Distinct Insular Functional Connectivity Changes Related to Mood and Fatigue Improvements in Major Depressive Disorder Following Tai Chi Training: A Pilot Study

Abstract

Objective: Tai chi (TC), a contemplative practice combining slow movements and deep breathing, has been shown to be clinically effective in alleviating depressive symptoms. Feelings of fatigue or low vitality often accompany major depressive disorder (MDD) though they are commonly overlooked and not well understood neurologically. By using resting state functional connectivity (rs-FC) using the insula as the seed, this study examines the relationship between mood and vitality symptoms in MDD and how they are impacted by TC training. Methods: Patients (N = 16) with MDD participated in a 10-week TC intervention. Self-report scores of vitality (using the SF-36 scale) and depressed mood (using the Beck Depression Inventory) as well as rs-fMRI were collected pre-and post-intervention. A seed-to-voxel approach was used to test whether changes in insular rs-FC were related to therapeutic improvement in MDD-related symptoms resulting from TC practice. Results: We found decreased self-reported depressed mood and increased vitality following the TC intervention. Furthermore, decreases in depressed mood were associated with increased rs-FC between the right anterior insula (AIC) and superior temporal gyrus and caudate (cluster-corrected p < 0.05). Increased vitality was associated with increased rs-FC between the right posterior insula (PIC) and regions associated with sensorimotor processes (cluster-corrected p < 0.05). Conclusion: These results provide support for differential changes in insula connectivity as neural correlates of symptom improvement in MDD.

If It All Comes Down to Bodily Awareness, How Do We Know? Assessing Bodily Awareness

“…But to my knowledge, although currently underway, little clinical research has been completed and published on brain imaging with mindful-movement practices and interoceptive bodily awareness. An exception is a recent study on tai chi and depression (Xu et al, 2020). Although bodily awareness was not assessed directly, the authors found connectivity changes indicating "a shift towards processing experience according to sensory rather than cognitive aspects .…”

Effects of Tai Chi Practice on Brain as Assessed with Neuroimaging Techniques – A Scoping Review

“…There were 13 randomized control trials with 17 articles [16][17][18]20,24,25,27,28,32,33,[40][41][42][43][44][45][46], 8 cross-sectional studies with 12 articles [21][22][23]26,[29][30][31]34,[36][37][38][39], and 3 single group pre-and postcomparisons with 3 articles [15,19,35]. Among these 24 studies, 17 of them with 21 articles had elderly subjects who were 60 years and older [20][21][22][23][24]26,[29][30][31][33][34][35][36][40][41][42][43][44][...…”

“…Among these 24 studies, 17 of them with 21 articles had elderly subjects who were 60 years and older [20][21][22][23][24]26,[29][30][31][33][34][35][36][40][41][42][43][44][45][46], 4/24 studies with 8 articles had mixed age groups with subjects 21-70 years old [17,19,27,28,32,[37][38][39], and 3 studies had healthy young subjects [16,18,25]. The majority of these studies used healthy subjects [15,16,18,[20][21][22][23][24][25][26][27][28][29][30][31][33][34][35][36]…”

“…• Left superior frontal gyrus ---posterior insula [19] • Left superior frontal gyrus ---ventral striatum [30] • Left middle frontal gyrus ---left superior parietal lobule [25] • Dorsolateral prefrontal cortex ---anterior cingulate cortex [27,32,37] • Dorsolateral prefrontal cortex ---medial prefrontal cortex [32] • Dorsolateral prefrontal cortex ---angular gyrus [37] • Bilateral prefrontal cortex -----bilateral hippocampus [43] • Medial prefrontal cortex (mPFC) ---anterior cingulate cortex [32] • Medial prefrontal cortex ---medial temporal lobe [45] • Left superior parietal lobule ---right posterior insula & left superior temporal gyrus -right posterior insula [22] • Superior temporal gyrus ---right anterior cingulate cortex [22] • Right anterior insula ---superior temporal gyrus [22] • Bilateral amygdala ---medial prefrontal cortex (mPFC) [15] • Medial hypothalamus ---thalamus and amygdala in fibromyalgia [17] • Medial orbito-frontal cortex ---periaqueduct grey (PAG) and ventral tegmental area [27] • Dorsolateral prefrontal cortex ---supplementary motor area and anterior cingulate cortex (ACC) [28] • Dorsolateral prefrontal cortex ---left thalamus and ventral striatum and right middle frontal gyrus [36] • Bilateral angular gyrus ---dorsal prefrontal cortex ---anterior cingulate cortex network [37] • Hippocampus/PAG ---ACC/mPFC [32]…”

Physical body experiences questionnaire simplified for active aging (PBE-QAG): Validation with Rasch measurement theory

“…Based on prior evidence of beneficial effects of body awareness training on mental health conditions,[43,44] we did a Kruskal-Wallis ANOVA test, to examine the impact on average person measures on four specific groups: healthy adults with and without currently performing body awareness training; and adults with mental health conditions with and without currently performing body awareness training. The result showed that adults with mental health conditions who are not doing any body awareness training have a significantly higher average person measure location (Median (IQR)=0.83(0.89) logits, p <0.0001)) compared to the other three groups (Fig 4).…”