The Science of Yoga and Neuroscience: Insights with Dr. Jonathan Rosenthal, Founder of NeuroYoga

I'm gonna really focus on scientific evidence, evaluate yoga. How do we know what we're finding is true and believable? And then I'll also do a little bit about what's been studied for a few mental health conditions. For, so for anxiety and depression, the evidence is like massive for yoga, which is really cool.

Any particular type of yoga or any yoga?

Oh, this is the best part of the research. So everyone always wants to know what school of yoga do I have to do? Is it Iyengar? Is it Bikram? Is it—

And it's welcome to the Mind Body Space Podcast, where you can stress less and boost your performance and wellness down to the cellular level just by listening. Hi, I'm Dr. Juna Bobby MD, a mom MD passionate about sharing evidence-based tips to keep you and your family well. For the past 10 years, I've been teaching the science of resilience to high-achieving individuals at many different schools and organizations. And currently I'm on faculty at the Juilliard School Pre-College Division, teaching gifted students how to stress less, and perform at their best. I started this podcast because I wanted to share what I learned with my students, fellow parents, educators, and anyone who's interested as I explore fascinating topics like neuroscience and meditation with experts in education, medicine, and psychology. Your support makes this possible. Please subscribe and share with a family friend, anyone who needs to stress less, boost performance, and be happier. If you have questions for my guests or for me, or if you have a topic that you'd like us to cover, please head on over to mindbodyspace.com/podcast. Podcast and ask away, and we will answer your questions on the podcast on the last Friday of every month. If you need a good night's sleep, head on over to my YouTube channel, Fall Asleep Easy, to drift off and sleep like a baby.

Today I am so excited to have Dr. Jonathan Rosenthal. He is a neurologist in New York City, currently a clinical fellow at Weill Cornell School of Medicine and Memorial Sloan Kettering Center. He completed both his Bachelor of Science degree in neuroscience and his Doctor of Medicine degree at NYU. His work on TBI, traumatic brain injury, was recognized by the American Academy of Neurology Young Investigator Award. He's an avid yoga student of Shri Dharma Mitra, which is how I met him. And since 2014, he's been hosting events about neuroscience and yoga and is working to expand his research programs to include Yoga Intervention. Thank you so much for being here today, Jonathan. I'm so excited to have this conversation with you.

Thank you so much for having me.

It's an honor to be here, and I'm just so excited to see how this neuro yoga has grown. I remember you started it when we met at NYU Medical School where I was teaching lifestyle medicine and mind-body medicine.

Yeah, I still remember when we first met. I think you had just done your teacher training at Dharma's, and I was just starting medical school, and someone worked at Dharma was like, oh, you have to meet Juna Bobby MD. She's a doctor at NYU and you're going to be there. Was like, how? I have no idea how I'm going to meet this person. And then you gave all of our wellness lectures.

Oh my gosh, that's so funny. That was Joanne, right?

Yeah, it was Joanne.

Yeah. Yes. And she told me, she was like, Juna, you have to meet Jonathan. I'm like, who's Jonathan? And she's like, he's a medical student at NYU. I would have never thought that I would meet somebody from NYU Medical School at Sri Dharmamitra's Yoga Center, which is an amazing place, by the way.

And Joanne is amazing too.

How did you find Sri Dharmamitra? I found him because I wanted somebody who was super wise, and he's much older, and I couldn't believe the incredible things he could still do physically, mentally and physically. So I was very drawn to it. And also it was not like regular yoga trainings where it might feel a little acrobatic. It was really traditional and there was a lot of meditations. But how did you come to that?

I had a very similar ask of the world. I wanted something like that. I'll tell you like my yoga story in the beginning. I don't know if we ever talked about this, but I don't— probably in 9th grade we read a book in high school English class called Siddhartha by Hermann Hesse. And it's not exactly the story of Siddhartha Gautama. It's fictional, but it's like similar. And it's this person wandering through different stages of life trying to find enlightenment. And I thought it was so interesting because at the end of the book, after doing all of these things to try to achieve enlightenment, they were an ascetic for 10 years, tried to follow all these sages around and learn from them, and nothing worked. And it was only at the end of his life, right when he gave up and he's whatever, whenever it happens, it'll happen. That's when it happened. And I just thought that was such a cool story. And so I wanted to find a yoga teacher and someone who was serious about yoga. And I ended up thinking if I took a yoga class, it would mostly be people my mom's age. And I was a teenage boy, like I, I didn't think that would be necessarily fun for me. And I never took a yoga class until I hurt my foot running. And then I showed up at my local yoga center and not only was everyone my mom's age, but they were actually all in bathing suits because it was also hot yoga. So, I really felt out of place. But then by the end of class, I was like, okay, actually that was really fun. I like the people, they're nice, and now I'm friends with all of them. Yeah, that was how I started on yoga and going there for a year. One of the teachers was a student of Dharma's and suggested I go and meet him, so I came into the city. I first met Dharma when I was 17, so I took the train into the city and I took class with him, and I was like, wow, okay, this is who I was looking for.

I didn't know you knew him for so long.

Yeah, so right before my 30th birthday, Dharma said to me, he like came over and adjusted me in class but was doing it in a teasing way. And which he always does, which he always does. And I was laughing and he goes, all right everyone, I'm just joking, I've known him for 30 years. And I was like, whoa, I'm still 29.

Wow. Yeah, whenever I brought my husband Paul with me, Dharma would come over and he's, you're killing yourself, stop. How to kill yourself or something like that.

So funny. Yeah.

Wow. That's so unusual though. 9th grader looking for a yogi. What was that about?

I don't know. I just thought it was really interesting. It was like fascinating to read about their experience of kind of being the witness and not being affected by things as much. I thought it was very interesting.

Wait, so who gave you the book?

My English teacher.

That's also very unusual.

Yeah.

Where did you go to high school?

In New Jersey.

I don't know. That's awesome. So the teacher will appear.

Yeah.

And so you started doing— You started going to Dharma Mitras for that whole time until I met you in medical school when you were like 23, right?

Yeah. 22, 23. Yeah.

And now you're, yeah, almost 30 or 30.

I'm 30. Yeah.

Congrats.

Thanks. I made it.

I, I can't believe I've known you this long. Tell us about how your interest in yoga turned into neuro yoga, because I remember you started it when I was teaching at NYU Medical School. And I even remember bringing my son Max in and I think he played cello.

Yeah.

During one of your yoga classes. That was so much fun.

That was so cool.

Live cello and Jonathan leading yoga.

Favorite memory.

So tell us about how neuro yoga started and what you wanna do with it.

To be clear, neuro yoga, I don't want people to hear that and think that it's Bikram yoga or something like that. My experience in yoga was I started getting really into the philosophy and took teacher training and thought yoga was really special and something that I wanted to share with people. But at the same time, I was pursuing a science career. I felt a hippie among scientists, but I also was a pariah among yogis because I believed in modern medicine. I was like, this is such a weird place to be in, not exactly aligned with either group. And so I started asking, is there scientific evidence on yoga? Is there— has anyone done research about is yoga effective for different diseases or performance enhancement, just like regular health stuff.

Mhm.

And as I looked into it, I realized there's a ton published. Like, it's an enormous body of literature. There are currently 15,000 studies published on yoga. 1,500 of them are randomized controlled trials. There are probably about 50 to 70 meta-analyses published a year on yoga. So I was like, oh, there's a lot to this.

So can you explain to our audience what a randomized controlled trial is and meta?

Yeah, I think the short way of saying it is if you try to figure out how do I know something for sure, how do I study something so that I know that it's true and I'm not just like lying to myself, you need to design a study in a way that all biases are removed. That's really what a randomized controlled trial is. And the longer way I like to say it is like someone might tell you garlic lowers blood pressure. If your grandma's like, oh, you have high blood pressure, take some garlic, it'll lower it. Now you don't know that's true. It's just anecdotal evidence. You've heard it from other people, but you could start studying it in different ways. You could look at people who took garlic pills and then see if they have lower blood pressure, but you didn't intervene. So you don't, you just know that those are associated. You don't know if that's the cause. And what's special about a randomized controlled trial and why it's such a high level of evidence is you actually intervene. You're making people take the garlic pills, you're making other people take a placebo to remove another source of bias, and then you're comparing those two groups and their outcomes, see if there's actually a difference in people who start garlic pills and their blood pressure.

And then of course the placebo also has an effect, right?

So exactly. So you're trying to make sure it's better than placebo. What if it's just placebo effect? Is, are we really gonna be promoting garlic?

Although the placebo effect is Actually very real and it's actually powerful, right?

Yeah. Yeah.

And that's why they use it in trials.

Okay.

So randomized controlled trial is basically when you take a bunch of people who have the similarities, like within that group, right? You're gonna take, let's say, 50 healthy individuals or 50 individuals with moderate high blood pressure or something like that. And then you randomize them to either placebo or yoga.

Yep. Right, exactly.

And then of course there's the question of did the garlic keep people away? So then their blood pressure got lower cuz nobody annoyed them. And then meta-analysis.

Yeah. So then a meta-analysis is where it's an even higher level of evidence where people take all the randomized controlled trials that are published and mathematically put them together and try to show what if we consider this as one big study instead of a lot of smaller studies, do we get? The same outcome. The meta-analyses on yoga are so convincing at this point that yoga is making its way into national guidelines. For example, national— 3 national cancer bodies have yoga as an adjunctive treatment for cancer. Not obvious, it's not curing cancer. No, it should be thinking that, but it's very helpful for managing symptoms in cancer. So it's helpful for managing pain, for managing depression, anxiety, sleep, And I think those are the 4 big ones that it's currently has evidence for. And it's currently a level B of evidence for migraine based on a few randomized control trials that have come out.

And A would be level—

So for migraine, A is like Botox. It's crazy cuz even a lot of the medications that are like first line that we use all the time, those don't even have level A of evidence.

But Botox works for migraines.

It does.

Yeah.

And then B would be yoga.

Yeah.

And other medications.

Right? Yeah, exactly.

So that's so amazing. So when you take the meta-analysis, you're basically taking a large amount of studies and number crunching it to see what comes out and see what stays true. Okay, so those are really interesting supportive statements about— yeah, as medicine. And obviously because there's so much false information out there and people are getting a little skeptical even of scientific studies, however, you can read the studies that are well done or well designed by reputable people. And honestly, nothing is ever 100%, but it's always better to have evidence than just to shoot in the dark.

Exactly.

Then evidence is evidence.

Yeah. And that's why science has to be replicable. Like, it's— of course there are going to be studies, and of course there are ways to manipulate the outcomes if people really want to. But that's the whole point of having multiple studies and showing that in different populations, when different people do the study, like, get the same outcome. And that's why a meta-analysis is an even higher level of evidence, is because it's combining across many studies. And as I realized this more and more, I was like, this was not included in yoga teacher training. This is not something that people are taught. People think yoga is like hippie-dippy. No one realizes there's so much evidence behind yoga.

And it's not taught in med school.

It's not taught in med school at all. And so I really thought—

not now even.

I don't think so.

I, I think I saw the mandala. I definitely saw that in the MCAT review book, like a mandala, like meditation. So I don't know if yoga's in there.

That's cool.

Yeah.

So I just wanna try to get that science out to people.

And I also wanna add, I know you said it doesn't cure cancer and it certainly doesn't. However, the secondary symptoms of cancer, like pain management, depression, anxiety, all those things could lead to lifestyle changes that could support remission. Or maybe even boost your immune system, right?

And they actually do have some studies that show that mortality is lower with yoga interventions in cancer. So people actually do survive longer. It could be immune-mediated, it could be stress-mediated, it could be metabolism-mediated. But I don't— the reason I always am shy to say that is because when I was growing up, I remember Steve Jobs died when I was in 11th grade. Yeah, and I love Steve Jobs, and I think Steve Jobs was awesome, but I'll never forget that he had pancreatic cancer and he decided to drink to try to cure it by drinking green juices and oranges.

No, he ate carrots, a lot of carrots.

Yeah, and he refused chemotherapy and he refused surgical intervention until it was too late. Yes, and that is something that always stuck with me, so I just, I never want people to do that.

No, definitely not. You need to use Western and non-invasive therapy together.

Yeah.

As much as you can.

Yeah.

Okay. So that's so awesome that you're bringing this research out to the community. And I remember you did one of your first neuro yoga classes or something you had. Did you put EEGs on people? What were you doing?

We, we've had a few different experiments. It's really fun to try to get people excited about science by showing them the experiments that have been done.

I remember sending you an intern from high school.

Catherine. Yes.

Catherine. Yes, shout out.

Yeah, so I forget what year that was, maybe it was 2018, I'm not sure. But we have done a few different experiments. My favorite one to do is heart rate variability because it's the most reliable, it's the easiest to conduct, and it has a lot of studies behind it. Huge meta-analyses have been published on yoga interventions and other mind-body interventions on heart rate variability, and the effect is like very strong.

Can you explain that a little bit? Because I know everybody has it on their Apple Watches. I got messages from my son like, my HRV is not doing well. And I was like, just relax, it's okay.

Yeah, heart rate variability is really interesting. It's a bizarre concept to think that the heart could beat irregularly. Now, it's not irregular like AFib or something, but if you think about if you have 60 beats per minute, it's not necessarily that each beat falls on 1 second. There's some variability where from one beat to the next might be 800 milliseconds and the next one might be 1,200 milliseconds. So they average that one beat every second, but they don't always fall on that. And that variability, there are a few things that drive it, but one of the main ones is the breath. And so if anyone wants to right now, you can put two fingers on your pulse at the base of your thumb. And if you breathe in, you'll notice that as you're inhaling, the heart rate speeds up and then as you exhale, it slows down. And yeah, this is called the respiratory sinus arrhythmia. And the main driver of this is the vagus nerve. So it's mediated by signals that go through the vagus nerve. And so this is a measure of parasympathetic nervous system function. You can actually get a crude measure of that and it's noisy. It's not perfect. Like I, I sometimes think that we read too much into it, but Um, on average it can actually be pretty meaningful. And that's why I think it's so helpful when we look at these big meta-analyses and show that yoga improves or increases heart rate variability. And in other words, it's increasing signaling through the vagus nerve and the parasympathetic nervous system.

Mm-hmm.

And what that really reflects is changes in brain activity. And yeah, I think it's a very fascinating measurement. But for your son, reading into it each day is probably not the most helpful thing, but it's definitely something that you can pay attention to over the course of a week and see trends. And yeah, that's one experiment we did. We also did EEG a couple of years. I bought like a portable EEG kit and fun. We just measured alpha power before and after yoga interventions. I would love to do EEG associated with different cognitive tasks. But that's a little more complicated. I would need to get it so that the timing of the task matches the timing of the EEG, which isn't easy.

But so before you would do the pre and then you do a yoga session and then a post?

Yep. That's how we always do it.

How long is the yoga?

Usually 45 to 60 minutes.

Oh wow. That's long.

Is it? Oh man.

I don't know. I like to break up my exercise into 20 to 25 minute segments, whatever I'm doing.

I'm still stuck in the back in the day when Dharma used to do, you would go to masterclass and it would be on the schedule for 2 2 hours, and then it would be 2 and a half hours, and you didn't even know how much time went by. Like, you were late to your next thing and you just had no idea.

Yeah, if I'm in a live class with Dharma, definitely the time flies. And also, he— did he do the Yoga Nidra at the same time?

Yeah, right. And yeah, we would end with that nice beautiful meditation and nap, Yoga Nidra.

I always— everybody falls asleep. It's that lucid dreaming almost, because You're hearing him, but you feel like you're totally asleep at the same time.

Yeah. I've been thinking a lot about Yoga Nidra. It's super interesting because in, in the yogic philosophy, there are three main states of consciousness: waking, sleep, and dreaming. And the idea is that consciousness is the same for all of them. You are the same witness watching all of those states. It's the same perceiver who's watching when you're awake as the one when you're dreaming, and when you're fully asleep, you don't remember anything, but there's still this element of consciousness. Like, you, you're aware you exist almost. And then the practice of yoga nidra is being in control of that, almost, in a way, where you're like, body and mind are almost asleep, but you're still awake enough that you can perceive what's going on. And I think it makes sense why that would be so helpful for identifying what the witness is.

Mm-hmm. That is so cool. I love how you explain that. How about an EEG when people are doing Yoga Nidra?

I think that study's been done. I actually am not a huge fan of EEG studies. Mm-hmm. So I do EEG for a living. Yes. And tell us about that. Yeah, so I've been—

you're a neurophysiologist.

Yeah. So I just read EEGs looking for seizures. And there's a lot you can tell from an EEG. I can see if someone's awake or asleep, and I can tell how sick they are from the EEG usually. But I'm not convinced that looking at an EEG, looking at the power bands, like how strong signals are in different frequency ranges, is really all that meaningful. Now, there are some newer technologies like high-density EEG where they put way more electrodes on the scalp and they can put that through a convoluted neural network and then you can predict what people are going to say or what they're thinking or what they're going to—

So AI is—

Yeah. And they, and you thought something and AI can translate your electrical signals into speech or movement. And yeah, it's fascinating.

But when you do it from the scalp, the, even the high-density EEG, the last studies that I've seen, and I, it could be different now, but The last studies that I saw were it was like 70% accurate. Oh, it's not that good for global stuff, right?

Like you're saying, like brain death or seizures, right?

Okay, exactly. So EEG is super reliable for epilepsy because synchronized epileptiform discharges create big signals. Of the signals that happen in the brain are so tiny.

Yes.

That it makes no sense that you would pick that up with EEG. So I think when we're doing yoga studies with EEG, they're just saying, oh look, there are changes in the brain, but it's of course there are changes in the brain.

But at least it's showing that there's changes, right?

Exactly.

EEG is electroencephalography.

Yeah.

And it's measuring the tiny little electrical signals from our neurons and our brains. For those of you who may or may not know, it runs on electricity.

Yeah.

So the EEG is measuring these tiny little currents that are given off by our cognition, our brains when, yeah. When we were alive. Yeah.

And the amount of cortex that it takes to generate signal on EEG— so the amount of cortex, the amount of brain tissue that you need in order to generate a signal on EEG is 6 square centimeters.

Wow.

Which is actually pretty big.

That's big.

So there are many neurons, like probably a million neurons in that 6 square centimeters of cortex.

Yeah.

So you're not as resolved, like you, you can't get signals that are specific. It's like this very big signals that you can get.

Our brains do run on oscillations, right? So consciousness is like really about multiple areas in sync. But this is so cool. I love geeking out on this with you. So let's go back to your Neuro Yoga New York City conferences, which came out of this interest in neuroscience and research, right?

Yeah.

You have some amazing people there like Deepak Chopra and Satguru Kalsa, who I've seen speak many times at Harvard Medical School. So tell us about how this came about.

So the neuro yoga events were every Brain Awareness Week for March. March is, uh, when Brain Awareness Week is. One was planned. For, I believe, March 16th, 2020. That one got canceled. Basically, I thought COVID was gonna be like 4 weeks or something like everyone was, but yeah, it became clear over time, especially as I spent more time in the hospital, that was not gonna happen. So then I was thinking like, all right, I guess we have to go online with this.

So it was supposed to be a live event, right?

It was supposed to be live in person.

Mm-hmm.

And the year before that, 2019. We did it at the Dharma Yoga Center, which could— how a lot of people were able to fit in the Dharma Yoga Center. I think we had 90 people or something. It was so cool. Then for online, I was like, wow, it's not going to be as fun. It's really not going to be as fun. So I was trying to think like, all right, how can we see this as an opportunity? What can we make better about it being online? And I realized that it removes all the geographic boundaries and we could invite researchers from all over the world, like instead of me or a graduate student or someone else presenting someone else's work, we could actually get the researcher themselves to present their own work. So it evolved into this conference. And so the first year was 2021, and it was every year we do 3 topics and have multiple presentations on each topic.

Mm-hmm.

So I think in 2021 we had yoga and cognition, yoga and mental health, and yoga and pain, which are really interesting topics in the literature. Yes. And the conference is free for everyone, and it's meant to be like a celebration of neuroscience, a celebration of Brain Awareness Week, and bringing yoga to everyone.

That's amazing, Jonathan.

This was the fourth year of the conference.

Yeah. And I was so proud of you because I heard about it through somebody else. I didn't even know about it from you. I heard about it from someone totally different, like a stranger.

I was like, that is really cool.

That's really cool. It was in my WhatsApp group for lifestyle medicine clinicians.

Wow. That's really cool.

So I thought that was really exciting. So tell us what happens during the conference. It's all remote, right?

Yes. So there are different—

live also.

Yeah. So there are different passes and different ways that it works. So It's a little too complicated. I need to simplify it next year.

But, but the point being, like, people could come live if they want to. And you actually have classes, right? Yoga classes and things like that.

The way it works is someone goes on the website. I've learned a little bit about marketing and I've learned you can't present too many options to people at once or else they won't make any decisions. You just have to present 2 or 3 things at a time and that's it. There's a free pass, like just sign up for it. And so the free pass is people get all the presentations for a limited time during the live conference. It's 24 hours. And then there's an encore of the conference, and everyone who did the live conference can also do the encore, and the encore is available year-round if anyone wants to do it now. And that is for 7 days. They have all the presentations. Then there's upgrades if people wanna take like yoga classes and experiments and question and answer sessions and discussion groups. And then there's like a mini teacher training. It's for people who are really interested in yoga, wanna use this for their career in some way. And that comes with a lot of educational material. So we make worksheets. Books based on all the presentations. There are quizzes. It's basically like school. And so people are meant to leave that, that higher pass, a really deep understanding of the topic. So this year the topics were yoga and cancer, yoga and sleep and insomnia, and yoga and eating disorders.

Mm-hmm.

The idea is that they could now go out, improve how they practice themselves, improve how they teach yoga to other people based on what's been studied. Mm-hmm. And then also be able to advocate for yoga, go to a school or a hospital or anywhere in their community and say, this is the evidence on yoga. I would love to teach yoga to your population if you'll have me.

This is amazing. And you change the topics every year, right? How do you choose the topics?

User feedback.

Oh, okay.

Yeah. Everyone, I, at the end of the conference, I have a form that goes out and I say, what do you wanna learn about next year?

And that's, oh my gosh, that's awesome. So what is it for next year, you think?

I don't know yet. I always want to keep it connected to neuro, but I think it's time to branch out a little bit. And I think, yeah, like metabolism, immune function, there's a lot there and it's pretty interesting. There's a lot coming out about yoga and high blood pressure, yoga and diabetes.

The immune system integrates the brain. You talk about that, right?

Yeah.

That would be interesting. What population do you feel like this has been really popular with or people are interested? Who is it mainly?

Primarily it is people between 30 and 70. I've noticed that we're not reaching enough young people. I definitely want to reach more young people. I want to get high schoolers interested in— I think that's the time to get people interested in yoga. That's when it, it really affects your development and how you cope with everything for the rest of your life. And then the gender distribution is predominantly female by a lot, which I want to change. I want to get more men interested in yoga. I'm trying to think about how to do that. Exactly. And then I always make sure that the presenters are 50/50, 50% male, 50% female. I try to have presenters from all over the world, multiple countries represented. But it's, I think just people hear yoga and they think it's for women.

And then what about medical specialties? I'm sure you get yoga teachers mainly, right?

Yeah, it's predominantly yoga teachers. I do have a few doctors who attend and reach out to me.

Wonderful. This is amazing work you're doing, Jonathan. Seriously.

Thank you. I love it.

And you're having an really amazing retreat in France, right? Tell us about that. How did that come about? You're doing so many things.

So it's because I'm finishing up my medical training and I'm just excited for all the things to come. So I'm trying to do a lot of stuff.

Oh, and you're taking a little break, right?

Yeah. I'm taking a vacation at the end of my fellowship and one of my friends who I met through the conference She lives in France. Her name is Charlotte. She's amazing. And she has a yoga school there where she hosts a lot of retreats about yoga and science. She's similarly really passionate about this. And she, when she heard that I was coming, she was like, we should do a retreat. And I was like, okay, I love it.

So yeah, beautiful.

What is it called? It's La Roche-Guyon.

And it's right outside of Paris, right?

It's about an hour and a half by train from Paris.

Okay.

And it's like the equivalent of— I'm trying to think of a town on the Hudson, like maybe Beacon. It's like Beacon, New York.

Beautiful. It looked gorgeous and historic.

Yes. It has unbelievable downtown charm, but also just that expansive nature. There's a river, the Seine runs through there, and it just looks like the idyllic French town almost.

Amazing. So you're gonna teach a lot of the neuro yoga. There.

There are a few people coming from all over France. Some people specialize in, like, yoga and trauma, or yoga and eating disorders. I'm gonna really focus on scientific evidence, evaluate yoga— how do we know what we're finding is true and believable? And then I'll also do a little bit about what's been studied for a few mental health conditions. For— so for anxiety and depression, the evidence is, like, massive for yoga, which is really cool.

Any particular type of yoga or any yoga?

Oh, this is the best part of the research. So everyone always wants to know what school of yoga do I have to do? Is it Iyengar? Is it Bikram? Is it— and it's no matter which one it is, the effect size is almost always the same.

Oh, fabulous.

And so it doesn't seem to be like if you do this posture, this is what's going to do it. It's really just the big picture focus on postures, breathing, meditation, relaxation, and doing them in an environment where You're paying attention to the breath as you do it and maybe renouncing your ego a little bit and stuff like that. That's what really seems to do it. And then the other question is, what if I don't like yoga? And there's this hu— this wonderful randomized controlled trial that was published. It was called a randomized controlled preference trial.

Mm-hmm.

And they randomized people to either you can choose to do yoga or the control group, which it wasn't active control. I'm forgetting what it was right now. It might've been aerobic exercise. And then the other group, you didn't choose. You were forced to do yoga whether you liked it or not, or you were forced to do the control whether you liked it or not.

Wait, let me guess. If you were forced to do it, it doesn't work as well.

It worked just as well.

It does work.

Yep.

Oh, so that makes me feel better. I used to force my kids to go to yoga with me.

Yep. So it seems like the effects—

you can force yoga?

Yep. The effects are independent of whether you like it or not.

Was it a big study or small?

Hundreds. I'm forgetting the exact number, but it might have been about 300.

That's funny.

Yeah.

My son used to get so angry. I think he would've been the outlier in that study cuz he would get so mad he would've had the benefits. Yeah. Um, that— I love hearing this because where I studied mind-body medicine with Dr. Herbert Benson at the Benson-Henry Center for Mind-Body Medicine at Harvard Medical School, he also looked at all different kinds of meditations. And it really just came down to being able to focus on a word or phrase or something repetitive and just being able to break the train of everyday thinking. It didn't really matter what type of meditation you were doing. So yeah, it makes it so much more accessible to everybody.

And I keep talking about yoga. Many of the studies are actually mindfulness-based stress reduction, MBSR, or tai chi, which is like Chinese yoga, you know.

Tai chi has a lot of studies that actually—

yeah, very strong. Support to the point that tai chi is a very high level of evidence in Parkinson's disease.

So they get Parkinson's people to do tai chi and it improves their movements?

And yes, exactly.

Amazing. Amazing. You know, I did kung fu, right?

Really?

Yeah, I did. I used to do kung fu for 4 years and I got up to level 2. Almost got up to the, the stick.

That's like when Dharma says angry determination, discipline.

But then I had a stress fracture in my Calcanius. And then I went to dharma after that.

Ouch.

Yeah. All right. This is awesome. I love it. And I can't wait to come to your next neuro yoga conference. But if people missed it this year, they can still watch the videos, right? From—

Yep. The encore runs year round.

Tell us where they can find it.

So if you just Google neuroscience and yoga conference, I'm pretty sure it will come up at this point. But if you want the exact website, it's neuro N-E-U-R-O yoga, Y-O-G-A, nyc.com.

Okay. And so Jonathan, you went to 4 years of medical school, 4 years of residency, or 5?

4.

4 years of residency and 2 years of fellowship?

1.

So now you are getting more and more involved in neuroscience and yoga, and you're gonna continue practicing medicine. And why is this so important to you?

Yeah, this is a really, really good question, and I'm, still figuring out for myself what this looks like in my career. I do still think I have a hint of feeling like a pariah in the science world for being interested in this.

No.

And I know I shouldn't, believe me, I know I shouldn't.

I know, but I feel the same way, so I know how you feel.

Yes. And I have, I have a mentor. I'm so lucky to have this mentor. Her name is Dr. Lewis. She's the best. I met her when I was an undergrad and she has been the, she's literally shaped my entire career at every stage. And she is an ICU doctor, so she's intense. She's incredibly intelligent. And so I was really scared to tell her about this yoga stuff I was doing. And so when I told her about it, she was like, that is so cool. You need to publish about this in the journal Neurology or something.

Great.

And I was like, I never even thought that anyone would want that. That's such a change in perspective for me. So yeah, that I'm still thinking about how this will look like in my career. For now. So my— I just accepted an attending job. Yay!

Congratulations!

Thank you.

In New York, right?

Yeah, but it's actually remote, so I'll be wherever I want.

Oh, wow. But you're at a hospital for special surgery?

No, I turned down hospital for special surgery. So I'm taking this job doing intraoperative monitoring remotely, and I'll be practicing at hospitals like across the country, like hundreds of hospitals.

Oh, wow.

Yeah, I'm really excited for it.

So it's almost like teleradiology, except you're just reading— not just, but you're reading EEG monitoring. So when people are operating on patients, you're reading what?

I read EEG. I read motor evoked potentials. So shocking over the scalp and recording muscle responses. Shocking at the sensory nerve. So in the hands or the feet and recording from the brain. And then also EMG, so measuring signals coming from muscles and a few other ones. But those are the— that's like the bread and butter. And the whole idea is I'm just making sure that brain and spine pathways are intact during surgery.

While they're surgarizing.

Yeah.

And a lot of people don't know this, but the brain doesn't have pain receptors.

Right. And you could so easily just cut something.

Yeah.

And you would never know until the person woke up. There's no way to tell unless you test. And so all of this, basically one of the coolest cases and probably the most useful is let's say you're doing surgery on the spine and there's this whole web of stuff in the way and you're like, is any of this a nerve? And you're not sure. The surgeon can just take a wand that we give them and they put it on that mess of stuff and we shock and then I can record from the muscles and see if anything responds. And if it responds, then we know the nerve is there. And it's even cooler because we can calculate how far away the nerve is based on how much amperage, how much current we had to deliver to get that response. Yeah.

So obviously you have to be live though. You, you have to be live during the surgery.

Yes.

And the surgeries can be long.

Yes, for sure.

What's the longest surgery you've been in?

So the great thing is that it's— what I do is interchangeable.

Oh, so what do you do? Swap out?

You just swap out. So it's pretty shift worky.

All right. So congratulations. That sounds like an amazing job.

Thank you.

And useful job.

We'll see. So I am going to have some flexibility with this job. I think I'll have one day off a week and I wanna keep pursuing yoga stuff. So we'll see what comes of that.

And before you go, I just wanna mention really quickly, you did something really interesting with an online study. I, I was so excited about it. And then I also actually submitted a video to a study. So it was like crowdsourcing and they were looking for 10-minute short interventions for depression. Interesting. Because there's a lot of research now showing that maybe you don't have to be on a therapist couch for 10 years every week. Yeah. You literally need 10 to 30-minute single interventions, and that can have an effect for as long as 8 to 10 months. So, uh, Jessica Schleider is one of the researchers who does a lot of work on that, and she's mentoring the postdoc at Northwestern University, and he's crowdsourcing 10-minute videos that might help with depressions. And I talked to him and I submitted one, so hopefully it'll be in there. But I thought about you as I saw that, 'cause I know you did something similar.

Yeah, so first I just have to say that is really cool because I totally agree. Like, therapy works for some people, but for other people they need something more like that. So that I think has the potential to help a lot of people.

And also people can't get access to therapy either.

Exactly.

And, and sometimes when you're talking about stuff over and over in therapy, it might not—

it makes it worse. Yeah, it makes it worse. I actually— and this is a separate thing, but I recently listened to this podcast that was like talking about mental health and being able to get people into therapy and all of that was supposed to make the mental health crisis better, but it's only gotten worse.

And it's—

and like, you think about interventions in medicine, like screening for breast cancer and expanding access to treatment for breast cancer improved outcomes. People really don't die from breast cancer the way they used to, but the opposite is happening in mental health. And it just makes you wonder, like, is screening for it and our treatments for it actually not effective?

Yeah.

Yeah.

And there's so much individuality, including the patient and doctor relationship, and especially in therapy for all medicine, but then especially when you're talking therapy. Yeah. But anyway, tell us about your yoga intervention that you did a study on. Yeah.

So while the amount of yoga research has been exponentially growing, mm-hmm, I do think that there are still some barriers to yoga research. The main ones are funding. So it's hard to get funding for high-quality yoga research. And that's why there is a pretty low quality of a vast majority of studies published on yoga. It's also hard to recruit people to participate in yoga studies.

Mm-hmm.

Often they need to be geographically located near an academic medical center, which most people are not.

Mm-hmm.

And then there are a few other things like standardizing the yoga intervention, making sure that people are getting the same things if they're in the same group. 'Cause you could imagine if it's like a multi-site study, if you have different yoga teachers teaching the classes, they might genuinely be practicing totally different things. And yeah, those are some of the main problems in yoga research. And I've become a huge fan of technology and the internet.

Mm-hmm.

And so I was wondering what it would be like to enroll people in a fully automated, low-cost, high-tech yoga research study. And so I just piloted this. I just put it out there and basically people signed up and went through a 3-week intervention where they did nightly pranayama for 10 minutes. It was randomized and controlled with the comparison group, the control group being sleep hygiene education. And it was also crossover. So half the group started with sleep hygiene, half the group started with breathing, and then they switched. And we were really just looking at measures of sleep quality and anxiety. We found positive results. They're significant. Like, that's interesting, but that's already been shown. I think the interesting part is setting up a study this way and having it be automated. And yeah, I really want to explore all of this more, see if there's ways to do research, but I just need to find a mentor. So if anyone listening to this is looking to take on someone who wants to study this and needs mentorship and laboratory resources, please reach out to me.

I could also introduce it to Ben.

That would be great.

Yeah. Yeah. That's amazing. So you got, anybody could sign up for it, right?

Yeah. So it was, uh, I sent it out to people who attended the Neuroscience and Yoga Conference.

Mm-hmm.

And we had about 58 people sign up and it had a very bad attrition rate. So by the end of it, the number that had completed everything, I believe was something like 56% or something like that. But what I realized is that's because the entire thing was automated. There was no follow-up. There was, it, you just got an email and if you didn't do it, you didn't get credit.

And it was like a video showing how to do pranayama breathing.

Exactly.

Pranayama means breathing, right? So, yeah, that's actually something that I would love to talk about in another time because one of the biggest issues with any of these apps or any of these interventions is compliance. Of people actually doing it and finishing.

Yes.

So that's why I love that short, immediate, 10-minute, 30-minute intervention and you're done kind of thing. In fact, I had a client who told me that in one session of what I taught her, she lost the whole 30 years of anxiety, shifted. It was incredible.

Yeah.

I know that's anecdotal, but it happened to me as well.

Yeah.

Yeah. When I learned about some of this stuff. Anyway, you're brilliant. This was an amazing conversation.

Aw.

And I can't believe like you're doing all this and I'm so excited that we met so many years ago and we continue collaborating. This is great.

Yes. I'm really grateful to know you. Thank you.

Um, thank you for being here. I'm so grateful. And again, one more time, your website.

It's neuroyogany.com.

Excellent. Thank you, Jonathan.

Thank you, Juna Bobby MD.

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