BENEFITS RISK OF YOGA FOUND FOR BIPOLAR DISORDER

Right now no one can say whether yoga provides clinical benefits to people with bipolar disorder, but in a new article in the Journal of Psychiatric Practice, researchers report survey responses they gathered from scores of people with the condition who practice yoga. What the collective testimony suggests is that yoga can be a substantial help, but it sometimes carries risks, too.

There is no scientific literature on hatha yoga for bipolar disorder," said lead author Lisa Uebelacker, associate professor (research) of psychiatry and human behavior in the Alpert Medical School of Brown University and a staff psychologist at Butler Hospital. Hatha yoga is the practice, familiar in the West, in which people move between various poses. It often includes breathing practices and meditation. "There is reason to think that there are ways in which it might be wonderful and ways in which it might not be safe. We are interested in studying hatha yoga for bipolar as an adjunctive treatment to pharmacotherapy."

The preponderance of responses from more than 70 people who answered the study's online survey were that yoga has benefits for people with bipolar disorder. When asked, "What impact do you think yoga has on your life?" the vast majority of responses were positive and about one in five respondents characterized yoga as "life changing." One even said, "Yoga has saved my life. ... I might not be alive today were it not for yoga."

Twenty-nine other respondents said yoga decreased anxiety and promoted calm or provided other emotional benefits. Calm also emerged as a specific benefit for 23 survey respondents when asked how yoga affects mania symptoms. Other benefits that were mentioned repeatedly included distraction from depressive thoughts and increased clarity of thought.

"There is clearly evidence that yoga seems to be a powerful practice for some individuals with BD," the researchers wrote in the paper. "It was striking that some of our respondents clearly believed that yoga had a major positive impact on their lives."

Throughout the survey there was also evidence that yoga could be problematic for some people with BD, although fewer people cited problems.

In response to survey questions about whether yoga has had a negative impact, for example, five respondents cited cases in which rapid or energetic breathing made them feel agitated. Another became too relaxed after a slow, meditative practice: "I fell into a relaxed state ... near catatonic as my mind was depressed already. I was in bed for three days afterward."

And like some people in general who practice yoga, 11 respondents warned that there is the potential for physical injury or pain. Another four said they became self-critical or frustrated with their performance sometimes during yoga.

"It's possible that you want to avoid any extreme practice, such as extended periods of rapid breathing," Uebelacker said. The survey also raised some concerns about heated yoga, which is consistent with evidence that the use of certain medications for bipolar disorder, including lithium and antipsychotic medications, are associated with possible heat intolerance and resulting symptoms of physical illness.

Next: a pilot clinical trial

The online survey is the first stage in a research program that Uebelacker, who has spent several years studying yoga for unipolar depression, and colleague Lauren Weinstock, an expert in bipolar disorder, are developing to examine yoga for bipolar disorder. They now have a grant from the Depressive and Bipolar Disorder Alternative Treatment Foundation to run a pilot clinical trial in which they will compare outcomes from yoga to outcomes from using a well-regarded workbook for bipolar disorder.

Those results could set the stage for a larger trial with enough statistical power to rigorously identify benefits and risks, Uebelacker said.

For many bipolar patients, symptoms persist for decades despite multiple medications. The current studies of yoga, Uebelacker said, are part of a broader program at Butler and Brown to determine what else can help people who are already undergoing conventional therapies.

"We're looking at alternative ways to cope with suffering that is part of people's everyday lives so that there are other options in addition to ongoing medication and psychotherapy" Uebelacker said.

As their research continues, they will learn what role hatha yoga might play.

Gene Found Thats Responsible For Sensing Pain

Today's post from sciencedaily.com (see link below) is actually another step in the current progress of gene therapy towards handling extreme pain. In this case, researchers have identified a gene that blocks pain-sensing nerve cells in a tiny minority of people who cannot feel pain. The emphasis has always been on researching those cells that do transmit pain signals but this could be equally important in leading to ways of genetically blocking selected pain signals in the future. It's a complex subject but this article explains it quite simply and gives us hope that scientists really are on the verge of major breakthroughs when it comes to treating neuropathic chronic pain.

'Pain sensing' gene discovery could help in development of new methods of pain relief 
May 25, 2015 University of Cambridge

A gene essential to the production of pain-sensing neurons in humans has been identified by an international team of researchers co-led by the University of Cambridge. The discovery, reported in the journal Nature Genetics, could have implications for the development of new methods of pain relief.

Pain perception is an evolutionarily-conserved warning mechanism that alerts us to dangers in the environment and to potential tissue damage. However, rare individuals -- around one in a million people in the UK -- are born unable to feel pain. These people accumulate numerous self-inflicted injuries, often leading to reduced lifespan.

Using detailed genome mapping, two teams of researchers collaborated to analyse the genetic make-up of 11 families across Europe and Asia affected by an inherited condition known as congenital insensitivity to pain (CIP). This enabled them to pinpoint the cause of the condition to variants of the gene PRDM12. Family members affected by CIP carried two copies of the variant; however, if they had only inherited one copy from their parents, they were unaffected.

The team looked at nerve biopsies taken from the patients to see what had gone wrong and found that particular pain-sensing neurons were absent. From these clinical features of the disease, the team predicted that there would be a block to the production of pain-sensing neurons during the development of the embryo -- they confirmed this using a combination of studies in mouse and frog models, and in human induced pluripotent stem cells (skin cells that had been reset to their 'master state', which enables them to develop into almost any type of cell in the body).

PRDM12 had previously been implicated in the modification of chromatin, a small molecule that attaches to our DNA and acts like a switch to turn genes on and off (an effect known as epigenetics). The researchers showed that all the genetic variants of PRDM12 in the CIP patients blocked the gene's function. As chromatin is particularly important during formation of particular specialised cell types such as neurons, this provides a possible explanation for why pain-sensing neurons do not form properly in the CIP patients.

"The ability to sense pain is essential to our self-preservation, yet we understand far more about excessive pain than we do about lack of pain perception," says Professor Geoff Woods from the Cambridge Institute for Medical Research at the University of Cambridge, who co-led the study. "Both are equally important to the development of new pain treatments -- if we know the mechanisms that underlie pain sensation, we can then potentially control and reduce unnecessary pain."

PRDM12 is only the fifth gene related to lack of pain perception to have been identified to date. However, two of the previously-discovered genes have already led to the development of new pain killers that are currently been tested in clinical trials.

"We are very hopeful that this new gene could be an excellent candidate for drug development, particularly given recent successes with drugs targeting chromatin regulators in human disease," adds Dr Ya-Chun Chen from the University of Cambridge, the study's first author. "This could potentially benefit those who are at danger from lack of pain perception and help in the development of new treatments for pain relief."

Story Source:

The above story is based on materials provided by University of Cambridge. Note: Materials may be edited for content and length.

Journal Reference:
Jan Senderek et al. Transcriptional regulator PRDM12 is essential for human pain perception. Nature Genetics, May 2015 DOI: 10.1038/ng.3308

http://www.sciencedaily.com/releases/2015/05/150525120428.htm