Effects of meditation and yoga on anxiety, depression and chronic inflammation in patients with Parkinson’s disease : a randomized clinical trial

Abstract

Introduction: Clinical guidelines recommend a holistic approach to Parkinson’s disease (PD) care, yet randomized trials examining mindfulness-based interventions in this context are scarce. This study investigated the effects of two mindfulness practices – meditation and yoga – on biopsychosocial outcomes in PD patients, including anxiety symptoms, depressive symptoms, motor/nonmotor symptoms, health-related quality-of-life (HRQOL), mindfulness, and stress and inflammation biomarkers, compared to usual care. Methods: 159 participants with a clinical diagnosis of idiopathic PD and a Hoehn and Yahr stage of 1, 2, and 3, were randomized into meditation (n = 53), yoga (n = 52), and control (n = 54). Meditation and yoga were delivered in 90-min groups for 8 weeks. Primary outcomes included anxiety symptoms and depressive symptoms. Secondary outcomes included motor and nonmotor symptoms, HRQOL, mindfulness, and serum levels of interleukin-6, cortisol and TNF-alpha. Assessments were done at baseline (T0), 2 months (T1), and 6 months (T2). Linear mixed models were conducted following intention-to-treat principle. Results: Compared to control, both meditation, and yoga groups had significant improvements in anxiety symptoms (meditation: mean difference [MD] = −1.36, 95% CI: −2.46 to−0.26; yoga: MD = −1.61, CI: −2.70 to −0.52), motor symptoms (meditation: MD = −5.35, CI: −8.61 to−2.09; yoga: MD = −6.59, CI: −9.82 to−3.36), HRQOL (meditation: MD = −2.01, CI: −3.41 to−0.62; yoga: MD = −1.45, CI: −2.83 to−0.08), and describing skills (meditation: MD = 0.97, CI: 0.04–1.89; yoga: MD = 0.92, CI: 0.01–1.84) at T1, and significant reductions in serum interleukin-6 levels (meditation: MD = −1.14, CI: −2.18 to−0.10; yoga: MD = −1.11, CI: −2.09 to−0.13) at T2. Only meditation significantly reduced depression (MD = −1.44, CI: −2.57 to−0.30) at T1 and sustained the motor and HRQOL improvements at T2. Conclusion: Meditation and yoga significantly improved anxiety symptoms, chronic inflammation, motor symptoms, mindfulness-describing facet, and HRQOL in PD patients. Meditation provided additional benefits in reducing depressive symptoms and sustaining motor and HRQOL improvements.