Effect of Add-on Yoga-Based Intervention on Schizophrenia: A Randomized Controlled Trial

Schizophrenia is a complex, highly heterogenous, and multifactorial psychiatric disorder. Antipsychotic medications which are the mainstay pharmacological therapy of Schizophrenia, have significant limitations in improving negative and cognitive symptoms and are frequently associated with adverse effects. Yoga, as an adjunctive intervention, has shown benefits in clinical outcomes, particularly in negative and cognitive symptoms. This study explored the impact of add-on yoga-based intervention on clinical outcomes, DNA methylation pattern, protein and mRNA expressions of immune molecules like cytokines and complement proteins in schizophrenia patients. Sixty-six patients were randomized to yoga therapy (YT, n = 33) and treatment-as-usual (TAU, n = 33) groups, of whom 30 patients in the YT group and 29 in TAU group completed three-month intervention period. Collection of blood samples to analyze plasma levels, lymphocyte gene expression, promoter DNA methylation pattern of interleukin-1β (IL-1β), IL-6, IL-10, IL-17A, and complement components (C3, C4, and C5) and clinical assessments were carried out at baseline and post-intervention. Patients of YT group demonstrated significant improvements in clinical outcomes, reductions in the levels of plasma IL-1β, expression of Il1b and Il6 genes, increased expression of C4 gene, hypermethylation of Il1b gene, hypomethylation of Il6, Il10 and C4 genes compared to TAU group post-intervention. These findings suggest that yoga-based intervention is associated with improvements in clinical outcomes, with concurrent changes in the expressions and DNA methylation patterns of a few immune markers. This study highlights the beneficial attributes of yoga-based intervention in schizophrenia and suggests that immunomodulation could be one of the mediating effects of yoga in Schizophrenia.