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ExploringtheNeurobiologyofMind-Body-SpiritUnity

StaceyPierce-TalsmaDO,MS,RYT-500,FNAOMETouroUniversityCaliforniaCollegeofOsteopathicMedicine

Mind-Body-SpiritUnit

“Thereisoneadditionthatisindispensabletocontrolthisactive

body,ormachine,andthatisthemind.Withthatadded,thewholemachinerythenworksasman.Thethree,when

unitedinfullaction,areabletoexhibitthethingdesired-complete”

A.T.StillDO

Ouremotionsandstressesbecomethefabricofourphysiology

Ourthoughtsandfeelingsbecomechemicalsandhormones

Ourfearsneuralimpulsesreachingouttoallareasofourbody

MoodEffectsonInpatientOutcomes

• 73%riskofbeingreadmitted• twofoldincreaseriskofdeath• Heartfailurepatientswithmoreadverseprognosis• Longerlengthofstay• Morefalls• Predictorofmortalityindialysispatients

MoodEffectsonOutpatientHealth

DepressionandAnxiety

•Strongestpredictorofdeclineinhealthstatus

•COPDpatients-worseQOLandincreased3yrmortality

•DM-increasedriskofmortality,increasedriskofmicro/macrovascularcomplications

•Increasedriskofstroke,MIandcardiacdeath

•Increasedriskofall-causemortality

•Severementaldisordersexperiencea10-20yearlifeexpectancyreduction

Mechanisms

• healthbehaviors• nonadherencetotreatmentplans• Alterationsinphysiology• heightenedSNSactivity• Increasedinflammationandhypercoagulability• Endothelialdysfunction

STRESSPrimaryStressHormones(HPA

Axis)

DisregulationofBiologicalPathways(insulin,glucose,lipids,neurotransmitters)

Impacttoallmajorsystems(organs,tissues,cells,DNA)

Trauma• Alteredchemical&hormonalnetworks,nervefiringpatternsandprocessingofsensoryinformation• pre-verbal• Functionchanges:

• DLPFC• hippocampus• Thalamus• Amygdala• MPFC• Insula

Shifttreatmenttofocuson

strategiesthatbringregionsofthebrainback

on-line

Still Senses•5senses

•Chemicalandelectricalsignalsleadingtoalertness,fear,danger,comfort,security,love

•Oursensesarelinkedtomultiplepathways•Smell•Hearing•Touch

•Oxytocin

Vagus nerve• 80%Afferent

• Interconnectedwithpathwaysthataffectmood,memoryandsenseofself

• VagalNerveStimulation

• Polyvagaltheory• Autonomicnervoussystemintegratedvianeuralcircuitstostriatedmusclesofthefaceandhead• Socialengagementsystem• Neuroception

Movement

Howcanwealterourneurobiology?Processtrauma?

Improveresilienceanddecreasestress?

Exercise

• Depression-neurobiologicalchangesinthemonoaminesystem,HPAaxis,neurogenesisandneuroimmunesystem

•Monoamines• EndogenousOpioids,serotonin,NE,EPI,dopamine

• IncreaseGrowth(Neurotrophicfactors)• VEGF,BDNF,GDNF

• PreventDegeneration(Neuroprotective)• Serotonin,Kynureninepathway,Inflammation(cortisol&immunefunction),oxidativestress

• ComplexNeuroCircuitry• multisynapticcircuitstomovement,cognitionandadrenalmedulla

• Neuroplasticity• exerciseleadstobloodflow,trophicfactors,immunefunction

MindfulMovement• WindowofTolerance

• Howyoushowuponyourmatishowyoushowupinlife

• DefaultModeNetwork

• ChallengeVs.Threat

• “TheAsanabeginsthemomentyouwanttocomeoutofit”B.K.SIyengar

PowerPoses• “Whereourbodieslead,ourmindsandemotionswillfollow”

• Slumpedvs.uprightposture• Confidence,selfesteem,mood,productivity,memory,painperception

• Proprioceptive,interoceptive,vagal

• Canpostureeffectnotonlyourmusculoskeletalhealthandemotions-butdecreaseourstressresponse

Meditation•Disrupts

• stresspathways• automaticreactionsandpatterns

• Focusedattention• strengthenneurologicpathways

BrainStructural&FunctionalChanges

• Thickercortices• diminishedagerelatedatrophy• Increasedgyrification• Largerprefrontalcortex,insula,hippocampusandcingulatecortex• Smalleramygdala• Areasofmoodregulation,responsecontrol,learningandmemory

Mindful,stabilizedattentioncreatesstrongerpathwaystoourself,identityandconsciousness

• TopDownApproach• Consciousness

• BottomUpApproach• Interception• Physiologicsafety

• Neuroplasticity

Telomere-TTAGGG

Breath“Whatwecall“I”isjustaswinging

door,whichmoveswhenweinhaleandwhen

weexhale”

~SHENRYUSUZUKI

WithineachbreathisaStillpoint

DysfunctionalRespiration

• mouthbreathing• hyperventilation

• alteredph• alteredSNS• lessO2delivery• increaseinanxiety

• thoracicbreathingpattern-increasedtension

Thewaywebreathdirectlyeffectsouremotionalstate

• RespiratorySinusArrhythmiaandoscillations

• Slowdeepbreathingincreasesparasympathetictone

• ImprovesHRV-autonomicflexibility

• 6breathsperminuteisthemagicfrequency• highestoscillationsinheartratevariability• Mostefficientgasexchange

• Altersbaroreceptoractivity• Connectionwiththeamygdala

• VagalAfferents

• Oscillationsintreatment

• Vagusnervemediated• Pacedbreathing• Alterscerebralbloodflow• Maypromoteimprovedpulmonaryfunction

• Mayeffectimmunefunction• Vibratoryenergy

“Idon’tsingbecauseI’mhappy-I’mhappybecauseIsing”~WilliamJames

Community• Lonelinessleadstohigherhealthcareutilizationinelderly• SocialisolationassociatedwithanincreasedriskofCADandstroke• comparabletosmoking• greaterthanobesityandhypertension

• LonelinessandsocialstressactivatestheHPAaxis• Canleadtobrainchanges• Powerfulprotectionagainsttrauma

Movement,Breath,Meditation,Mantra• Getpeoplemoving• AndEncouragegoodposture

• Teachthemhowtobreathe• Beginadailymeditationpractice• Chant,sing,pray• Becomepartofacommunity• Socialsupport

• Foryourneurobiology,physiologyandlife!

Bibliography• Slide1Introduction

• AshtangaYogaOpeningPrayerhttps://sharathjois.com/the-practice/opening-prayer/• Slide2Mind,Body,SpiritUnit

• A.T.Still“ThePhilosophyandMechanicalPrinciplesofOsteopathy”1892• Slide3MoodEffectonInpatientOutcomes

• Pederson,Warkentin,Majumdar,McAlister.Depressivesymptomsareassociatedwithhigherratesofreadmissionormortalityaftermedicalhospitalization:asystematicreviewandmeta-analysis.JHospMed.2016May;11(5):373-80

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• Farrokhi,etal.Associationbetweendepressionandmortalityinpatientsreceivinglong-termdialysis:asystematicreviewandmeta-analysis.AmericanJournalofKidneyDisease,2014:63(4):623-635Slide6MoodeffectsonOutpatient

• Slide4MoodEffectonOutpatientHealth• Fan,Ramsey,Giardino.Sex,Depression,andriskofhospitalizationandmortalityinchronicobstructivepulmonarydisease.Arch

InternMed.2007;167(21):2345-2353• Rumsfeld,Jetal.Depressivesymptomsarethestrongestpredictorsofshort-termdeclinesinhealthstatusinpatientswithheart

failure.JournaloftheAmericanCollegeofcardiology.2003;42;(100):1811-1817• Sullivan,etal.Depressionpredictsall-causemortalityepidemiologicalevaluationfromtheACCORDHRQLsubstudy.Diabetes

Care2012;35:1708-1715• Linetal.DepressionandIncreasedMortalityinDiabetes:unexpectedcausesofdeath.AnnFamMed2009;7:414-421• Watkins,L.etal.Associationofanxietyanddepressionwithall-causemortalityinindividualswithcoronaryheartdisease.JAm

HeartAssoc2013• Prematuredeathamongpeoplewithseverementaldisorders.WorldHealthOrganization.

Bibliography• Slide5Stress

• McEwen,B.Nasca,C.Gray,J.Stresseffectsonneuronalstructure:hippocampus,amygdala,andprefrontalcortex.Neuropsychopharmacology2016;41(1):3-23

• Lupien,S.,Juster,RP.,Raymond,C.,Marin,MF.Theeffectsofchronicstressonthehumanbrain:fromneurotoxicity,tovulnerability,toopportunity.FrontiersinNeuroendocrinology.April2018;49:91-105

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• Slide6Trauma• BesselVanDerKolk.Thebodykeepsthescore-brain,mind,andbodyinthehealingoftrauma.PenguinBooksNY,NY2014

• Slide7ATStill’sThoughtsontheSenses• A.T.Still“ThePhilosophyandMechanicalPrinciplesofOsteopathy”1892• Lehrner,J,etal.Ambientodorsoforangeandlavenderreduceanxietyandimprovemoodinadentaloffice.Physiology&Behavior2005;86:92-95• Lotsch,etal.Smellofpain:intersectionofnocieptionandolfaction.Pain2016;157:2152-215• Hole,J.etal.Musicasanaidforpostoperativerecoveryinadults:asystematicreviewandmeta-analysis.TheLancet2015;386(10004):1659-1671• Raglio,A.etal.Effectsofmusicanmusictherapyonmoodinneurologicalpatients.2015:WorldJPsychiatry;5(1):68-78• Hertenstein,M.Touch:Itscommunicativefunctionsininfancy.HumanDevelopment2002;45:70-94• Hertenstein,M.etal.Touchcommunicatesdistinctemotions.Emotion2006;6(3):528-533• Light,K.etal.Morefrequentpartnerhugsandhigheroxytocinlevelsarelinkedtolowerbloodpressureandheartrateinpremenopausalwomen.Biological

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2016-02-03/the-health-benefits-of-hugging• 8VagusNerve

• Lehrer,P.,Gevierts,R.Heartratevariabilitybiofeedback:howandwhydoesitwork?FrontPsychol.2014;5:756• Porges,S.Thepolyvagaltheory:newinsightsintoadaptivereactionsoftheautonomicnervoussystem.CleveClinJMed.2011;72(suppl2):S86-S90• Porges,S.Thepocketguidetothepolyvagaltheorythetransformativepoweroffeelingsafe.2017W.W.Norton&Company

• Slide9MovementIntroduction

Bibliography• Slide10-Exercise

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• Slide11-MindfulMovement

• Baptiste,B.PerfectlyImperfecttheartandshouldofyogapractice.HayHouseInc2016

• Robin,M.Aphysiologicalhandbookforteachersofyogasana.FenestraBooks2002

• Slide12PowerPosing• Cuddy,AmyPresenceBringingyourBoldestSelftoyourBiggestChallenges.BackBayBooksLittle,BrownandCompany,NY2015

• Nair,S.etal.Doslumpedanduprightposturesaffectstressresponses?Arandomizedtrial.HealthPsychology-AmericanPsychologicalAssociation2014

• Slide13-MeditationIntroduction

Bibliography• Slide14MeditationandBrainchangesStructural&Functional

• Tang,Holzel,Posner.Theneuroscienceofmindfulnessmeditation.NatureReviewsNeuroscience.2015• Gotink,Etal.8-weekmindfulnessbasedstressreductioninducesbrainchangessimilartotraditionallong-termmeditationpractice-asystematicreview.BrainandCognition2016;108:32-41

• Luders,Clark,Narr,Toga.Enhancedbrainconnectivityinlong-termmeditationpractioners.Neuroimage2011;57(4):1308-16• Luders,E.etal.Theuniquebrainanatomyofmeditationpractioners:alterationsincorticalgyrification.Front.HumNeurosci2012

• Slide15MeditationandBrainChanges-Thepathway• Slide16MeditationandTelomeres

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• Slide17-Breath• Baptiste,B.Perfectlyimperfecttheartandsoulofyogapractice.HayHouse2016• Xun-chao,L.etal.Effectsofyogatraininginpatientswithchronicobstructivepulmonarydisease:asystematicreviewandmeta-analysis.JThoracDis.

2014;6(6):795-802• Ali,A.etal.theinfluenceofsnoring,mouthbreathingandapneaonfacialmorphologyinlatechildhood:athree-dimensionalstudy.BMJOpen;5(9)• Vleeming,Mooney,Stoeckart.MovementStability&lumbopelvicpainintegrationofresearchandtherapy2ndedition.ChurchillLivingstoneElsevier2007

Bibliography• Slide18BreathandPhysiology

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• Torkamani,F.etal.Effectsofsingle-sessiongroupmantra-meditationonsalivaryimmunoglobulinAandaffectivestate:apsychoneuroimmunologyviewpoint.Explore201814(2):114-121

• Slide20Community• Valtoraetal.Lonelinessandsocialisolationasriskfactorsforcoronarydiseaseandstroke:systematicreviewandmeta-analysisonlongitudinalobservationalstudies.BMJ2016

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• Slide21Howtochangeyourpatientsneurobiology