Mehta Urvakhsh Meherwan, Keshavan Matcheri S, Gangadhar Bangalore N
a Department of Psychiatry , National Institute of Mental Health & Neurosciences (NIMHANS) , Bengaluru , India ;
b Department of Psychiatry , Beth Israel Deaconess Medical Center and Harvard Medical School , Boston , MA , USA.
Int Rev Psychiatry. 2016 Jun;28(3):254-64. doi: 10.1080/09540261.2016.1176905. Epub 2016 May 17.
Schizophrenia patients experience a 'disconnect' at multiple levels-neuronal networks, mental processes, and interpersonal relationships. The resultant poor quality-of-life and functional disability are related to the persistent cognitive deficits and negative symptoms, which are rather resistant to conventional antipsychotic medications. Yoga has emerged as an important therapeutic intervention to improve quality-of-life in schizophrenia. Recent preliminary evidence suggests that effects of yoga on cognitive and negative symptoms may drive this benefit. This study attempts to integrate evidence from neuroscience-based research, which focuses on the neuroplasticity-harnessing effects of yoga to bridge the schizophrenia connectopathy. In an overarching model to study putative neurobiological mechanisms that drive therapeutic effects of yoga, it is proposed that (a) various styles of meditation may help in strengthening the lateral and medial prefrontal brain networks, thus improving neurocognition and mentalizing abilities, and (b) learning and performing co-ordinated physical postures with a teacher facilitates imitation and the process of being imitated, which can improve social cognition and empathy through reinforcement of the premotor and parietal mirror neuron system. Oxytocin may play a role in mediating these processes, leading to better social connectedness and social outcomes. Clinical and heuristic implications of this model are further discussed.
精神分裂症患者在多个层面存在“脱节”现象，包括神经网络、心理过程和人际关系。由此导致的生活质量低下和功能残疾与持续的认知缺陷及阴性症状有关，而这些症状对传统抗精神病药物具有相当的抗性。瑜伽已成为改善精神分裂症患者生活质量的一项重要治疗干预措施。最近的初步证据表明，瑜伽对认知和阴性症状的影响可能带来了这种益处。本研究试图整合基于神经科学的研究证据，该研究聚焦于瑜伽利用神经可塑性的作用来弥合精神分裂症的连接病。在一个用于研究驱动瑜伽治疗效果的假定神经生物学机制的总体模型中，提出以下观点：（a）各种冥想方式可能有助于强化外侧和内侧前额叶脑网络，从而改善神经认知和心理化能力；（b）在教师指导下学习和执行协调的身体姿势有助于模仿和被模仿过程，这可以通过强化运动前区和顶叶镜像神经元系统来改善社会认知和同理心。催产素可能在介导这些过程中发挥作用，从而带来更好的社会联系和社会结果。本模型的临床和启发意义将进一步讨论。
