A feasibility study on yoga's mechanism of action for chronic low back pain: psychological and neurophysiological changes, including global gene expression and DNA methylation, following a yoga intervention for chronic low back pain

Author: Bandita Adhikari1, Angela Starkweather2, Wanli Xu3, Rebecca L Acabchuk4, Divya Ramesh5, Bright Eze3, Yuxuan Yang3, Gee Su Yang3, Joseph Walker6, Reinhard Laubenbacher7, Crystal L Park4
1 Penn Frontotemporal Degenerative Center, Philadelphia, PA, USA.
2 Center for Advancement in Managing Pain, University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT, 06269, USA. angela.starkweather@uconn.edu.
3 Center for Advancement in Managing Pain, University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT, 06269, USA.
4 Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
5 Senior Clinical Scientist, Apellis Pharmaceuticals, Boston, MA, USA.
6 Department of Orthopedic Surgery and Neurosurgery, UConn Health, Farmington, CT, USA.
7 Systems Medicine Lab, University of Florida, Gainesville, FL, USA.
Conference/Journal: Pilot Feasibility Stud
Date published: 2022 Jul 7
Other: Volume ID: 8 , Issue ID: 1 , Pages: 142 , Special Notes: doi: 10.1186/s40814-022-01103-2. , Word Count: 284

Yoga has been shown to reduce pain and improve function in populations with chronic low back pain (cLBP), yet the underlying molecular mechanisms remain elusive. This study examined the feasibility and acceptability of a yoga research protocol, including recruitment, retention, and data collection, and investigated the preliminary effects of yoga on psychological and neurophysiological functions, including gene expression and DNA methylation profiles, in participants with cLBP.

A one-arm trial was conducted with 11 participants with cLBP who enrolled in a 12-week yoga intervention. Data on subjective pain characteristics, quantitative sensory testing, and blood for analysis of differentially expressed genes and CpG methylation was collected prior to the start of the intervention and at study completion.

Based on pre-determined feasibility and acceptability criteria, the yoga intervention was found to be feasible and highly acceptable to participants. There was a reduction in pain severity, interference, and mechanical pain sensitivity post-yoga and an increase in emotion regulation and self-efficacy. No adverse reactions were reported. Differential expression analysis demonstrated that the yoga intervention induced increased expression of antisense genes, some of which serve as antisense to known pain genes. In addition, there were 33 differentially hypomethylated positions after yoga (log2 fold change ≥ 1), with enrichment of genes involved in NIK/NF-kB signaling, a major pathway that modulates immune function and inflammation.

The study supports the feasibility and acceptability of the proposed protocol to test a specific mechanism of action for yoga in individuals with cLBP. These results also support the notion that yoga may operate through our identified psychological and neurophysiologic pathways to influence reduced pain severity and interference.

Keywords: Chronic low back pain; Emotion regulation; Gene expression; Methylation; Yoga.

PMID: 35794661 DOI: 10.1186/s40814-022-01103-2