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Mindfulness Meditation Reduces Intraocular Pressure, Lowers Stress Biomarkers and Modulates Gene Expression in Glaucoma: A Randomized Controlled Trial.

Journal of glaucoma
December 1, 2018
Tanuj Dada et al. (14 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine whether mindfulness-based stress reduction could lower intraocular pressure (IOP) and normalize stress biomarkers in patients with primary open-angle glaucoma (POAG).

Results Summary

Mindfulness meditation significantly reduced IOP, improved quality of life, lowered stress-related biomarkers (e.g., cortisol, IL6, TNF-α, ROS), and elevated beneficial biomarkers (e.g., β-endorphins, BDNF, TAC), with all changes statistically significant (P<0.001). Gene expression profiling also correlated positively with these changes.

Population

90 POAG patients (180 eyes) aged above 45 years.

Effective Dosage

Daily mindfulness meditation practice.

Duration

21 days.

Interactions

None mentioned.

Extracted Claims (11)
InterventionDirectionEndpointPopulationDosageImpactClaim #
mindfulness-based stress reduction by meditation
decrease
IOP
POAG patients
OD: 18.8 to 12.7, OS 19.0 to 13.1 mm Hg
significantly lowered
#1
mindfulness-based stress reduction by meditation
decrease
cortisol
POAG patients
497.3 to 392.3 ng/mL
significantly lowered
#2
mindfulness-based stress reduction by meditation
decrease
IL6
POAG patients
2.8 to 1.5 ng/mL
significantly lowered
#3
mindfulness-based stress reduction by meditation
decrease
TNF-α
POAG patients
57.1 to 45.4 pg/mL
significantly lowered
#4
mindfulness-based stress reduction by meditation
decrease
ROS
POAG patients
1625 to 987 RLU/min/104 neutrophils
significantly lowered
#5
mindfulness-based stress reduction by meditation
increase
β-endorphins
POAG patients
38.4 to 52.7 pg/mL
elevated
#6
mindfulness-based stress reduction by meditation
increase
BDNF
POAG patients
56.1 to 83.9 ng/mL
elevated
#7
mindfulness-based stress reduction by meditation
increase
TAC
POAG patients
5.9 to 9.3
elevated
#8
mindfulness-based stress reduction by meditation
increase
QOL
POAG patients
-
improved
#9
mindfulness-based stress reduction by meditation
neutral
stress biomarkers
POAG patients
-
normalizes
#10
mindfulness-based stress reduction by meditation
neutral
gene expression
POAG patients
-
positively modifies
#11
Abstract

BACKGROUND: Reducing intraocular pressure (IOP) in primary open-angle glaucoma (POAG) is currently the only approach to prevent further optic nerve head damage. However, other mechanisms such as ischemia, oxidative stress, glutamate excitotoxicity, neurotrophin loss, inflammation/glial activation, and vascular dysregulation are not addressed. Because stress is a key risk factor affecting these mechanisms, we evaluated whether mindfulness-based stress reduction can lower IOP and normalize typical stress biomarkers. MATERIALS AND METHODS: In a prospective, randomized trial 90 POAG patients (180 eyes; age above 45 y) were assigned to a waitlist control or mindfulness meditation group which practiced daily for 21 days. We measured IOP (primary endpoint), quality of life (QOL), stress-related serum biomarkers [cortisol, β-endorphins, IL6, TNF-α, brain-derived neurotrophic factor (BDNF), reactive oxygen species (ROS), total antioxidant capacity (TAC)], and whole genome expression. RESULTS: Between-group comparisons revealed significantly lowered IOP in meditators (OD: 18.8 to 12.7, OS 19.0 to 13.1 mm Hg) which correlated with significantly lowered stress-biomarker levels including cortisol (497.3 to 392.3 ng/mL), IL6 (2.8 to 1.5 ng/mL), TNF-α (57.1 to 45.4 pg/mL), ROS (1625 to 987 RLU/min/104 neutrophils), and elevated β-endorphins (38.4 to 52.7 pg/mL), BDNF (56.1 to 83.9 ng/mL), and TAC (5.9 to 9.3) (all P<0.001). These changes correlated well with gene expression profiling. Meditators improved in QOL (P<0.05). CONCLUSIONS: A short course of mindfulness-based stress reduction by meditation in POAG, reduces IOP, improves QOL, normalizes stress biomarkers, and positively modifies gene expression. Mindfulness meditation can be recommended as adjunctive therapy for POAG.

Medical Subject Headings (MeSH)
AgedAntioxidantsBiomarkersBrain-Derived Neurotrophic FactorCytokinesFemaleGene Expression ProfilingGene Expression RegulationGlaucoma, Open-AngleHumansIntraocular PressureMaleMeditationMiddle AgedMindfulnessOxidative StressProspective StudiesQuality of LifeReactive Oxygen SpeciesSingle-Blind MethodTonometry, Ocularbeta-Endorphin
Study Links
Quality Scores
Safety90
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations77
Citations/Year11.0
Relative Citation Ratio5.06
NIH Percentile93.2%
Research Impact Scores
APT Score0.75
Weight Score2.34
Normalized Score0.86
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