Physiology of Mind-Body Therapies: Meditative Breathing and Autonomic Adaptations

描述（由申请人提供）：Suzanne M. Bertisch，医学博士，公共卫生硕士，是一名接受过临床研究培训的普通内科医生，长期对身心治疗感兴趣。她的长期目标是发展一项独立的研究事业，研究冥想技术的生理效应，并为心血管风险增加的人群开发有针对性的循证身心疗法。她的近期目标是掌握自主心血管生理学和身心临床试验方法的知识和技能。Bertisch博士提出的职业发展计划包括：1)获得心肺生理学的实验室测量和数据分析技能；2)积累开展身心医学临床试验的经验；3)通过正规教学提高生理学、生物统计学、研究设计等方面的知识；4)与她的导师和专家合作团队定期互动。该提案包括两个项目，重点是表征身心慢呼吸（MBSB）对自主神经活动的急性和长期影响。尽管有几个研究小组做出了努力，但关于MBSB对交感神经活动的急性影响以及重复练习MBSB引起的自主神经张力的持续适应，仍有很多未知之处。候选人计划：1)在急性横断面研究中比较长期身心实践者和非实践者MBSB在心血管和自主神经方面的差异；2)评估开展一项为期12周的随机对照试验的可行性，以测量MBSB对非从业人员肥胖和高血压患者自主神经活动和血压的影响；并为未来更明确的研究获得初步数据。这两个项目都将率先使用现代测量和分析技术，包括直接测量交感神经活动。完成拟议的研究和培训计划将增强Bertisch博士进行以患者为导向的身心研究的能力，进一步了解自主心血管生理学，并使她能够实现她的职业目标，成为一名独立的临床研究人员，研究身心治疗的生理机制和临床应用。

DESCRIPTION (provided by applicant): Suzanne M. Bertisch, MD, MPH, is a general internist fellowship-trained in clinical research, who possesses a long-standing interest in mind-body therapies. Her long-term goal is to develop an independent research career studying the physiological effects of meditative techniques and developing targeted evidence-based mind-body therapies in populations with increased cardiovascular risk. Her immediate goal is to acquire knowledge and skills in autonomic cardiovascular physiology and mind-body clinical trial methodology. Dr. Bertisch's proposed career development plan includes: 1) acquiring laboratory measurement and data analytic skills in cardiopulmonary physiology; 2) gaining experience in the conduct of mind-body medicine clinical trials; 3) improving her knowledge of physiology, biostatistics, and study design through formal didactics; and 4) regular interaction with her mentors and expert collaborative team. This proposal includes two projects that focus on characterizing the acute and long-term effects of mind-body slow breathing (MBSB) upon autonomic activity. Despite efforts by several groups, much remains unknown about the acute effects of MBSB on sympathetic activity and the sustained adaptations in autonomic tone evoked by repetitive practice of MBSB. The candidate plans to: 1) compare the differential cardiovascular and autonomic effects of MBSB among long-term mind-body practitioners and non-practitioners in an acute cross-sectional study; 2) evaluate the feasibility of conducting a 12-week randomized controlled trial measuring the effects of MBSB upon autonomic activity and blood pressure in non-practitioners with obesity and high blood pressure; and obtain preliminary data for future more definitive studies. Both projects will be among the first to use modern measurement and analytic techniques, including a direct measure of sympathetic nerve activity. Completion of the proposed research and training plan will enhance Dr. Bertisch's ability to conduct patient-oriented mind-body research, further her understanding of autonomic cardiovascular physiology, and allow her to achieve her career goal of becoming an independent clinical researcher investigating the physiological mechanisms and clinical applications of mind-body therapies. PUBLIC HEALTH RELEVANCE: Findings from this proposal will provide important information for future clinical and mechanistic studies of mind-body therapies, particularly in cardiovascular disease populations, such as hypertension. A better understanding of the clinical benefits and mechanisms of mind-body-breathing practices will assist the development of targeted mind-body based treatments for lowering blood pressure.