to include the practice of relaxation and meditation techniques, such as -
  Trataka.

 

 

 

 

 

 

 

 

Bibliography

 

  1. (rus) Preobrazhenskaya IS  "Dementia - epidemiology, clinical presentation, diagnosis, treatment approaches." Neurology, Neuropsychiatry, Psychosomatics - 4, 2013. p.71

  2. Electronic resource:  http://www.medicalj.ru/symtoms/head/676-narushenie-kognitivnyh-funkcij

  3. Preobrazhenskaya IS "Dementia - epidemiology, clinical presentation, diagnosis, treatment approaches." Neurology, Neuropsychiatry, Psychosomatics - 4, 2013. s.71-72

  4. Electronic resource:  http://www.medicalj.ru/symtoms/head/676-narushenie-kognitivnyh-funkcij

  5. Preobrazhenskaya IS "Dementia - epidemiology, clinical presentation, diagnosis, treatment approaches." Neurology, Neuropsychiatry, Psychosomatics - 4, 2013. p.76

  6. H. Whiteman. One hour of after-school exercise linked to better cognitive functioning // 2014.http://www.medicalnewstoday.com/articles/283169.php

  7. A. Sachdeva, K. Kumar and KS Anand. Non-Pharmacological Cognitive Enhancers - Current Perspectives. // J Clin Diagn Res. July 2015; 9 (7)

  8. VK Sharma, M. Rajajeyakumar, Velkumary S., SK Subramanian, AB Bhavanani, Madanmohan, A. Sahai, and D. Thangavel. Effect of fast and slow practice pranayama on cognitive functions in healthy volunteers // J Clin Diagn Res. Jan 2014; 8 (1): 10-13

  9. AS Sarokte, MV Rao. Effects of Medhya Rasayana and yoga practices in improving short-term memory in school children // Ayu. 2013 OCT; 34 (4): 383-9.

  10. gold: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline;">10. Gothe NP, AFKramer, E. McAuley. The effects of an 8-week Hatha yoga intervention on executive function in older adults // J Gerontol A Biol Sci Med Sci. 2014 Sep; 69 (9): from 1109 to 1116.

  11. H. Nagendra, V. Kumar, S. Mukherjee. Cognitive assessment of behavior based on physiological parameters in young healthy subjects with yoga as an intervention // Computing Mathematical Methods Med. 2015;

  12. C. Ferreira-Vorkapic, JM Feitoza M. Marchioro, J. Simões, E. Kozasa, and S. Telles. What are the benefits of teaching in yoga schools? A systematic review of randomized control trials of interventions // Evid Based Complement Alternat Med Yoga-Based. 2015; 2015: 345,835.

  13. VR Hariprasad, V. Koparde, PT Sivakumar, S. Varambally, J. Thirthalli, M. Varghese, IV Basavaraddi, and BN Gangadhar. Randomized Clinical Trial of a Yoga-Based Intervention in Nursing Home Residents: Effects on Cognitive Function //​​ Indian J Psychiatry. 2013 Jun; 55 (Supp 3): S357-363

Author: Natalia Gordeeva, “Yogatherapeutic Society of St.Petersburg” 
Translated by: Aleksei Papin

 

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