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      Treating Depression With Tai Chi: State of the Art and Future Perspectives

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          Abstract

          Major depressive disorder (MDD) is one of the most prevalent mental illnesses in America. Current treatments for MDD are unsatisfactory given high non-response rates, high relapse rates, and undesirable side effects. Accumulating evidence suggests that Tai Chi, a popular mind–body intervention that originated as a martial art, can significantly regulate emotion and relieve the symptoms of mood disorders. In addition, the availability of instructional videos and the development of more simplified and less structured Tai Chi has made it a promising low-intensity mind-body exercise. In this article, we first examine a number of clinical trials that implemented Tai Chi as a treatment for depression. Then, we explore several mechanisms by which Tai Chi may alleviate depressive symptoms, hypothesizing that the intervention may modulate the activity and connectivity of key brain regions involved in mood regulation, reduce neuro-inflammatory sensitization, modulate the autonomic nervous system, and regulate hippocampal neurogenesis. Finally, we discuss common challenges of the intervention and possible ways to address them. Specifically, we pose developing a simplified and tailored Tai Chi protocol for patients with depression, comparatively investigating Tai Chi with other mind–body interventions such as yoga and Baduanjin, and developing new mind–body interventions that merge the advantages of multiple mind–body exercises.

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          Most cited references65

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          Emotional processing in anterior cingulate and medial prefrontal cortex.

          Negative emotional stimuli activate a broad network of brain regions, including the medial prefrontal (mPFC) and anterior cingulate (ACC) cortices. An early influential view dichotomized these regions into dorsal-caudal cognitive and ventral-rostral affective subdivisions. In this review, we examine a wealth of recent research on negative emotions in animals and humans, using the example of fear or anxiety, and conclude that, contrary to the traditional dichotomy, both subdivisions make key contributions to emotional processing. Specifically, dorsal-caudal regions of the ACC and mPFC are involved in appraisal and expression of negative emotion, whereas ventral-rostral portions of the ACC and mPFC have a regulatory role with respect to limbic regions involved in generating emotional responses. Moreover, this new framework is broadly consistent with emerging data on other negative and positive emotions. Published by Elsevier Ltd.
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            The neuroscience of mindfulness meditation.

            Research over the past two decades broadly supports the claim that mindfulness meditation - practiced widely for the reduction of stress and promotion of health - exerts beneficial effects on physical and mental health, and cognitive performance. Recent neuroimaging studies have begun to uncover the brain areas and networks that mediate these positive effects. However, the underlying neural mechanisms remain unclear, and it is apparent that more methodologically rigorous studies are required if we are to gain a full understanding of the neuronal and molecular bases of the changes in the brain that accompany mindfulness meditation.
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              Resting-state functional connectivity in neuropsychiatric disorders.

              This review considers recent advances in the application of resting-state functional magnetic resonance imaging to the study of neuropsychiatric disorders. Resting-state functional magnetic resonance imaging is a relatively novel technique that has several potential advantages over task-activation functional magnetic resonance imaging in terms of its clinical applicability. A number of research groups have begun to investigate the use of resting-state functional magnetic resonance imaging in a variety of neuropsychiatric disorders including Alzheimer's disease, depression, and schizophrenia. Although preliminary results have been fairly consistent in some disorders (for example, Alzheimer's disease) they have been less reproducible in others (schizophrenia). Resting-state connectivity has been shown to correlate with behavioral performance and emotional measures. It's potential as a biomarker of disease and an early objective marker of treatment response is genuine but still to be realized. Resting-state functional magnetic resonance imaging has made some strides in the clinical realm but significant advances are required before it can be used in a meaningful way at the single-patient level.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                12 April 2019
                2019
                : 10
                : 237
                Affiliations
                [1] 1Psychiatry Department, Massachusetts General Hospital, Harvard Medical School , Charlestown, MA, United States
                [2] 2Depression Clinical and Research Program, Massachusetts General Hospital , Boston, MA, United States
                Author notes

                Edited by: Saeed Farooq, Keele University, United Kingdom

                Reviewed by: Farooq Naeem, University of Toronto, Canada; Jung Eun Shin, Yonsei University, South Korea

                *Correspondence: Georgia Wilson, gjwilson@ 123456mgh.harvard.edu

                This article was submitted to Public Mental Health, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2019.00237
                6474282
                31031663
                790ad221-2714-4271-8bda-bf7f9af6da34
                Copyright © 2019 Kong, Wilson, Park, Pereira, Walpole and Yeung

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 14 December 2018
                : 28 March 2019
                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 90, Pages: 9, Words: 4367
                Funding
                Funded by: National Institutes of Health 10.13039/100000002
                Categories
                Psychiatry
                Perspective

                Clinical Psychology & Psychiatry
                tai chi,mind–body intervention,major depressive disorder,depression,brain network,anti-inflammation

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