International Day of Yoga 2023

Okay, well, I think we can get started with a fun little talk about science and yoga. We should start with Om. Abha, do you want to lead the Om?

Sure.

Right.

All right, finding a comfortable seat wherever you are, chair or on the floor is just fine. And let's slowly start to tune inward towards our own breath, not changing anything quite yet, just the normal rhythm of breathing. And slowly bringing our hands to heart center, if you want, in Anjali Mudra. Taking a deep inhale through the nose. Open mouth, let it go. Inhaling through the nose again. Exhaling through the nose. This time inhaling through the nose, and on the exhale. We say the sound of om.

Ah.

Slowly rubbing your hands if you want, placing it over your eyes, your face, and gently letting the light in through your eyes. Welcome everyone, so nice to be here.

Thank you so much, Abha. That was actually really, really relaxing.

Oh, thank you.

So we have a pretty casual setup here. We're not, you know, presenting anything too crazy, and we really wanna talk with everyone and have an interactive session. Happy International Day of Yoga. It's really awesome that we get to spend some time together on a day like today, and I have some slides. Again, these are not too serious, so don't, don't stress about slides. But Abha and I have been doing an event for International Day of Yoga for a few years now where we just talk and, and have a, a discussion based on people's submitted questions. And so we'll briefly introduce ourselves. Abha, do you wanna go first?

Sure. Or you want, you can go ahead since you're on.

Okay. So, I'm Jonathan. I am a neurologist in New York City. I actually just finished my residency a week and 2 days ago, which was like one of the, you know, things I've worked the hardest for in my life. So, it's, it feels really good to come out the other end of that. And I'm doing my fellowship in Epilepsy. So, you know, I take care of patients with strokes and seizures and multiple sclerosis, but I really want to become like a super subspecialist in epilepsy. I'm a student of Sridharma Mitra here in New York City, and Anne Yokum here was my first yoga teacher actually. And I am really passionate about yoga. And so it's very natural for me, I feel, to be curious about how yoga affects the brain. And I love that there are other people interested in that too. So it's really special for me to have an event like this where we can talk about it.

Awesome. My turn. Thank you. That's so amazing. Congratulations on the, on finishing.

Thank you.

So, hi everyone. My name is Abha Rajpandari and I am an assistant professor in the departments of psychiatry and neuroscience at Icahn School of Medicine at Mount Sinai in New York. And by training, I am More a biologist, so I study how cells and brain work. So for me, you know, I I guess I look at things more like inside out. And so I have been a practitioner of yoga all my life. So I'm originally I was born in Nepal, and I practiced yoga throughout my childhood, but in different formats like pranayama and dhyana or meditation. And then moving back to the U.S., I started practicing yoga for my own strength. stress reduction during graduate work and postdoctoral work. And then I slowly started getting passionate because I study mechanisms, biological mechanisms of fear and stress. And so I started getting more curious in mind-body practices, understanding the biological mechanisms of it. And so yeah, my lab actually studies how the vagus nerve functions and what are its roles in regulation of stress and fear. And so for me, I think at this point in life. Yoga is obviously part of life, but I look at it through both the lens of science as well as spirituality. And in a lot of ways I find like commonalities and ways to integrate both in my life lately. So yeah, that's my broad sort of share on yoga from both of those perspectives. And so amazing to do this with Jonathan every year.

And so today we have an outline that's pretty loose. We're just going to quickly go over some kind of grounding things. So like, what is yoga when we talk about it in the context of science? What is neuroscience? Why is it so important to talk about these together? An overview of how yoga affects the brain. And then we have a ton of audience-submitted questions. Abha and I were talking before this and getting organized ourselves, and it's overwhelming.

Yeah.

I mean, there were over like 180 questions submitted, so I don't think we're going to get through through everything, but we will do our best and comment on the things we can comment on. Okay, so quickly, I think most people here practice yoga and are familiar with yoga, but it's important to remember that when we talk about yoga, it has many components, and those include yama, the ethical rules, niyama, the personal observances, pranayama, which is breath control and also more than that, Asana, which is the postures, pratyahara, withdrawal from the senses, dharana, which is concentration, dhyana, which is meditation, and samadhi, which is becoming one with the object of meditation. And when we talk about the science, scientific studies on yoga, we really should be thinking about what components of yoga did they include in their studies. And the main ones that are included in well-rounded yoga interventions are postures, breathing, meditation, and relaxation. That's usually what the scientific standard is. But we should also recognize that teaching about the philosophical principles, the ethical rules, the personal observances are really important too. And I think the research really is moving in that direction. There's a lot of even work just teaching those principles alone. So there are kind of new therapies coming out like acceptance therapy that, that works on this. So just bringing this up because it's important for so many of the things we'll talk about in the rest of the session. And then what is neuroscience? I think we all know the term neuroscience. You probably wouldn't have clicked on any links or signed up for this if you hadn't heard that term and were interested in the brain before. But so we all know that neuroscience is the study and of the function and dysfunction of the nervous system. And I think what's really key to recognize is that it exists at many layers. And individual researchers become experts maybe at just one layer, but like at most at a few. No one is doing every single layer of neuroscience. And when I show you all of them, you'll see why you can't really become an expert at all of them. So there's a molecular layer of neuroscience. This is how neurotransmitters and proteins and receptors and signaling cascades contribute to the function of the nervous system. There's the genetic layer, so how the expression of genes and what genes there are affect nervous system function. There's the synaptic layer, so how the actual connections between cells, how that communication takes place. There's the cellular layer, which is really about how electrical signals are transmitted through the cell. There's the network layer, so how information is processed in a network. There's the system layer, so how multiple networks can work together to accomplish goals. And then there's the behavioral layer, which is like what we see happening in our everyday lives. And lastly is this social layer, and not everyone includes this in neuroscience, but Really, this is also an emergent property of nervous systems, right? Social interactions. And if you think about these layers, they really cover every other area of science. And this is why neuroscience is the most interdisciplinary science that we have. So the ones that are lower down, like smaller scale, but higher up on this list, that's like physics, electrical engineering, chemistry. As we get a little bit into the bigger stuff, that's more biology. As we get into the networks, that's computer science. And as we get into behavior, that's psychology. And as we get into the social layer, that's like economics and social psychology. So neuroscience literally covers every other science, right? It's enormous. It is also incredibly interesting. And there are so many techniques that can examine these layers. And the image I'm about to show you— I've covered part of it— is extracted from a recent paper in Nature where they summarize the different techniques in neuroscience. And you can see they kind of have very similar layers that they use to separate the spatial scale of the nervous system. But there's also the time scale, right? So you can study things on the order of milliseconds. You can study things on the order of minutes to hours, on the order of days, weeks, months, etc. And so many of the different research techniques that we have cover particular parts of these scales. So if we really want to look down at the microscopic level, the, the molecule level, the synapse level, the neuron level, we have to use things like measuring metabolic pathways, measuring gene transcription and regulatory networks. If you want to go a little bit higher and look at circuits, you're going to be looking at electrical signals. So putting like implanted electrodes into a single neuron or into a very small region of neurons. If you want to look at systems or the whole brain, you'll use some of the techniques that people are very familiar with, I'm sure. So EEG, fMRI. But you'll notice that A lot of these techniques are very restricted. So like the ones that we all hear about in the news really only covers a very small part of this map, right? And the ones that we want to be able to like really get a full picture of everything, like you can't do them so easily in the only model we have that practices yoga, which is humans. So like measuring gene transcription in a human brain. It's pretty tough to do, right? You'd have to like take a brain sample every time someone did yoga. But the other stuff like optical imaging, connectomics, like even that stuff is completely inaccessible. So in the world of yoga, we really only have the green, the blue, and the purple. That's all we have to really study the way the practices of yoga affect the brain. So I think that's the overview of neuroscience that I hope helps us all speak the same language a little bit. And now I just want to talk about why this is so important. We live in a time when science misinformation, particularly around yoga, has become very prevalent. And we see this on the internet. We see this even in journals, like in published journals from yoga organizations. So there are unproven statements that are repeated over and over again. And most of the time these are pretty benign. So you might hear things like, this posture improves pituitary secretion. I don't think that that's harmful. I don't know what it really means, so it's hard to prove it true or false. But it's, it's definitely not a true scientific statement. And then there are times that these statements can become harmful though. So sometimes people hear, you don't need medication if you practice yoga. And so people have actually abandoned chemotherapy regimens for cancer because of statements like this. So I think it's really important to know what are the things that are true about yoga so that we can really make sure that we're not causing any harm. And despite a lot of this misinformation, there's also a significant growing body of evidence about the effects of yoga on the brain. And this includes things like the effects of yoga on sleep and cognition and empathy and mood and pain processing. So there's so much we really can talk about and statements that we can make. And so, yeah, the point of today is to make sure that those are the things that we're talking about. And this is just a graphic from a recent paper that was looking at science misinformation as a problem in society. And the root causes of it are really just like minor changes, you know, like the game telephone. You say one thing to someone and it gets changed a little bit, and then by the end it's completely different.

Yeah.

That's really how scientific misinformation is happening. It gets passed through so many sources that it ends up coming out completely different by the end. And the way they recommend addressing this is by really educating people about going to the primary literature on science, which is a whole separate topic. But today is really just, we all get to talk together and look at sources. And an overview of how yoga affects the brain, you know, yoga is a huge intervention. It has so many parts like we saw before, and so it has many different mechanisms by which it works, meaning that it doesn't just have one way that it works. So it's not just yoga reduces stress and every other benefit we see from yoga comes from stress reduction. Yoga has effects on sleep, on attention, on memory, on mood, all kind of independently, right? So if you— even if people don't have the stress benefits, they sometimes still have the sleep benefits. So it's not— and it's not the same for everyone too. So it's a very complicated intervention. And so I think this is the best summary of how yoga affects the nervous system. This is from Dr. Satbir Khalsa. And he's one of the preeminent yoga researchers, and he put together this slide showing how yoga practices have so many different effects that feed into each other and kind of contribute to global human functioning. You'll notice that many of these exist at the level of behavioral and psychological parameters, right? Kind of like on that scale of neuroscience we were talking about. And that's because that's where a lot of the evidence lives right now. But you can see that postures, breathing, relaxation, and meditation altogether combined has effects physically, so on fitness, including flexibility and strength and respiratory function, but also on a very mental level. So self-regulation, like the ability to pay attention to what stressors you have and building resilience and equanimity towards those stressors. Also improved attention and concentration and cognition, right? So with practice of all of those systems, they get stronger. And then there's an aspect that's so hard to study scientifically, which is the spiritual aspect. So people experience transcendence and flow states and life meaning and purpose changes. And all of that results in this overall improved sense of well-being and values and life purpose and meaning. And that has so many implications for disease. So I think with that, we can jump into some of the questions that were submitted. Abha, which one do you think we should start with?

You can start with stress.

Okay, perfect.

My favorite topic.

Yeah. Do you wanna go first?

Sure. So I guess we can talk about yoga's effect on stress and emotions and I guess related panic attacks, especially PTSD. So, and then maybe we can bring up polyvagal theory, right?

Okay.

Because it all sort of ties in. So I guess the questions are in relation to how yoga helps with stress and difficult emotions. And as well as burnout, I'm going to put that in the same category. And so in terms of stress, so that's like my area of expertise. That's why I love talking about how stress even works. And so, you know, first of all, stress is not a bad thing, right? Like we humans actually evolved because of stressors, right? So when we were, I guess, cave animals, there were stressors all around us and we had to stay safe from predators and all other things. And in that way, our brain learned to adapt, right? So through 3 sort of defensive mechanisms. So whenever there was this threat or stressors, as we call it, in the environment, then our body had this natural defensive reaction that are in the continuum of the fight or flight or freeze reactions. So whenever there was a threat, we sort of resorted to those defensive reactions. And these defensive reactions are modulated. It's very complicated. You know, it looks— it may sound simple, but what it involves is the entire brain and body axis, right? So whenever there is fight or flight or freeze reactions, the body has to utilize energy from, you know, or the brain has to utilize energy from the bodily resources. The heart rate goes up, the breathing rate goes up, and you flee or fight or freeze in that situation. And so, so in that way, stress was important. And so now what has happened in the modern-day world is that, you know, the stressors, a lot of times, you know, where we have faced threat in certain situations, but in a lot of other situations, it's actually a perceived stress or perceived threat rather than a real threat, right?

So something experience of—

some kind of experience of a threatful stimulus can lead to then later perceiving, you know, similar situations as a stressful situation. And it triggers the same fight or flight or freeze mechanism or defensive reactions that have been present, you know, in us. And so those are regulated by the autonomic nervous system, which has 2 branches, the sympathetic and the parasympathetic system. So the sympathetic system is the one that causes causes these increases in heart rate, breathing, and kind of that fleeing or fighting. Whereas the parasympathetic system is more like a brake to that, right? So it actually decreases, it does the opposite of the sympathetic system. So it puts a brake on that, allowing rest and digestion. So heart rate goes down, breathing rate goes down, and all the other bodily functions kind of go in place. And so in that way, you, when you think, when you look at yoga as a holistic practice, how does it with this system is one of the major ways, you know, it's hard to prove empirically and measure exactly if vagus nerve is up or down. So, there are indirect measures of looking at, right, vagal tone, which is through looking at heart rate variability. And maybe Jonathan, you can expand on that. I know, like, yeah, you have a specific way of describing that, but you can look at it indirectly, but there's It's like, you know, like that presentation Jonathan had earlier. It's very difficult to look at like specific molecules that are changing or, you know, like excitation or inhibition that are changing. It's very difficult to do that. But the way yoga works, you know, is through this parasympathetic system, right? So the major driver of the parasympathetic system is the vagus nerve, which carries a lot of this information from the heart and gut, as well as the lungs into the brain, telling certain parts of the brain that receive this information in the brainstem to kind of dampen the response of the forebrain structures like the prefrontal cortex, the hippocampus, the amygdala, which is important for stress. So telling it to dampen and not lead to a stressful reaction. So that's why it's important in that sort of way. Do you want to add anything in that way?

Yeah. So I think it's also helpful to think about what's upstream of everything. So it's really brain pathways that are determining what is stressful and what is not stressful. And when we're talking about how yoga is working, again, it's working on so many different pathways, and many of those are these higher brain pathways, like those stress-determining networks, like, is this a stressor or not? I think those are the main areas of interest.

This interaction between forebrain as well as the bodily system, this communication is, I guess, what yoga is showing. A lot of research is actually ongoing to understand exactly what are the changes in brain. Obviously, things like Jonathan had shared, like fMRI, which is the imaging of brain regions, those have been conducted, right? Like with interventions of yoga or in long-term practitioners of yoga, like monks, you know, their brain activity has been measured and looked to see which brain areas are changed. And one of the outputs are sort of known from this research is that the prefrontal cortex, which is our decision-making center or critical thinking center of the brain, which actually makes us human and different from a lot of other species because of this stability actually also dampens structures like the amygdala, which leads to the fight or flight or freeze reactions also through communication with brainstem structures. And so in that way, fMRI or imaging studies have shown that in a lot of cases there is this crosstalk between the prefrontal cortex and the amygdala. So yoga can decrease activity in the prefrontal cortex or decrease activity in the amygdala. Increase activity in the prefrontal cortex to dampen these stressful reactions.

And Michelle has a really good question here. She's saying, so are you saying yoga helps us discern between real and perceived threats, or is the heart rate variability really related, also kicking us over into a parasympathetic process? And I think the way to think about it is these are all kind of networks in the brain, right? So it's kind of at that network level and they are talking to each other. So the vagus nerve isn't something that's like deciding, like, now it's time to be fight or flight, now it's time to be rest and digest. The vagus nerve is just the messenger, right? It's the— it's what's passing that along to the rest of the body. And so the brain is ultimately deciding what is a stressor or not, and the main networks that do that localize to the amygdala. So it's really the decision that this is a stressor is made, and then it goes to the vagus nerve or wherever else. Like stress is gonna mobilize so many things. So it's gonna end up affecting the hypothalamus, which then releases certain hormones from the pituitary. Stress also affects the neurotransmitter pathways throughout the brain, kind of like heightening arousal, increasing the amount of attention that you're able to exert. It has effects on all the major descending pathways. So sympathetic pathways going out to kind of increase heart rate, increase sweating, all of that kind of stuff. So it's both, Michelle, I think is the answer, and they're all connected. So it's really that what yoga does is helps with that self-regulation part. And then it ends up affecting vagus nerve activity because of that. And like we were saying, we're really measuring vagus nerve as making an inference about how the stress networks in the brain are working.

Yeah. And one like clarification to add to that is that obviously heart rate variability is an output measure, right, of how the heart is functioning. And so it's very indirect in a lot of ways. And one aspect of this brain-body communication that's not clearly known is obviously, you know, the brain sends information to the body, but the body's also sending information to the brain, right, through the vagus nerve. But very little is known in terms of the mechanisms, right, that are involved in terms of the biological mechanisms, how this all works. And that's an ongoing set of studies in a lot of different labs right now to understand how this bidirectional communication actually happens and how sensory information in the body is actually transferred to the brain. So yeah, I think it relates to that. But yeah, everything, I guess, You know, I guess we can't think of brain just as an isolated organ in that sense. Obviously we have to think, but brain is the driver of, you know, processing these information. So yeah, should we? Mm-hmm.

Go ahead. One person is saying, you know, they, they're positing that the main mechanism by which yoga works is by increasing activation of the parasympathetic nervous system. And I think that that is a mechanism, but it's really hard to say that that's the major or the main mechanism. And I've said this before, but I think it would still be a really interesting study if anyone ever wants to do it, is finding patients who have had their vagus nerve cut. So sometimes that's done for therapeutic reasons, and then seeing if they practice yoga, do they still experience many of the known benefits? And I think the answer will be yes. I think that they will still have improved sleep, improved cognition, they'll have better mood, better mental health. Like, I think that will stand. And that's because a lot of the things that are happening are taking place in the brain. And then, you know, there are effects that go down through the vagus nerve, but that's not the only pathway.

Yeah, I think that's a good segue maybe to kind of clarify about the polyvagal theory then.

100%.

Right. Yeah. I think you already sort of said, because, you know, the polyvagal theory is touted or talked about a lot, especially in the yoga world. But I think one thing that we have to start with is understanding that polyvagal theory is just a theory, right? So it's like, there's a difference in empirical, which is, you know, studies that are, that can be conducted in a lab setting or some kind of research setting versus theory, right? So one of the problems with polyvagal theory is many aspects of that theory is actually even difficult to do in a research or lab setting. And then there are very nuanced aspects of that theory that have holes in it that have either been shown through research or even through some other clear mechanisms of people who understand how vagus nerve works, right? So I think what you said leads to that is that when we talk about polyvagal theory, I think one of the researchers who has published a lot about how polyvagal theory is actually something that we have to really look at critically. And one of the things is that vagus nerve is just a messenger, right? It's not the message and it's not the driver of the message. And so I think that's a very important point because That means brain orchestrates a lot of this communication and there's a lot of things happening in the brain regions, right? Like neuroplasticity. So at a cellular level, at the level of neurotransmitters, at the level of molecules, things are changing. And so yeah, obviously then the polyvagal theory posits that everything is sort of regulated by vagus nerve in a way. And so I think That's one of the holes. I don't know if you want to add more to that.

Yeah, definitely. Everything in science is trying to build a model of how the world works. So what's the relationship between different factors? How does X affect Y? And then once you know that they affect them, how? What's the connection? Can I break it? Can I make it stronger? So really understanding the connections between things. And all models that we build of the world are simplifications. So therefore they are wrong. But some are very useful, right? So like understanding how salt in the diet increases blood pressure is incredibly useful and it's like pretty true even though it's a simplification still, right? It's not the perfect model. The problem with polyvagal theory is not only is it, is there a lot of evidence against it is that it's also actually not that useful. Like, I think it's useful in certain contexts, like when— for a lot of people who are first starting out in studying how, you know, the brain works and how some of these mind-body interventions might work. But you don't need the vagus nerve to think about fight or flight, freeze, or rest and digest. Like, it's not necessary to have these kind of arbitrary lines in the vagus nerve of dorsal and ventral to make that work. That works because of brain regions. That works because of brain networks that we already know about. So those kind of responses have existed long before polyvagal theory. And I think that's the thing that people really find useful once they learn about it. They're like, oh, I'm having a freeze response right now. I'm having a fight or flight response right now. And when they're able to use that label, it increases their metacognition and it increases their self-regulation. So I don't think the polyvagal theory is even all that useful because you could use another theory that has the exact same benefit. The other theory being that, you know, there are these 3 possible responses to a strong stressor: fight or flight, rest and digest, Or Greece. So someone's asking us to define polyvagal theory. We can try. Yeah. So the creator of it himself has said that it is not a falsifiable theory, meaning that it's kind of like not a theory. Anything that, you know, is something in science should be able to be proved wrong. Like if—

because you can't do empirical tests on it, right?

Exactly.

Right. So like it can't just be, you know, there's this famous, there's this famous This thing from ancient Greece. This philosopher Democritus said that everything is made of water, and if you squeeze it hard enough, the water will come out. And his evidence was that if you take an apple and you squeeze it hard, water will come out, right? But then people said, well, what about rocks? And his answer was, well, you're not squeezing hard enough. And so, like, we know that rocks are not made of water, right? But you can't prove him wrong by saying, you know, oh, we just have to squeeze harder and water will come out of rocks. That's why it's just not a good theory that rocks are water, and there's so many other ways to disprove it. So I hope that makes sense as an explanation for, like, why it's so important to be able to prove something wrong when you're using it as an explanation. But the core tenets of Polyvagal theory are basically that there isn't one vagus nerve, which I think everyone agrees with, but it kind of breaks the vagus nerve up into this dorsal and ventral systems that have very separate responses where one of them is kind of promoting this like rest and digest behavior. And then another one is more like this freeze. behavior. And it also emphasizes how kind of facial expressions are very connected to vagus nerve function, which, you know, that part really never made sense to me. And there's a lot of neuroanatomical criticism of that because they are separate nuclei in, in the brainstem. But that's kind of the— gist of polyvagal theory. I don't know if you want to add anything to that.

Yeah, I think it's like more emphasis on the responses, right? The immobilization or the freeze response, the mobilization or fleeing response or fighting response, and then social engagement that happens when those responses are not present are all sort of modulated through the vagus nerve pathways. That either, you know, there are these dorsal structures of the vagal nuclei in the brainstem that send projections. There's another region that sends projections to the heart. So basically it's saying all of these reactions or responses in the continuum of that freeze or fighting or fleeing or being socially engaged are all through the vagus. Right? Those nuclei of the vagus. And I think that's the biggest problem because, you know, years of neuroscience research shows that social engagement or these fight or flight responses are regulated by higher order or forebrain structures. And so that itself is problematic. And I think it also places a heavy focus on just the cardiorespiratory or cardiovascular system, kind of ignoring other systems in the body like the gut function. Because, you know, these structures, these nuclei in the brainstem that are major vagal modulators are not— they not only modulate cardiorespiratory functions, but they also modulate immune functions, they modulate gut functions, pancreas, and many other functions. So it kind of completely ignores those, right? So yeah, that's what I would Yeah.

That being said, there's a ton of behavioral, um, and even blood serum level measurements of how yoga affects the stress systems. And there's a ton of evidence that yoga improves both— it has both acute and chronic effects on stress. So doing yoga even just once, and, you know, There are studies even just doing breathing exercises. There are studies just doing meditation. There are studies just doing postures. There's studies doing all of them. There's studies doing yoga nidra. All of them seem to have effects on stress. This has been measured through like standardized subjective scales, but also if you look at things like cortisol measurements, if you look at things like heart rate variability. And again, none of these is a perfect measure, but I think putting it all together, we have multiple layers of neuroscience that yoga has has pretty large effects on stress. This has also been shown in different populations. So, you know, you could say, does it affect stress in a healthy person between the ages of 18 and 65? So like a healthy adult, yeah, it affects stress. But what about people with cancer, right? They have way significant stressors than other people, and it also helps a lot with stress there. What about people who are in really stressful jobs that have like a lot of shift work and sleep disturbance? You know, there I think the evidence is more mixed, honestly, but that's because those populations, you know, I don't, I don't think anything will help them except getting out of those situations.

Right. I think just helping with sleep itself can help many other aspects of life, including immune functions and brain functions, right? Sleep is, I think we take it for granted, but that, that's also where I think yoga has huge beneficial effects for conditions that involve stress, stressors, right? Like post-traumatic stress, panic disorders, or others where, you know, increases in these heart rates and things because of that, those stressors can cause disturbances in sleep. And so even in like firefighters and veterans with PTSD, I think these studies have been done showing that one of the major beneficial effects of yoga, especially like, I guess, meditation-based practice can help with sleep. And consequently help with other aspects of life, right? Because once you have a good night's sleep, I think it, you know, management of stress or your immune system, I think all of those are affected.

Yeah. And this is another study that I've been saying I wanna see for a while, which is do a yoga intervention, but control how much sleep people get. So don't let their sleep get better and see if they still have cognitive benefits, see if they still have mood benefits. And if they don't, then that means that sleep is really one of the main mediators, right? So like you need to have better sleep after yoga in order for everything else to get better. But if they do still have benefits, that means that there are separate pathways on top of sleep too, which would be super interesting to see.

Yeah, there's more questions.

What about yoga for PTSD, Abha? Do you want to add anything about that? I know that was—

Yeah, yeah. So for, I mean, I think PTSD, there's a lot more research that has been done, right? Both like randomized control as well as other studies that show that actually, and this is what I was referring to, is that yoga's beneficial effect. Actually, another thing we talked about sleep is also pain management, right? So, cuz yoga also helps with either like, cuz you know, pains, there's no pain recep— pain is not, it's signal coming from the body to the brain, but brain itself doesn't have pain receptors, right? And so The brain senses pain. And so there are studies showing that modulation with mind-body practices like yoga and other can alter how you perceive the pain that you're sensing. And so I think that's another place where in people who have, you know, either injuries that are associated with that trauma they've experienced, it also helps with management of the pain. And so that's That's another area where research has shown. I think sleep is one of the major ones where it has shown beneficial effects. And then yoga nidra, there's studies shown, actually showing that yoga nidra, actually, even though it's a short practice, it has a very similar effect on brain activity, like sleep, even for short periods of time, you know, with the different waves that are happening in our brain during sleep are very similar. During yoga nidra. And so yoga nidra or this deep sleep can actually help with actual sleep. And so that's another way it can have, it has been shown to have beneficial effects in people with PTSD, in stress management, in immune regulation and other functions. I think also eating patterns and things like that.

Mm-hmm.

And then what about adverse childhood experiences? There's a lot of research showing that adverse childhood experiences worsen outcomes, health outcomes later in life. So higher risks of cancer and diabetes and heart disease, but also psychosocial outcomes like incarceration and addiction. What, what do we know about yoga's ability to prevent adverse childhood experiences from resulting in disease later in life, if anything?

Yeah. So that's a very complicated, right? And I don't think there's been like, obviously for that, there has to be a long-term study. And so that hasn't been conducted because you'd have to track, right, someone with that, but someone at an adult, so similar to like PTSD, because there are compounding stressors or traumatic events, right, that can have, that can lead to PTSD. And so in that case, You know, the traumatic events or experiences or adverse outcomes, childhood experiences are similar. You know, in terms of diagnosis, that's another sort of controversial area, right? Like how these conditions are diagnosed. But I would say, I think from the studies, few studies that are there, it's very similar, right? Like management of stressors and outlook on life. One I know study from one researcher, I'm blanking on her name right now, who have looked at actually women who've either had traumatic experiences, you know, in their early life and later developed PTSD. It can help with things like, and so there's, this is an actual study done showing like meditation as well as asana-based practice has actually helped with things like rumination. So decreasing ruminating thoughts. So this is used like this is measured by asking people to, I guess, fill out questionnaires. And so they've looked at, you know, rumination, anxiety scales. So measures of anxiety and then physiological measure. I think heart rate is what they looked at and they've found beneficial effects of yoga on all 3 of those measures. So that's what I would say, you know, even though there's not like long-term studies that have been done so that it kind of hints, right, that it has a very similar effect. One thing about yoga is like, you know, I think Eddie uses this a lot, like someone with pain, someone with trauma, someone with some other condition, like everybody with different, like sort of things walk into a yoga space and practice and then leave feeling better in a way. Right. So it affects, yoga has, I guess, this multidimensional sort of effect in many aspects. So it's not just one, right? way that we can look at things. Yeah.

And that's that global functioning.

Yeah.

Yeah, exactly.

So, wow, we've talked so much.

Oh my gosh. Yeah.

We didn't, we didn't even get through a fraction of these questions. I don't know how to address them.

But I think we covered a lot in that, right? In when we talked about stress. So should we go through the live questions? Some of these, I don't know if there are any.

Absolutely. I also opened the mics if anyone wants to ask a question or jump in. Michelle, in terms of like nerve connections, I think we need to narrow down on what that really means. So it's very hard to measure a synapse-level thing. Like in a human, you would need to sacrifice them and measure the synapses, right? And it's very hard to do it without that. So the, I think the answer to your question is We are making inferences about how synapses are changing in the brain. Sometimes you can do studies where you look after someone passes away, you can take their brain and look at synaptic connections. But the only way you'd be able to do that with respect to yoga is see at the end of someone's life after they've been practicing yoga for a long time, how does their brain compare to someone who hasn't been practicing yoga? And it's, it's hard to, I mean, think about this. There are 100 billion neurons in the brain. It's really like 80 billion, but whatever, it's 100 billion, we'll say. And each of them has 1,000 connections or more. But we're literally talking in the hundreds of trillions of connections number, right? So it's like really hard to make clear conclusions when you're dealing with such large numbers. There are people who try to— there's actually a very famous researcher who believes that by mapping the entire brain, we will understand it completely. But there are a lot of neuroscientists, including one of my mentors, who strongly disagrees with that. He thinks what really matters beyond connection is function. So not just how are these things connected, but what happens when they talk to each other. And, you know, I think he's right, obviously.

There are 2 hands.

Hi, Carla. Thank you very much, Dr. Abba and Jonathan. Dr. Jonathan, congratulations. Has there been any research that you can point us toward for the neuropathy that people have been experiencing in their feet? A lot of times it's attributed to diabetes, but I have clients that over the past few years have seemed to have developed this. I don't know what it's from, but I'm looking to try to help them be more comfortable in their own body. So that was the nature of my question. If you know of any studies that are looking at that and any advice. Thank you.

Definitely. So, hi Carla. The thing with neuropathy, it's one of the worst diseases. I hate it so much. It's, there are thousands of causes of neuropathy. So you really, if someone is experiencing what is thought to be neuropathy, they really should see, you know, a doctor and have those causes looked for. Many of them are reversible, many of them are not. And so it's, it's can be really tough. And there are studies looking at yoga interventions for neuropathy. And really the takeaway is that it helps with kind of compensating from the neuropathy. So the improved self-regulation, the improved sleep, the improved mood all help with coping with neuropathy. And then, you know, one of the really tough things with neuropathy is, is mostly you know, a lot of neuropathy occurs in the feet. And so, if you can't feel your feet, one of the main ways that you balance is by receiving information from your feet about where they are in space. And if that's not working, balance gets a lot harder. So, yoga, as we know, includes a lot of balancing practice. And you're basically training other systems in the brain, like the vestibular system, which uses the head position to figure out balance, That gets stronger. And so now you have kind of a compensation mechanism for neuropathy. So those are kind of like the main ways that yoga can help neuropathy. But again, like it's, I would never say like, all you need to do is yoga and your neuropathy will get better, right? That's not true. The most common cause is diabetes, but there are other causes like vitamin deficiencies. There are also toxicities. So actually during, this is crazy, but during COVID a lot of people were taking zinc supplements. Mm-hmm.

Right.

Zinc toxicity causes neuropathy and also something like a myelopathy, which is where you get spine— the same thing happening in the spine. So this is like, you know, these are the kinds of things that someone has to be thinking about and looking for, because stopping taking the zinc is what would help that person. But that doesn't mean that no one should take zinc. It's just, you know, you need someone who's looking at the individual and thinking about what for them is best.

Like you said, it's a big world of a lot of ifs. So, yeah.

I was going to pull up this, you know, there's this review book. There's a whole book from the American Academy of Neurology on neuropathy. And it goes over how to test for and look for the causes. And I was going to show you the list of causes. It's like insane. It's like keeping track of them is, yeah.

Well, thank you so much. You've expanded my consciousness tremendously. Thank you. Thank you.

I think there's one more.

Yeah.

Hi, Abha.

Hi, Jonathan.

Hello.

I hope I'm saying your names correctly. So I have done my MA in yoga, and I'm an ardent yoga practitioner for past 14 years. And my studies revolve more around the theory, theoretical understanding of yoga coming from Vedic texts. And I have done a mastery in Patanjali Yoga Sutras. Now putting it into the research and the scientific category, my question to you guys is, is there any current research that you could guide me towards where they are really trying to find out how asanas are helping to reduce the rajas component, the, the rajasic tendencies, while the pranayama is helping to reduce The Tao music and ringing of the bells. So these are again the science ideologies, but I am more fascinated being a student of science. I want to know what's going on in the scientific world with regards to these theoretical or experiential aspects through the knowledge of the traditional knowledge or the ancient knowledge.

Yeah, I think I am myself also curious a lot of times about those aspects. As far as I know, I don't think those kind of things, it's like there's theory-based, there's a researcher at MIT who studies like consciousness and he's broken down a lot of the traditional knowledge, you know, including like Patanjali's Yoga Sutras, as well as aspects of Bhagavad with Gita and also like the Sankhya philosophy into those aspects of consciousness. And again, it's more like a theory. It's, there's no empirical study showing how, you know, these rajas, tamasic, you know, these kind of aspects are measured. And I mean, that would be amazing, right? If that's something that's— Yeah. I would be the crux.

Somebody does that research, it would be the crux of yoga.

Yeah, I think it's as far as I know that hasn't been done. I know a lot of like different groups of yoga lineages, right? Like teachers like Sadhguru's Isha Foundation works with a bunch of researchers at Harvard and they're trying to look at aspects of like one specific kind of practice. Like what is it called? Like kriya practices and how that impacts, right? Like again, the similar kind of outcomes like heart rate and things like that. And then the Sudarshan Kriya, right? I think there's There's a lot, I think Jonathan and I had talked about this, there's a lot of research on that. I think that group actually even got a big grant recently, right? To study.

Yeah.

They got a big research grant to study like aspects of that Kriya practice. But again, the outcome measures, like you said, it's not at the level of those, you know, things that like tamasic or these components, but rather again, these tangible sort of scientific measures, right? That's traditionally used. Yeah. So unfortunately, I think, right? Would you agree, Jonathan?

Yeah, I think, I think we would need to standardize measures of things like rajas and tamas and sattva. Like we don't have that right now. So how would you even measure it to start?

Okay. Okay. And then I just have one last question for Abha. Abha, you are working in the vagus nerve. Department and being a scholar in that field, I would really like to know, have you been ever able to map it with Kundalini energy or Sushumna Nadi or anything like from gross to subtle? Have you ever experienced anything during your studies?

No, absolutely not, because I study again molecules, biological systems, and if know, right? Like the Kundalini yoga system, the nadis and the chakras, they're not, they're not at the physical plane at all, right? They're all energetic. And so similar to like gravity or magnetism and other things, which, which is, you know, I guess magnetism you can still measure, but it's one of those subtle aspects, right? So yeah, no, not at all. Everything we do is at that physical level, right? Like molecules and cells and synaptic connections and things like that. But yeah, it would be curious, you know, because this philosophy—

Nonetheless, you're doing amazing work.

Thank you so much. Thank you for the question. All right, it's— oh my gosh, there's so much more. I guess we could go on.

If anyone, you know, needs to go, please, please don't. You know, we always have more things coming You know, always feel free to write questions down. And I think one of the things that we're really working on is empowering everyone. I think that's a major goal. And if you want to learn more and, you know, don't wanna wait for your turn for a question, there's, there's not that we even could answer every question honestly, but there's Google Ananda, right? That's what my yoga teacher says. So Swami Google Ananda. And if you go to like Google Scholar or PubMed, there are tons of papers there. And we have actually a video on the Neuroscience and Yoga YouTube page about how to find these papers and how to read them. And I think that that's a really empowering skill. So—

I, I just saw related to, I guess, Shweta's question, I think the impact of yoga and arousal may kind of address the 3 gunas. Yeah, somewhat, maybe, right? Looking at, I guess, reactivity, startle reactivity and things like that. But again, it won't encompass all the aspects, subtle things. Are we going on this?

Yeah, I guess if you— Abha, if you need to run, please.

No, no, I'm good.

I think Deanna has her hand up.

Oh yeah.

I will make this really quick. I started yoga in the '90s because I had cancer and health problems with a background of having encephalitis as a child. So it was amazing the first time I took it. I've been teaching since, and I just wanted to share if anybody's in the Philadelphia area and they're interested in doing a research project and you need a yoga teacher, or if there are any projects going on that you would like to participate I am interested in participating and helping in any way if any of you need it. So that's what I wanted to share. And it's not really a question other than if people are— if there's a research project in this area.

There were actually a lot of questions submitted about how do I get involved in research. And I think that that's a fantastic thing, like that people want that. And so, yeah, the— there are always the options to participate as a subject in research, meaning that you're one of the people who's, you know, contributing data. And the— I think the best ways to get involved with that kind of thing are to go to clinicaltrials.gov. And I've actually never done this for yoga. I've never even thought about Becoming, you know, wow. So if you go to clinicaltrials.gov and you search yoga, there's actually a lot. There's 150 studies recruiting right now.

Oh, wow.

I didn't know that.

That's so cool. So you could browse this and see, you know, which ones stand out to you. So there's some that are very specific. So this one is yoga therapy during chemotherapy and radiation treatment for the improvement of physical and emotional well-being. being in patients with stage 1B2 to 3B cervical cancer, right? So that's a very focused study. But then there are some like tele-yoga and dystonia. That's really cool. That one's probably open to, you know, a very wide geographical area. Of course, the disease dystonia is very narrow. Yeah, there's a ton. So this is a great way to find studies if you're interested in participating. And then And if you're interested in conducting research, I think that also is amazing. And generally, you're gonna have to find, you know, like a supervisor, like someone with— like Abha. So Abha like runs a lab. She has graduate students who work kind of like on individual studies, and then there are assistants who are assisting the graduate students, and then Abha is like supervising everyone. And the job of a research assistant is open. Like, that's a— that's something that is a way to contribute if you haven't done much science before and you want to start getting into it. And then to do some of the other work in the lab, it's like an educational ladder. So like a master's, a PhD, those are kind of like the ways to climb the science ladder. But yeah, like research assistant, research coordinator, those are job titles open to everyone.

Yeah.

And I also just a little addition to that, cuz that presentation in the beginning, there are many aspects, right? There's the biological systems, there is the imaging and all of that. So also it's important to understand what the lab is working on because, because, you know, It's like expectation versus reality in terms of like each lab is working on a very, very focused area of research and it's difficult for one researcher to do everything, right? So that's why like it's like divide and conquer kind of method in science. And so, you know, there are labs that are doing active studies in recording brain activities, you know, with imaging. short-term, long-term yoga intervention or yoga practice. But then there are labs like mine which are studying like molecules and biological systems, right? Like that coordinate these mechanisms and things like that. So it's also, I guess that's the aspect, right? Like understanding what you're trying to learn or get yourself into.

Yeah. And there's so much more to say about like choosing a lab and finding the right mentor And how do you tell if someone's a good, like, principal investigator? Like, those are all things that maybe we should talk about another time.

Yeah. Something that doesn't usually come up, but yeah, definitely. Yeah. So much interest. But yeah. Oh my gosh. It's like endless, right? We can, I think we can have like so many of these sessions and it'll still probably be short.

Yeah. Fantastic. Thank you so much.

Thank you.

I really appreciate that you guys are doing It's definitely, yeah, we'll have to do that.

It's awesome for us.

It just fascinates me most about yoga because, you know, I started out as an art therapist and so the mind-body thing has always just been so fascinating to me. So I appreciate that you guys are taking the time to do this.

Well, we appreciate that you're taking the time to be here.

Yeah.

It's a great, I think this is the best way to celebrate International Day of Yoga. We're really talking about the future of yoga, right? Yoga is really old and traditional. It's been around for thousands of years, but it's always evolving. And I think really the next stage of it is this scientific stage where we understand the benefits and limitations so well that it's integrated into every aspect of society, like schools and health systems and And yeah, I think that's really the work that all of us are doing right now, which is an amazing way to celebrate International Day of Yoga.

Yeah. And it's definitely moving in that direction because the NIH, National Institute of Health, is actually funding a lot of research in understanding mind-body practices, including, I think this was related to question about tai chi, qigong, like yoga, you know, any other of these mind-body practices. They want to understand what's the biological mechanisms, right? 'Cause we know there's beneficial effects. Ancient traditions have always like touted, but it's more like for a lot of people, they need hardcore scientific evidence. Right. And so I think that also helps drive, I think these kinds of practices being like kind of a mainstay in any kind of therapeutic avenue, right? Like obviously it may not replace pharmacological or other treatments, which we talk about, right? Like for example, in blood pressure, you, you need that. But in terms of managing symptoms as a complementary practice, right, it's already gaining a lot of, I guess, attention in that regard. Yeah.

Yeah.

All right.

So we can wrap up and keep the conversations going elsewhere.

Yeah.

Thank you so much, everyone. If anyone wants to continue the conversation, there's also the Facebook group, which if you're not in, just email me and I'll put you in it.

I'm actually not in Facebook.

Yeah, I made a Facebook just for this group. Otherwise, I don't have a Facebook.

Okay.

All right. So we will wrap up.

Closing breath.

Say that again, Carla.

With your— with the closing breath again.

Yes, we'll do a closing om. Abba, do you wanna do it?

Do you wanna do it? No?

Sure.

Okay.

All right.

So sitting up nice and tall, shoulders back, eyes closed. And as you inhale, follow the breath from the center of the chest all the way up to the space between the eyebrows. And exhaling down center of the chest. Inhaling up space between the eyebrows. Exhaling down center of the chest. Inhaling up. Exhaling completely. And inhaling to a quiet om. Shanti, shanti, shanti. Thank you all for coming. Happy International Day of Yoga.

Thank you so much, everyone. It's such a pleasure to be here with you all.