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A sensation of vibration is experienced during audible 'OM' chanting. This has the potential for vagus nerve stimulation through its auricular branches and the effects on the brain thereof. The neurohemodynamic correlates of 'OM' chanting are yet to be explored. Using functional Magnetic Resonance Imaging (fMRI), the neurohemodynamic correlates of audible 'OM' chanting were examined in right-handed healthy volunteers (n=12; nine men). The 'OM' chanting condition was compared with pronunciation of "ssss" as well as a rest state. fMRI analysis was done using Statistical Parametric Mapping 5 (SPM5). In this study, significant deactivation was observed bilaterally during 'OM' chanting in comparison to the resting brain state in bilateral orbitofrontal, anterior cingulate, parahippocampal gyri, thalami and hippocampi. The right amygdala too demonstrated significant deactivation. No significant activation was observed during 'OM' chanting. In contrast, neither activation nor deactivation occurred in these brain regions during the comparative task - namely the 'ssss' pronunciation condition. The neurohemodynamic correlates of 'OM' chanting indicate limbic deactivation. As similar observations have been recorded with vagus nerve stimulation treatment used in depression and epilepsy, the study findings argue for a potential role of this 'OM' chanting in clinical practice.
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Int J Yoga. 2011 Jan-Jun; 4(1): 3–6.
doi: 10.4103/0973-6131.78171
PMCID: PMC3099099
Neurohemodynamic correlates of ‘OM’ chanting: A pilot functional magnetic
resonance imaging study
Bangalore G Kalyani,Ganesan Venkatasubramanian,Rashmi Arasappa,Naren P Rao,Sunil V Kalmady,Rishikesh V
Behere,Hariprasad Rao,Mandapati K Vasudev, and Bangalore N Gangadhar
Department of Psychiatry, Advanced Center for Yoga, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India
Address for correspondence: Dr. B. N. Gangadhar, Department of Psychiatry, Advan ced Center for Yoga, National Institute of Mental Health
and Neurosciences, Bangalore – 560 029, India. E-mail: kalyanybg@yahoo.com
Copyright © International Journal of Yoga
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly ci ted.
Abstract
Background:
A sensation of vibration is experienced during audible ‘OM’ chanting. This has the potential for vagus
nerve stimulation through its auricular branches and the effects on the brain thereof. The
neurohemodynamic correlates of ‘OM’ chanting are yet to be explored.
Materials and Methods:
Using functional Magnetic Resonance Imaging (fMRI), the neurohemodynamic correlates of audible
‘OM’ chanting were examined in right-handed healthy volunteers (n=12; nine men). The ‘OM’ chanting
condition was compared with pronunciation of “ssss” as well as a rest state. fMRI analysis was done using
Statistical Parametric Mapping 5 (SPM5).
Results:
In this study, significant deactivation was observed bilaterally during ‘OM’ chanting in comparison to the
resting brain state in bilateral orbitofrontal, anterior cingulate, parahippocampal gyri, thalami and
hippocampi. The right amygdala too demonstrated significant deactivation. No significant activation was
observed during ‘OM’ chanting. In contrast, neither activation nor deactivation occurred in these brain
regions during the comparative task – namely the ‘ssss’ pronunciation condition.
Conclusion:
The neurohemodynamic correlates of ‘OM’ chanting indicate limbic deactivation. As similar observations
have been recorded with vagus nerve stimulation treatment used in depression and epilepsy, the study
findings argue for a potential role of this ‘OM’ chanting in clinical practice.
Keywords: Meditation, fMRI, ‘OM’ chanting, vagus nerve stimulation
INTRODUCTION
Vagal nerve stimulation (VNS) is used as treatment in depression and epilepsy.[1,2] A positron emission
tomography (PET) study[3] has shown decreased blood flow to limbic brain regions during direct
(cervical) VNS. Another functional magnetic resonance imaging (fMRI) study[4] has shown significant
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deactivation of limbic brain regions during transcutaneous VNS. In this procedure electrical stimulus is
applied over the inner part of the left tragus and hence the auricular branch of the vagus.
The use of ‘OM’ chanting for meditation is well known.[5] Effective ‘OM’ chanting is associated with the
experience of vibration sensation around the ears. It is expected that such a sensation is also transmitted
through the auricular branch of the vagus nerve. We therefore hypothesized that like transcutaneous
VNS, ‘OM’ chanting too produces limbic deactivation. Specifically, we predicted that ‘OM’ chanting would
evoke similar neurohemodynamic correlates, deactivation of the limbic brain regions, amygdala,
hippocampus, parahippocampal gyrus, insula, orbitofrontal and anterior cingulate cortices and
thalamus) as were found in the previous study.[4]
MATERIALS AND METHODS
Healthy volunteers (n=12; nine men) who were right-handed and were consenting to participate as
controls in an ongoing MRI research were approached. Two qualified psychiatrists independently
assessed these volunteers to exclude: 1) Psychiatric diagnosis, 2) family history of major psychiatric
disorder in first-degree relative, 3) pregnancy or post-partum, 4) co-morbid substance abuse or
dependence, 5) significant neurologic disorder, 6) any contraindication for MRI and, 7) left/mixed
handedness. The absence of psychiatric diagnosis was established using Mini International
Neuropsychiatric Interview Plus.[6] The age range of the subjects was 22-39 years (mean±SD=28±6
years). All were literate. Four of these had formal training in yoga including meditation and the rest were
naïve to this technique. The NIMHANS ethics committee had cleared the experimental protocol. In
addition to the consent that they had already given for the ongoing imaging study they were provided
with additional information about the present research (fMRI) and the need to be trained to chant ‘OM’
prior to the fMRI test. Written consent was obtained from all subjects for this study.
fMRI task
All the subjects were trained in ‘OM’ chanting by an experienced yoga teacher. The subjects were trained
to chant ‘OM’ without distress and interruption – the vowel (O) part of the ‘OM’ for 5 sec continuing into
the consonant (M) part of the ‘OM’ for the next 10 sec. While earlier electrophysiological studies used
mental ‘OM’ chanting, loud chanting of ‘OM’ was chosen in this study. This helped to objectively confirm
the task performance during fMRI as well as to provide the vibration sensation and stimulate vagus
nerves via the auricular branches thereof. The control condition was continuous production of ‘sssss….’
syllable for the same duration (15 sec). This was chosen to control for the expiratory act of chanting ‘OM’
but without the vibratory sensation around the ears. These practices were achieved in a supine posture.
They were familiarized with the same procedure while lying in the MRI console. Once they were
comfortable, the fMRI procedure was conducted. At the end of the task, one of the investigators
ascertained if the subjects experienced a vibration sensation while chanting ‘OM’ but not “ssss”.
The fMRI procedure had a block design. The fMRI experiment consisted of the following phases: 1) a
high-resolution structural brain scan was first performed; 2) this was followed by echoplanar imaging
(EPI) sequence in which blood oxygen level-dependent (BOLD) scans were performed. The EPI scans had
a repetition time (TR) of 3 sec. Two hundred EPI scans were performed over 10 min. These 10 min
consisted of 15-sec blocks of ‘OM’ and “ssss”. These blocks were interspersed with 15 sec of rest period.
Altogether there were 10 blocks of ‘OM’, 10 blocks of “ssss” and 20 blocks of rest Figure 1.
Image sequences
Imaging was done using 3 Tesla MRI scanner at NIMHANS. After the initial localization sequences, high-
resolution T -weighted, structural MR images of 1-mm slice thickness with no inter-slice gap were
obtained (TR=8.1 msec; TE=3.7 msec; matrix=256×256). This high-resolution structural image was
utilized for the purpose of localization of brain activation and also to rule out any gross brain abnormality
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in the study subjects. This was followed by a BOLD sensitive EPI sequence (TR=3000 msec; TE=35
msec; slice thickness=8 mm; number of slices=16; matrix=128×128). The total duration of EPI scans was
10 min. During the EPI scans, the subjects were cued to alternate among various states (i.e., ‘OM’, “ssss”
and “REST”) every 15 sec (as described above) through a MRI-compatible monitor display which was
synchronized with the image acquisition by e-prime software incorporated in eloquence fMRI hardware
setup.
Image analysis
fMRI analyses were carried out for all patients using Statistical Parametric Mapping 5 (SPM5)
(http://www.fil.ion.ucl.ac.uk/spm). Images were realigned, corrected for slice timing variations, spatially
normalized[79] and smoothened with a Gaussian kernel of 8-mm full-width-at-half-maximum. The
blocks were modeled by a canonical hemodynamic response function. SPM5 combines the General Linear
Model and Gaussian random field theory to draw statistical inferences from BOLD response data
regarding deviations from the null hypothesis in three-dimensional brain space. The voxel-wise fixed
effects analysis produced a statistical parametric map in the stereotactic space of the Montreal
Neurological Institute[10]. ‘OM’ as well as “ssss”-related BOLD-activation and de-activation, were
assessed using a subtraction paradigm by respectively contrasting with the “REST” condition. The BOLD
changes were examined specifically in the à priori regions-of-interest, namely the limbic brain regions
[amygdala, hippocampus, parahippocampal gyrus, insula, orbitofrontal and anterior cingulate cortices
and thalamus – the last three brain regions were examined because of their intricate connections with the
limbic brain]. For these à priori regions-of-interest masks were created using the WFU Pickatlas for SPM
analyses.[11] Significance corrections for multiple comparisons for the individual region-of-interest were
performed using a Family-wise Error Correction (FWE) [P<0.001].
RESULTS
Compared to rest condition the BOLD fMRI signals did not detect any significant brain activation during
‘OM’ chanting. However, significant deactivation was seen in the amygdala, anterior cingulate gyrus,
hippocampus, insula, orbitofrontal cortex, parahippocampal gyrus and thalamus during ‘OM’ chanting [
Table 1 and Figure 2]. The “ssss” task did not produce any significant activation/deactivation in any of
these brain regions. The coordinates of significant areas of deactivation were transformed from MNI
space[10] into the stereotactic space of Talairach and Tournoux.[12]
DISCUSSION
In this study, significant deactivation was observed bilaterally during ‘OM’ chanting in comparison to the
resting brain state in orbito-frontal, anterior cingulate, parahippocampal gyri thalami and hippocampi.
In addition the right amygdala demonstrated significant deactivation. No significant activation was
observed during ‘OM’ chanting. In contrast, neither activation nor deactivation occurred in these brain
regions during the comparative task – namely the ‘ssss’ condition.
Though there is no previous report on the effect of ‘OM’ chanting on brain hemodynamic responses, an
earlier study by Kraus et al.,[4] had examined the impact of transcutaneous VNS on BOLD changes using
fMRI. Because of the commonality of the vagus involvement (as hypothesized in the current study), we
compared our study observations with this earlier study.[4] Interestingly, our study findings are in tune
with this previous study; significant deactivation was observed in the amygdala, parahippocampal,
hippocampal brain regions. This suggests that neurophysiological effects of ‘OM’ chanting may be
mediated through the auricular branches of the vagal nerves. Using a different methodology (positron
emission tomography), other researchers[3] demonstrated reduced blood flow bilaterally in the
hippocampus, amygdala, and cingulate gyri following left cervical VNS in epilepsy patients. Similarly,
VNS treatment in depressed patients reduced regional cerebral blood flow in the amygdala, left
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hippocampus, left subgenual cingulate cortex, left and right ventral anterior cingulum, right thalamus
and brainstem as measured by single photon emission computed tomography.[13] Interestingly, these
regions become hyperactivated in patients with depressive disorder[14] for which VNS is used as therapy.
However, our observations to support VNS as the mechanism of ‘OM’ chanting are preliminary and
further studies are required to support our hypothesis.
Alternatively, ‘OM’ chanting may have been a cue to relaxation. As meditation is shown to activate
structures involved in relaxation response, namely cingulate cortex, dorsolateral, prefrontal and parietal
cortices, hippocampus and temporal lobes,[15] the confounding effect of relaxation could not be ruled
out.
In summary, the hemodynamic correlates of ‘OM’ chanting indicate limbic deactivation. Since similar
observations have been recorded with VNS treatment used in depression and epilepsy, the clinical
significance of ‘OM’ chanting merits further research.
Acknowledgments
This study was supported by the Innovative Young Biotechnologist Award grant to Dr. G.
Venkatasubramanian awarded by the Department of Biotechnology, Government of India.
Footnotes
Source of Support: Nil
Conflict of Interest: None declared
REFERENCES
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temporal brain structures and mood enhancing effect by transcutaneous vagus nerve stimulation. J
Neural Transm. 2007;114:1485–93.[PubMed: 17564758]
5. Kumar S, Nagendra H, Manjunath N, Naveen K, Telles S. Meditation on ‘OM’: Relevance from ancient
texts and contemporary science. Int J Yoga. 2010;3:2–5. [PMCID: PMC2952121][PubMed: 20948894]
6. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International
Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic
psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59:22–33. quiz 4-57.
[PubMed: 9881538]
7. Friston K, Ashburner J, Frith CD, Poline JB, Heather JD, Frackowiak RS. Spatial registration and
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9. Venkatasubramanian G, Spence SA. Schneiderian first rank symptoms are associated with right
parietal hyperactivation: A replication utilising fMRI. Am J Psychiatry. 2005;162:1545.
10. Evans A, Collins DL, Mills SR, Brown RD, Kelly RL, Peters TM. 3D statistical neuroanatomical
models from 305 MRI volumes. IEEE Nucl Sci Symp Med Imag Conf Proc. 1993;108:1877–8.
11. Maldjian J, Laurienti PJ, Kraft RA, Burdette JH. An automated method for neuroanatomic and
cytoarchitectonic atlas-based interrogation of FMRI data sets. Neuroimage. 2003;19:1233–9.
[PubMed: 12880848]
12. Talairach P, Tournoux JA. A Stereotactic Co-Planar Atlas of the Human Brain. Thieme. 1988
13. Zobel A, Joe A, Freymann N, Clusmann H, Schramm J, Reinhardt M, et al. Changes in regional
cerebral blood flow by therapeutic vagus nerve stimulation in depression: An exploratory approach.
Psychiatry Res. 2005;139:165–79.[PubMed: 16043331]
14. Malhi GS, Lagopoulos J, Ward PB, Kumari V, Mitchell PB, Parker GB, et al. Cognitive generation of
affect in bipolar depression: An fMRI study. Eur J Neurosci. 2004;19:741–54.[PubMed: 14984424]
15. Lazar SW, Bush G, Gollub RL, Fricchione GL, Khalsa G, Benson H. Functional brain mapping of the
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Figures and Tables
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Figure 1
Shows one cycle of REST-‘OM’-REST-ssss; 10 such cycles were performed by each subject during the
fMRI scan
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Table 1
Brain regions with significant deactivation during ‘OM’ condition in comparison with “REST” condition
Brain region X Y Z T FWE-p
Right amygdala 24 -10 -08 5.2 <0.001
Left anterior cingulate gyrus -02 45 -02 10.2 <0.001
Right anterior cingulate gyrus 12 49 -01 9.8 <0.001
Left hippocampus -32 -18 -11 6.5 <0.001
Right hippocampus 30 -31 -05 4.6 <0.001
Left insula -28 19 -06 6.5 <0.001
Right insula 38 15 -06 4.9 <0.001
Left orbitofrontal cortex -28 29 -08 6.6 <0.001
Right orbitofrontal cortex 30 29 -08 7.3 <0.001
Left parahippocampal gyrus -30 -20 -21 5.1 <0.001
Right parahippocampal gyrus 32 -28 -22 5.0 <0.001
Left thalamus -14 -05 13 6.6 <0.001
Right thalamus 16 -07 11 6.2 <0.001
X, Y, Z Talairach coordinates of peak activation
Family-wise error corrected ‘P’ value
** *
****
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Figure 2
Compared to REST, ‘OM’ chanting produced deactivation of thalami (A) and limbic structures - anterior
cingulum (B), hippocampi (C), insula (D) and parahippocampi (E); Whereas control condition ‘ssss’
produced no deactivation in any of these regions (F). The color bar represents the T scores given in the
table
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... This has the potential for vagal stimulation through its auricular branches and the effects on the brain thereof. [5] Pranayama produces relaxed state and in this state, parasympathetic activity overrides sympathetic activity [6] and increases cardiac-vagal baroreflex sensitivity, improves oxygen saturation, lowers blood pressure, pulse rate, and reduces anxiety. Slow breathing improves oxygenation in normoxia; however, the effects could be more pronounced in hypoxemia and hypoxia. ...
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Opinion statement: Vagus nerve stimulation (VNS) for epilepsy is a well established and effective treatment for medically intractable epilepsy. VNS is indicated if resective epilepsy surgery is unsuccessful or is not an option. About 50% of patients with VNS have a seizure reduction greater than 50%, but less than 10% become seizure-free. VNS also has an alerting effect on patients and may allow a reduction in sedating medications. The major adverse event is hoarseness, but treatment is generally well tolerated. The therapeutic effect can be delayed: patients may improve several months after VNS implantation. Direct brain stimulation (DBS) is an emerging treatment for epilepsy. Scheduled stimulation is similar to brain stimulation in Parkinson's disease. Only the anterior thalamic nucleus has been studied in a larger randomized, controlled trial, in which patients with the stimulator turned on had a significantly reduced seizure frequency. Responsive stimulation applies an electrical stimulus at the site of seizure onset to terminate the seizure if one occurs. The seizure-onset zone must be well defined before implantation. Responsive stimulation requires seizure detection and application of a stimulus online. A large pivotal trial showed a significant reduction in seizure frequency. Both DBS and responsive neurostimulation are well tolerated, but there has been some concern about depression with DBS. Infection, hemorrhage, and lead breakage are adverse events possible with any type of stimulator. None of the brain stimulation devices have been approved by the US Food and Drug Administration, but final approval is expected soon. These devices are indicated for patients with bilateral seizure onset or seizure onset in eloquent areas. Although the initial trials of brain stimulation do not show overwhelming improvement in seizure frequency, the technology will improve with time as we continue to learn about the use of brain stimulation for epilepsy. Optimization of VNS has been going on for 10 years, and we need to ensure that brain stimulation is similarly developed further. In addition, sophisticated devices such as responsive neurostimulators can greatly enhance our understanding of the pathophysiology of epilepsy.
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The Mini-International Neuropsychiatric Interview (M.I.N.I.) is a short structured diagnostic interview, developed jointly by psychiatrists and clinicians in the United States and Europe, for DSM-IV and ICD-10 psychiatric disorders. With an administration time of approximately 15 minutes, it was designed to meet the need for a short but accurate structured psychiatric interview for multicenter clinical trials and epidemiology studies and to be used as a first step in outcome tracking in nonresearch clinical settings. The authors describe the development of the M.I.N.I. and its family of interviews: the M.I.N.I.-Screen, the M.I.N.I.-Plus, and the M.I.N.I.-Kid. They report on validation of the M.I.N.I. in relation to the Structured Clinical Interview for DSM-III-R, Patient Version, the Composite International Diagnostic Interview, and expert professional opinion, and they comment on potential applications for this interview.
Article
To measure vagus nerve stimulation (VNS)-induced cerebral blood flow (CBF) effects after prolonged VNS and to compare these effects with immediate VNS effects on CBF. Ten consenting partial epilepsy patients had positron emission tomography (PET) with intravenous [15O]H2O. Each had three control scans without VNS and three scans during 30 s of VNS, within 20 h after VNS began (immediate-effect study), and repeated after 3 months of VNS (prolonged study). After intrasubject subtraction of control from stimulation scans, images were anatomically transformed for intersubject averaging and superimposed on magnetic resonance imaging (MRI) for anatomic localization. Changes on t-statistical maps were considered significant at p < 0.05 (corrected for multiple comparisons). During prolonged studies, CBF changes were not observed in any regions that did not have CBF changes during immediate-effect studies. During both types of studies, VNS-induced CBF increases were similarly located in the bilateral thalami, hypothalami, inferior cerebellar hemispheres, and right postcentral gyrus. During immediate-effect studies, VNS decreased bilateral hippocampal, amygdalar, and cingulate CBF and increased bilateral insular CBF; no significant CBF changes were observed in these regions during prolonged studies. Mean seizure frequency decreased by 25% over a 3-month period between immediate and prolonged PET studies, compared with 3 months before VNS began. Seizure control improved during a period over which some immediate VNS-induced CBF changes declined (mainly over cortical regions), whereas other VNS-induced CBF changes persisted (mainly over subcortical regions). Altered synaptic activities at sites of persisting VNS-induced CBF changes may reflect antiseizure actions.
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This study probed the ability of people with chronic schizophrenia to control their behavior in time by requiring them to deliberately vary responses within the temporal domain (i.e., to avoid regular inter-response intervals). Thirteen schizophrenia patients performed single finger movements (at moments of their own choosing) in an event-related functional magnetic resonance imaging paradigm. Their performance was computed using the coefficient of variation of inter-response interval duration. Task performance was positively correlated with activation of left lateral prefrontal cortex. Post hoc analyses revealed an inverse correlation between activation in this region and severity of attentional impairment. These findings implicate left lateral prefrontal cortex in the modulation of the temporal response space in schizophrenia and imply greater attentional (executive) impairment among those who fail to modulate their behavior in time.
Article
Abnormalities in regional cerebral blood flow (rCBF) have been reported to characterize depressive episodes; they are at least partly reversed by antidepressant treatment. Treatment-specific as well as response-related changes in rCBF have been reported. We explored the changes in rCBF induced by vagus nerve stimulation (VNS), a recently proposed antidepressant strategy, by application of single photon emission-computed tomography with (99m)Tc-hexamethyl-propylene amine oxime in otherwise treatment-refractory patients. Both region-of-interest (ROI) and statistical parametric mapping (SPM) analytic approaches were used. Decreases of rCBF in the amygdala, left hippocampus, left subgenual cingulate cortex, left and right ventral anterior cingulum, right thalamus and brain stem were observed; the only increase of rCBF was found by SPM analysis in the middle frontal gyrus. This pattern shares features with changes of rCBF previously associated with the administration of selective serotonin reuptake inhibitors. Similarities to other brain-stimulation strategies in antidepressant treatment were less pronounced.