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 intentionto- 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.