Brain Health Research & Clinical Trials

About Our Scientific Approach

The Sadhguru Center uses scientific approaches to integrate medical and contemplative sciences to improve brain health and general well-being. Our team conducts research that employs both clinical and mindfulness-based interventions such as multimodal intraoperative general anesthesia, and opioid-sparing effective pain control in the postoperative period to improve post-operative outcomes, particularly related to cognitive decline and delirium that often occur in aged patients.

The Center's work will provide insight into how consciousness, cognition and compassion are aided by meditative practices. With the aid of enhanced functional MRI (fMRI) tools developed over the last decade, there has been a substantial increase in research conducted on how meditative practices change the brain size and neural network connectivity. There are ongoing clinical studies conducted in the Center that explore how meditative practices affect consciousness and cognition, as well as emotional well-being. Work is also underway to create a database of people who have integrated meditation into their daily routine with the goal of evaluating long-term benefits of regular meditation on emotional well-being. Combined, these approaches will help elucidate how meditative practices influence the potential physiological changes.

Ongoing Clinical Trials

Dr. Bala Subramaniam is leading several major clinical trials investigating approaches intended to reduce post-operative cognitive decline in patients that have undergone cardiac surgery. PANDORA, a multicenter clinical trial funded by the National Institute of Aging, is investigating whether analgesic treatments during the perioperative period, particularly the use of acetaminophen, help to reduce delirium. In another trial, PATHFINDER, Dr. Subramaniam uses minimal opioid medication after surgery to determine if this reduces cognitive decline and delirium after cardiac surgery.

Dr. Subramaniam and his team are exploring the novel concept of "prehabilitation" (pre-surgery interventions) to reduce postoperative neurocognitive disorders. One prospective clinical trial uses guided meditative practices performed prior to cardiac surgery. Dr. Subramaniam and colleagues also investigated the feasibility of prehabilitation with neurocognitive techniques to enhance preporative cognition (PEaPoD).

Publications

Yoga & Meditation: Impact on Well-being

Consciousness, Cognition, and Compassion. Subramaniam, B., Chang, T.F.H., & Sadhasivam, S. (2022). Editorial: Consciousness, cognition, and compassion. Front. Psychol. 13:998315. doi: 10.3389/fpsyg.2022.998315.

Yoga for Student Mental Health & Well-Being. Chang, T. F. H., Ley, B. L., Ramburn, T. T., Srinivasan, S., Hariri, S., Purandare, P., & Subramaniam, B. (2022). Online Isha Upa Yoga for student mental health and well‐being during COVID‐19: A randomized control trial. Applied Psychology: Health and Well-Being. doi: 10.1111/aphw.12341.

Inner Engineering Online Program for Reducing Stress. Upadhyay, P., Chang, T. F. H., Hariri, S., Rallabandi, S., Yathavakilla, S., Novack, V., & Subramaniam, B. (2022). The Effect of Inner Engineering Online (IEO) Program on Reducing Stress for Information Technology Professionals: A Randomized Control Study. Evidence-Based Complementary and Alternative Medicine, 2022, 1–11. doi: 10.1155/2022/9001828.

Inner Engineering Completion Online Program on Stress & Well-Being. Upadhyay, P., Joshi, A., Mishra, I., Kelly, L., Novack, L., Hariri, S., Kveraga, K., & Subramaniam, B. (2022). Short Term Effects of Inner Engineering Completion Online Program on Stress and Well-Being Measures. Frontiers in Psychology, 13. doi: 10.3389/fpsyg.2022.814224.

Impact of Yoga on Individuals’ COVID-19 Response. Upadhyay, P., Narayanan, S., Khera, T., Kelly, L., Mathur, P., Shanker, A., Novack, L., Sadhasivam, S., Hoffman, K., Pérez-Robles, R., & Subramaniam, B. (2021). Perceived stress, resilience, well-being, and COVID 19 response in Isha yoga practitioners compared to matched controls: A research protocol. Contemporary Clinical Trials Communications, 22, 100788. doi: 10.1016/j.conctc.2021.100788.

Yogic Breathing Techniques & COVID-19 Related Stress. Rain, M., Subramaniam, B., Avti, P., Mahajan, P., & Anand, A. (2021). Can Yogic Breathing Techniques Like Simha Kriya and Isha Kriya Regulate COVID-19-Related Stress? Frontiers in Psychology, 12. doi: 10.3389/fpsyg.2021.635816.

Yoga Breathing Techniques for Health Care Workers During COVID-19 Pandemic. Narayanan, S., Tennison, J., Cohen, L., Urso, C., Subramaniam, B., & Bruera, E. (2021). Yoga-Based Breathing Techniques for Health Care Workers During COVID-19 Pandemic: Interests, Feasibility, and Acceptance. The Journal of Alternative and Complementary Medicine, 27(8), 706–709. doi: 10.1089/acm.2020.0536.

Meditative Practices in Hospitalized Cancer Patients. Narayanan, S., Reddy, A., Lopez, G., Liu, W., Wu, J., Liu, D., Manzano, J., Williams, J. L., Mallaiah, S., George, M., Amaram, J., Subramaniam, B., Cohen, L., & Bruera, E. (2020). Randomized Feasibility Study of Meditative Practices in Hospitalized Cancer Patients. Integrative cancer therapies, 19, 1534735420909903. doi: 10.1177/1534735420909903.

Impact of One-Time Guided Meditation on Stress & Mood Disturbances. Rangasamy, V., Thampi Susheela, A., Mueller, A., F. H. Chang, T., Sadhasivam, S., & Subramaniam, B. (2019). The effect of a one-time 15-minute guided meditation (Isha Kriya) on stress and mood disturbances among operating room professionals: a prospective interventional pilot study. F1000Research, 8, 335. doi: 10.12688/f1000research.18446.1.

Meditation to Enhance Postoperative Recovery After Cardiac Surgery. Packiasabapathy, S., Susheela, A. T., Mueller, A., Patxot, M., Gasangwa, D. V., O'Gara, B., Shaefi, S., Marcantonio, E. R., Yeh, G. Y., & Subramaniam, B. (2019). Guided meditation as an adjunct to enhance postoperative recovery after cardiac surgery: study protocol for a prospective randomized controlled feasibility trial. Trials, 20(1), 39. doi: 10.1186/s13063-018-3103-8.

Yoga & Meditation: Neuro-physiology

Advanced Meditation, Vegan Diet, & Blood Lipid Levels. Vishnubhotla, R. V., Wood, P. L., Verma, A., Cebak, J. E., Hariri, S., Mudigonda, M., Alankar, S., Maturi, R., Orui, H., Subramaniam, B., Palwale, D., Renschler, J., & Sadhasivam, S. (2022). Advanced Meditation and Vegan Diet Increased Acylglycines and Reduced Lipids Associated with Improved Health: A Prospective Longitudinal Study. Journal of Integrative and Complementary Medicine. doi: 10.1089/jicm.2022.0480.

Meditation to Boost Immunity—Evidence from Gene Expression. Chandran, V., Bermúdez, M. L., Koka, M., Chandran, B., Pawale, D., Vishnubhotla, R., Alankar, S., Maturi, R., Subramaniam, B., & Sadhasivam, S. (2021). Large-scale genomic study reveals robust activation of the immune system following advanced Inner Engineering meditation retreat. Proceedings of the National Academy of Sciences, 118(51). doi: 10.1073/pnas.2110455118.

Advanced Meditation Program to Improve Mental & Physical Health. Sadhasivam, S., Alankar, S., Maturi, R., Williams, A., Vishnubhotla, R. V., Hariri, S., Mudigonda, M., Pawale, D., Dubbireddi, S., Packiasabapathy, S., Castelluccio, P., Ram, C., Renschler, J., Chang, T., & Subramaniam, B. (2021). Isha Yoga Practices and Participation in Samyama Program are Associated with Reduced HbA1C and Systemic Inflammation, Improved Lipid Profile, and Short-Term and Sustained Improvement in Mental Health: A Prospective Observational Study of Meditators. Frontiers in Psychology, 12. doi: 10.3389/fpsyg.2021.659667.

Advanced Meditation & Resting-State Brain Network Connectivity. Vishnubhotla, R. V., Radhakrishnan, R., Kveraga, K., Deardorff, R., Ram, C., Pawale, D., Wu, Y. C., Renschler, J., Subramaniam, B., & Sadhasivam, S. (2021). Advanced Meditation Alters Resting-State Brain Network Connectivity Correlating With Improved Mindfulness. Frontiers in Psychology, 12. doi: 10.3389/fpsyg.2021.745344.

Yoga & Meditation associated with Cannabimimetic Effects & Mental Health. Sadhasivam, S., Alankar, S., Maturi, R., Vishnubhotla, R. V., Mudigonda, M., Pawale, D., Narayanan, S., Hariri, S., Ram, C., Chang, T., Renschler, J., Eckert, G., & Subramaniam, B. (2020). Inner Engineering Practices and Advanced 4-day Isha Yoga Retreat Are Associated with Cannabimimetic Effects with Increased Endocannabinoids and Short-Term and Sustained Improvement in Mental Health: A Prospective Observational Study of Meditators. Evidence-Based Complementary and Alternative Medicine, 2020, 1–9. doi: 10.1155/2020/8438272.

Anesthesia: Perioperative Neurocognitive Disorders

Effects of Sedatives on Risk of Post-Extubation Delirium in the ICU. Azimaraghi, O., Wongtangman, K., Wachtendorf, L. J., Santer, P., Rumyantsev, S., Ahn, C., Kiyatkin, M. E., Teja, B., Sarge, T., Subramaniam, B., & Eikermann, M. (2022). Differential Effects of Gamma-Aminobutyric Acidergic Sedatives on Risk of Post-Extubation Delirium in the ICU: A Retrospective Cohort Study From a New England Health Care Network. Critical care medicine, 50(5), e434–e444. doi: 10.1097/CCM.0000000000005425.

Sleep, Pain, and Cognition: Optimal Perioperative Brain Health. O’Gara, B. P., Gao, L., Marcantonio, E. R., & Subramaniam, B. (2021). Sleep, Pain, and Cognition: Modifiable Targets for Optimal Perioperative Brain Health. Anesthesiology, 135(6), 1132–1152. doi: 10.1097/aln.0000000000004046.

Scheduled IV Acetaminophen to Prevent Postoperative Delirium. Khera, T., Mathur, P. A., Banner-Goodspeed, V. M., Narayanan, S., Mcgourty, M., Kelly, L., Palihnich, K., Novack, L., Davis, R., Talmor, D., Marcantonio, E. R., & Subramaniam, B. (2021). Scheduled Prophylactic 6-Hourly IV AcetaminopheN to Prevent Postoperative Delirium in Older CaRdiac SurgicAl Patients (PANDORA): protocol for a multicentre randomised controlled trial. BMJ Open, 11(3), e044346. doi: 10.1136/bmjopen-2020-044346.

Review: Cognition & Pain. Khera, T., & Rangasamy, V. (2021). Cognition and Pain: A Review. Frontiers in Psychology, 12. doi: 10.3389/fpsyg.2021.673962.

Perioperative Cognitive Training to Prevention Early Postoperative Decline. O'Gara, B. P., Mueller, A., Gasangwa, D., Patxot, M., Shaefi, S., Khabbaz, K., Banner-Goodspeed, V., Pascal-Leone, A., Marcantonio, E. R., & Subramaniam, B. (2020). Prevention of Early Postoperative Decline: A Randomized, Controlled Feasibility Trial of Perioperative Cognitive Training. Anesthesia and analgesia, 130(3), 586–595. doi: 10.1213/ANE.0000000000004469.

Intravenous Acetaminophen Combinations on Postoperative Delirium. Subramaniam, B., Shankar, P., Shaefi, S., Mueller, A., O’Gara, B., Banner-Goodspeed, V., Gallagher, J., Gasangwa, D., Patxot, M., Packiasabapathy, S., Mathur, P., Eikermann, M., Talmor, D., & Marcantonio, E. R. (2019). Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery. JAMA, 321(7), 686. doi: 10.1001/jama.2019.0234.

Cardiac Anesthesia

Type of Anesthesia and Postoperative Pulmonary Complications. Bartels, K., Frendl, G., Sprung, J., Weingarten, T. N., Subramaniam, B., Martinez Ruiz, R., Lee, J. W., Henderson, W. G., Moss, A., Sodickson, A., Giquel, J., Vidal Melo, M. F., Fernandez-Bustamante, A., & Perioperative Research Network (PRN) investigators (2022). Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study. BMC anesthesiology, 22(1), 136. doi: 10.1186/s12871-022-01679-5.

Intraoperative Hypotension and Cardiopulmonary Bypass. de la Hoz, M. A., Rangasamy, V., Bastos, A. B., Xu, X., Novack, V., Saugel, B., & Subramaniam, B. (2022). Intraoperative Hypotension and Acute Kidney Injury, Stroke, and Mortality during and outside Cardiopulmonary Bypass: A Retrospective Observational Cohort Study. Anesthesiology, 136(6), 927–939. doi: 10.1097/aln.0000000000004175.

Long-term Intravenous Acetaminophen Outcomes After Cardiac Surgery. Khera, T., Helfand, J., Kelly, L., Mueller, A., Shankar, P., Marcantonio, E. R., & Subramaniam, B. (2022). Twelve-Month Cognitive and Functional Outcomes Following Cardiac Surgery: The DEXACET Trial of Intravenous Acetaminophen Versus Placebo. Frontiers in Pharmacology, 13. doi: 10.3389/fphar.2022.803903.

Specific CNS Targets in Patients Undergoing Cardiac Surgeries. Shanker, A., Abel, J. H., Narayanan, S., Mathur, P., Work, E., Schamberg, G., Sharkey, A., Bose, R., Rangasamy, V., Senthilnathan, V., Brown, E. N., & Subramaniam, B. (2021). Perioperative Multimodal General Anesthesia Focusing on Specific CNS Targets in Patients Undergoing Cardiac Surgeries: The Pathfinder Feasibility Trial. Frontiers in Medicine, 8. doi: 10.3389/fmed.2021.719512.

Impact of Frailty in Cardiac Surgical Patients. Subramaniam, B., Shanker, A., Upadhyay, P., Rangasamy, V., & Muralidhar, K. (2021). Impact of frailty in cardiac surgical patients—Assessment, burden, and recommendations. Annals of Cardiac Anaesthesia, 24(2), 133. doi: 10.4103/aca.aca_90_20.

Preoperative Blood Pressure Complexity & Patients Undergoing Cardiac Surgery. Rangasamy, V., Henriques, T. S., Xu, X., & Subramaniam, B. (2020). Preoperative Blood Pressure Complexity Indices as a Marker for Frailty in Patients Undergoing Cardiac Surgery. Journal of cardiothoracic and vascular anesthesia, 34(3), 616–621. doi: 10.1053/j.jvca.2019.09.035.

Intravenous Acetaminophen with Propofol or Dexmedetomidine Outcomes Following Cardiac Surgery. Subramaniam, B., Shankar, P., Shaefi, S., Mueller, A., O'Gara, B., Banner-Goodspeed, V., Gallagher, J., Gasangwa, D., Patxot, M., Packiasabapathy, S., Mathur, P., Eikermann, M., Talmor, D., & Marcantonio, E. R. (2019). Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial. JAMA, 321(7), 686–696. doi: 10.1001/jama.2019.0234.

Compassion Studies

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Yoga & Meditation: Impact on Well-being

Study by Upadhyay et al. (2022) finds Inner Engineering Online (IEO) had significant positive effect on employee wellbeing and positive organizational behavior.

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Yoga & Meditation: Neuro-Physiology

Large-scale genomic study by Chandran et al. (2021) reveals robust activation of the immune system following an advanced meditation program.

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Anesthesia: Perioperative Neurocognitive Disorders

Study by Azimaraghi et al. (2022) found that deep levels of benzodiazepine-induced sedation were associated with a fewer number of delirium-free days after extubation.

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Cardiac Anesthesia

Study by Shanker et al. (2021) finds successful use of a total intravenous anesthesia (TIVA)-based MMGA strategy for cardiac surgery.

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