Iyengar Yoga for Prolonged Grief Disorder

Study Overview
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Brief Summary
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Experiencing the death of a loved one is inevitable for older adults. Before the coronavirus disease 2019 (COVID-19) pandemic, over 2.5 million people died annually in the United States, including 52,000 in Wisconsin alone, and COVID-19 has added to this toll. Each person who dies leaves an average of five grieving people behind. Most grieving older adults are resilient and recover their pre-loss functioning within one year. However, in about 10%, acute grief becomes protracted and debilitating, leading to the development of prolonged grief disorder (PGD), a clinically diagnosable mental health condition. PGD in older adults increases the risk for poorer medical, mental health, and cognitive outcomes; lower quality of life; disability; premature mortality; and suicide. Despite the magnitude of this problem, the neurobiology of PGD in older adults is poorly understood. By using Iyengar Yoga (IY) as a probe for PGD neurobiology, this pilot project aims to address this critical gap.

Detailed Description
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Our goal is to conduct a pilot study to examine in PGD the modulating effects of 10-week IY on circulating endocannabinoid and emotion processing brain circuit, and the associations between biological changes and clinical response.

Official Title
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Iyengar Yoga as a Probe of Prolonged Grief Disorder Neurobiology

Conditions
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Prolonged Grief Disorder

Intervention / Treatment
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* Other: Iyengar Yoga
* Other: Socialization Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male or female greater than or equal to 40 years of age Bereavement >6 months Score >25 on the Inventory of Complicated Grief (ICG) Presence of PGD Adequate visual and auditory acuity Exclusion Criteria: Delirium/unstable medical conditions Lifetime history of neurological illnesses: seizures, stroke, dementia of any etiology, severe head injury, brain tumor or surgery Serious back, joint or neck injuries within the past 3 months Currently practicing yoga Gross structural abnormalities on T1-weighted images Lifetime history of the following psychiatric disorders: bipolar or psychotic disorders, including psychotic depression Current alcohol/drug abuse or dependence Magnetic resonance imaging (MRI) contraindications Acute suicidality

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Iyengar Yoga<br>Participants will engage in 10 weekly IY classes | Other: Iyengar Yoga<br>* Participation in Iyengar Yoga classes<br>|
| Active Comparator: Socialization Control<br>Participants will engage in 10 weekly socialization control group sessions | Other: Socialization Control<br>* Participation in socialization control group sessions<br>|
| No Intervention: Healthy Comparison Group<br>A group of participants will also be followed for 10 weeks | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in circulating endocannabinoid concentrations | Change in circulating endocannabinoids from baseline to post-intervention | 10 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in neural activity measured using Functional magnetic resonance imaging (fMRI) | Change in neural activity from baseline to post-intervention | 10 weeks | 
| Inventory of Complicated Grief (ICG) scale score change | ICG score ranges from 0 to 76 (higher scores indicate worse outcome) | 10 weeks |