1
|
Evanski JM, Iadipaolo A, Ely SL, Zundel CG, Gowatch LC, Bhogal A, Owens Z, Cohen C, Goldberg E, Bluth MH, Taub J, Harper FWK, Rabinak CA, Marusak HA. Smaller Hippocampal Volume Is Associated With Reduced Posttraumatic Stress Symptoms in Children With Cancer and Survivors Following a Brief Novel Martial Arts-Based Intervention. Arch Clin Neuropsychol 2024; 39:167-174. [PMID: 37518896 DOI: 10.1093/arclin/acad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
PURPOSE Children with cancer and survivors frequently report posttraumatic stress symptoms (PTSS), which are associated with volumetric changes in stress-sensitive brain regions, including the hippocampus. METHODS We examined the impact of a novel, 4-week martial-arts-based meditative intervention on cancer-related PTSS in 18 pediatric patients and survivors and whether baseline hippocampal volumes correlate with PTSS severity and/or PTSS changes over time. RESULTS Overall, PTSS did not significantly change from baseline to post-intervention. Smaller hippocampal volume was correlated with more severe re-experiencing PTSS at baseline, and greater reductions in PTSS post-intervention. CONCLUSIONS Together, hippocampal volume may be a biomarker of PTSS severity and intervention response. Identifying hippocampal volume as a potential biomarker for PTSS severity and intervention response may allow for more informed psychosocial treatments.
Collapse
Affiliation(s)
- Julia M Evanski
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | | | - Samantha L Ely
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Clara G Zundel
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Leah C Gowatch
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Amanpreet Bhogal
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Zazai Owens
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | | | - Elimelech Goldberg
- Kids Kicking Cancer, Southfield, MI, USA
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Martin H Bluth
- Kids Kicking Cancer, Southfield, MI, USA
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Maimonides Medical Center, Brooklyn, NY, USA
| | - Jeffrey Taub
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Children's Hospital of Michigan, Detroit, MI 48201, USA
| | - Felicity W K Harper
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Christine A Rabinak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI 48201, USA
| | - Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
| |
Collapse
|
2
|
Kruszewski A. From Ancient Patterns of Hand-to-Hand Combat to a Unique Therapy of the Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3553. [PMID: 36834248 PMCID: PMC9960953 DOI: 10.3390/ijerph20043553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this publication is to provide generalized knowledge of the area of changes that took place over past centuries in relation to health, social and cultural conditions. In Greek mythology, it was necessary to nurture both body and spirit to be a perfect human being. This link between the concepts of physical beauty and goodness can be also found in later works dedicated to ancient Greek history. Particularly in Greek myths, and in Greek education in general, it was believed that both physical and spiritual excellence were necessary to raise men to achieve their true form. Some of the main forms of implementing this idea were hand-to-hand combat exercises (wrestling, boxing and pankration). Ideas characteristic of the world of ancient Greece, in a general sense, can be observed in the culture of the Far East. The main difference is the fact that these principles did not survive in Western culture as a result of transformation into a consumer society focused on the rejection of moral principles. The brutalisation of the forms of the Roman Games meant that the ideals of the ancient world were forgotten for more than 1500 years. The modern Olympic Games were resurrected in the 19th century. Inspired by the ancient Greek cult of health of body and spirit, they gave rise to a movement known as Olympism. In the Olympic Charter written by Coubertin, Olympism was called "a philosophy of life exalting and combining in a balanced whole the qualities of body, will and mind". The combat sports disciplines have had their place there since the beginning of the modern Olympic Games. The evolution of hand-to-hand combat disciplines, including numerous scientific studies indicating a very broad impact in the area of health, led to this type of physical activity being reached for as an essential element in supporting the health-promoting behaviour of society. Nowadays, physical activity in the area of exercise with elements of hand-to-hand combat, combat sports, or martial arts is an indissoluble link in the prevention and treatment of 21st century diseases. For Parkinson's disease patients, drug treatment is an essential resource for continuing to function in society, but it will not be completely effective without supporting the treatment with appropriate and attractive physical activity (e.g., "Rock Steady Boxing"). Of similar importance is the prevention of dangerous falls, which are common in this population as well as among the elderly or those affected by other diseases of civilisation. Implementing the principles and techniques of safe falling in the teaching of the young population significantly increases the likelihood of applying appropriate responses to these individuals in adulthood and old age. Actions that should be taken now for prevention can be implemented through social programmes, such as "Active today for a healthy future".
Collapse
Affiliation(s)
- Artur Kruszewski
- Department of Individual Sports, Jozef Pilsudski University of Physical Education in Warsaw, 01-813 Warsaw, Poland
| |
Collapse
|
3
|
Hehr A, Iadipaolo AS, Morales A, Cohen C, Taub JW, Harper FW, Goldberg E, Bluth MH, Rabinak CA, Marusak HA. Meditation reduces brain activity in the default mode network in children with active cancer and survivors. Pediatr Blood Cancer 2022; 69:e29917. [PMID: 35927934 PMCID: PMC9420817 DOI: 10.1002/pbc.29917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/18/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Mounting evidence demonstrates that meditation can lower pain and emotional distress in adults, and more recently, in children. Children may benefit from meditation given its accessibility across a variety of settings (e.g., surgical preparation). Recent neuroimaging studies in adults suggest that meditation techniques are neurobiologically distinct from other forms of emotion regulation, such as distraction, that rely on prefrontal control mechanisms, which are underdeveloped in youth. Rather, meditation techniques may not rely on "top-down" prefrontal control and may therefore be utilized across the lifespan. PROCEDURE We examined neural activation in children with cancer, a potentially distressing diagnosis. During neuroimaging, children viewed distress-inducing video clips while using martial arts-based meditation (focused attention, mindful acceptance) or non-meditation (distraction) emotion regulation techniques. In a third condition (control), participants passively viewed the video clip. RESULTS We found that meditation techniques were associated with lower activation in default mode network (DMN) regions, including the medial frontal cortex, precuneus, and posterior cingulate cortex, compared to the control condition. Additionally, we found evidence that meditation techniques may be more effective for modulating DMN activity than distraction. There were no differences in self-reported distress ratings between conditions. CONCLUSION Together, these findings suggest that martial arts-based meditation modulates negative self-referential processing associated with the DMN, and may have implications for the management of pediatric pain and negative emotion.
Collapse
Affiliation(s)
- Aneesh Hehr
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan
| | - Allesandra S. Iadipaolo
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan
| | - Austin Morales
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan
| | | | - Jeffrey W. Taub
- Department of Pediatrics, Wayne State University, Detroit, Michigan
- Children’s Hospital of Michigan, Detroit, Michigan
| | - Felicity W.K. Harper
- Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, Wayne State University, Detroit, Michigan
| | | | - Martin H. Bluth
- Kids Kicking Cancer, Southfield, Michigan
- Department of Pathology, School of Medicine, Wayne State University, Detroit, Michigan
- Department of Pathology, Maimonides Medical Center, Brooklyn, NY
| | - Christine A. Rabinak
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, Michigan
| | - Hilary A. Marusak
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan
- Karmanos Cancer Institute, Detroit, Michigan
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, Michigan
| |
Collapse
|
4
|
Marusak HA, Borg B, Morales A, Smith JC, Blankenship K, Allen JL, Goldberg E, Bluth MH. Martial arts-based curriculum reduces stress, emotional, and behavioral problems in elementary schoolchildren during the COVID-19 pandemic: A pilot study. MIND, BRAIN AND EDUCATION : THE OFFICIAL JOURNAL OF THE INTERNATIONAL MIND, BRAIN, AND EDUCATION SOCIETY 2022; 16:5-12. [PMID: 35669694 PMCID: PMC9165706 DOI: 10.1111/mbe.12307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 11/18/2021] [Indexed: 06/15/2023]
Abstract
This exploratory study examined the impact of Heroes Circle, a martial arts-based curriculum on stress, emotional, and behavioral problems in elementary school children. While students completed classroom surveys at baseline, post-curriculum surveys were collected from teachers, students, and parents/guardians two and five months after COVID-19-related school shutdowns. Satisfaction with the curriculum was high among those who received the intervention. Children reported increased mindfulness and decreased stress over the school year. Most children (77%) were still using the program's techniques and reporting benefits five months later, including lower internalizing symptoms and COVID-19-related fears. These patterns were not observed at the control school.
Collapse
Affiliation(s)
- Hilary A. Marusak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI
| | - Breanna Borg
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI
| | - Austin Morales
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI
| | | | | | - J. Lloyd Allen
- School of Social Work, Wayne State University, Detroit, MI
| | - Elimelech Goldberg
- Kids Kicking Cancer, Southfield, MI
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI
| | - Martin H. Bluth
- Kids Kicking Cancer, Southfield, MI
- Department of Pathology, School of Medicine, Wayne State University, Detroit, MI
- Department of Pathology, Maimonides Medical Center, Brooklyn, NY
| |
Collapse
|
5
|
Faraj MM, Lipanski NM, Morales A, Goldberg E, Bluth MH, Marusak HA, Greenwald MK. A Virtual Reality Meditative Intervention Modulates Pain and the Pain Neuromatrix in Patients with Opioid Use Disorder. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:2739-2753. [PMID: 33956146 DOI: 10.1093/pm/pnab162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Standard of care for opioid use disorder (OUD) includes medication and counseling. However, there is an unmet need for complementary approaches to treat OUD patients coping with pain; furthermore, few studies have probed neurobiological features of pain or its management during OUD treatment. This preliminary study examines neurobiological and behavioral effects of a virtual reality-based meditative intervention in patients undergoing methadone maintenance treatment (MMT). DESIGN Prospective, non-blinded, single-arm, 12-week intervention with standardized assessments. SETTING Academic research laboratory affiliated with an on-site MMT clinic. METHODS Fifteen (11 female) MMT patients completed a virtual reality, therapist-guided meditative intervention that included breathing and relaxation exercisessessions were scheduled twice weekly. Assessments included functional magnetic resonance imaging (fMRI) of pain neuromatrix activation and connectivity (pre- and post-intervention), saliva cortisol and C-reactive protein (CRP) at baseline and weeks 4, 8 and 12; and self-reported pain and affective symptoms before and after each intervention session. RESULTS After each intervention session (relative to pre-session), ratings of pain, opioid craving, anxiety and depression (but not anger) decreased. Saliva cortisol (but not CRP) levels decreased from pre- to post-session. From pre- to post-intervention fMRI assessments, pain task-related left postcentral gyrus (PCG) activation decreased. At baseline, PCG showed positive connectivity with other regions of the pain neuromatrix, but this pattern changed post-intervention. CONCLUSIONS These preliminary findings demonstrate feasibility, therapeutic promise, and brain basis of a meditative intervention for OUD patients undergoing MMT.
Collapse
Affiliation(s)
| | - Nina M Lipanski
- Department of Biological Sciences, University of California, San Diego
| | - Austin Morales
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University
| | - Elimelech Goldberg
- School of Medicine, Wayne State University, Detroit, Michigan
- Kids Kicking Cancer
| | - Martin H Bluth
- School of Medicine, Wayne State University, Detroit, Michigan
- Kids Kicking Cancer
- Maimonides Medical Center, Brooklyn, New York, USA
| | - Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University
| | - Mark K Greenwald
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University
- Department of Pharmacy Practice, Wayne State University
| |
Collapse
|
6
|
Marusak HA, Iadipaolo AS, Cohen C, Goldberg E, Taub JW, Harper FWK, Bluth MH, Rabinak CA. Martial Arts-Based Therapy Reduces Pain and Distress Among Children with Chronic Health Conditions and Their Siblings. J Pain Res 2020; 13:3467-3478. [PMID: 33402843 PMCID: PMC7778380 DOI: 10.2147/jpr.s283364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/18/2020] [Indexed: 01/14/2023] Open
Abstract
Objective Test whether a martial arts-based therapy, Kids Kicking Cancer (KKC), can reduce pain and emotional distress in children with cancer, other chronic health conditions (e.g., sickle cell), and healthy siblings. Methods This study surveyed children’s pain and distress levels immediately before and after a 1-hr in-person KKC class. Eligible participants were enrolled in standard KKC classes, were diagnosed with a chronic health condition (e.g., cancer, sickle cell) or were the sibling of a child diagnosed and were between the ages of 5–17 years (inclusive). Children reported on their pain and distress using Likert-style scales (Coloured Analog Scale and modified FACES scale, respectively). Friedman test was used to test for overall changes in pain and distress, and within subgroups. Age and sex effects were evaluated using Spearman’s rank-order correlation. Additional Yes/No questions were administered regarding KKC satisfaction and use of techniques. Results Fifty-nine youth (19 cancer patients, 17 non-cancer patients, 23 siblings; 5–17 yrs, 26 females) completed this study. Overall, there was a significant reduction in pain (p = 0.033) and emotional distress (p < 0.001) after a 1-hr class, with 50% and 89% of youth reporting a reduction in pain and distress, respectively. On average, pain levels remained within the mild/moderate range on average (i.e., pre vs. post levels; pre: M = 1.67, post: M = 1.33) and emotional distress went from mild/moderate to none/mild distress, on average (pre: M = 1.92, post: M = 1.08). Youth with higher pre-class pain and distress reported greater reductions (p = 0.001 and p < 0.001, respectively). The reduction in pain appeared to be most pronounced with cancer and non-cancer patients. In contrast, the reduction in distress appeared to be most pronounced among healthy siblings. However, overall, reductions in pain and distress did not significantly differ among subgroups (i.e., cancer patients, non-cancer patients, siblings), and change in pain and distress was not associated with age or sex. Ninety-six percent of youth would recommend KKC to others and 81% reported using KKC techniques (e.g., the Breath BrakeTM or other martial arts techniques) outside of class, such as at home. Conclusion Results support the more widespread application of KKC as a psychosocial intervention for reducing pain and distress in various pediatric populations.
Collapse
Affiliation(s)
- Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA.,Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA
| | - Allesandra S Iadipaolo
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | | | - Elimelech Goldberg
- Kids Kicking Cancer, Southfield, MI, USA.,Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Jeffrey W Taub
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA.,Department of Oncology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Felicity W K Harper
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA.,Department of Oncology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Martin H Bluth
- Kids Kicking Cancer, Southfield, MI, USA.,Department of Pathology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Christine A Rabinak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA.,Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA.,Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA.,Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| |
Collapse
|
7
|
Marusak HA, Elrahal F, Peters CA, Kundu P, Lombardo MV, Calhoun VD, Goldberg EK, Cohen C, Taub JW, Rabinak CA. Mindfulness and dynamic functional neural connectivity in children and adolescents. Behav Brain Res 2017; 336:211-218. [PMID: 28887198 DOI: 10.1016/j.bbr.2017.09.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 09/01/2017] [Accepted: 09/04/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Interventions that promote mindfulness consistently show salutary effects on cognition and emotional wellbeing in adults, and more recently, in children and adolescents. However, we lack understanding of the neurobiological mechanisms underlying mindfulness in youth that should allow for more judicious application of these interventions in clinical and educational settings. METHODS Using multi-echo multi-band fMRI, we examined dynamic (i.e., time-varying) and conventional static resting-state connectivity between core neurocognitive networks (i.e., salience/emotion, default mode, central executive) in 42 children and adolescents (ages 6-17). RESULTS We found that trait mindfulness in youth relates to dynamic but not static resting-state connectivity. Specifically, more mindful youth transitioned more between brain states over the course of the scan, spent overall less time in a certain connectivity state, and showed a state-specific reduction in connectivity between salience/emotion and central executive networks. The number of state transitions mediated the link between higher mindfulness and lower anxiety, providing new insights into potential neural mechanisms underlying benefits of mindfulness on psychological health in youth. CONCLUSIONS Our results provide new evidence that mindfulness in youth relates to functional neural dynamics and interactions between neurocognitive networks, over time.
Collapse
Affiliation(s)
- Hilary A Marusak
- Department of Pharmacy Practice, Wayne State University College of Pharmacy and Health Sciences, Detroit, MI, 48201, United States.
| | - Farrah Elrahal
- Department of Pharmacy Practice, Wayne State University College of Pharmacy and Health Sciences, Detroit, MI, 48201, United States
| | - Craig A Peters
- Department of Pharmacy Practice, Wayne State University College of Pharmacy and Health Sciences, Detroit, MI, 48201, United States
| | - Prantik Kundu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States
| | - Michael V Lombardo
- Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, 1678, Cyprus; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK
| | - Vince D Calhoun
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, 87131, United States; The Mind Research Network, Albuquerque, NM, 87131, United States
| | - Elimelech K Goldberg
- Kids Kicking Cancer, Southfield, MI, 48034, United States; Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, 48201, United States
| | - Cindy Cohen
- Kids Kicking Cancer, Southfield, MI, 48034, United States
| | - Jeffrey W Taub
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, 48201, United States; Children's Hospital of Michigan, Detroit, MI, 48201, United States
| | - Christine A Rabinak
- Department of Pharmacy Practice, Wayne State University College of Pharmacy and Health Sciences, Detroit, MI, 48201, United States; Department of Pharmaceutical Sciences, Wayne State University College of Pharmacy and Health Sciences, Detroit, MI, 48201, United States; Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, 48201, United States
| |
Collapse
|