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Abstract
Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid (GABA) levels and cerebral blood flow (CBF) in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress (t = 4.02, P < 0.001), anxiety (z = 2.33, P = 0.02), fatigue (t = 3.35, P = 0.004), and sleep quality (t = 4.14, P < 0.001) improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms (t = −5.25, P < 0.001). The prefrontal GABA levels decreased (t = 2.53, P = 0.02), while relative CBF increased (t = −3.32, P = 0.004) after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention (t = 2.22, P = 0.04). The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress.
Highlights
Relaxation training has been reported to improve various stressrelated symptoms (Bastani et al, 2005; Rausch et al, 2006)
We examined whether changes in prefrontal gamma-aminobutyric acid (GABA) and relative cerebral blood flow (CBF) might be associated with the improvement of stress-related symptom after the 10-session intervention, using regression models including the following variables: changes in prefrontal GABA level or relative CBF as an independent variable and composite stress-related symptom scores after the intervention as a dependent variable of perceived stress level, anxiety, fatigue, and sleep quality
We report that computerized relaxation training may induce GABA level and CBF changes in the prefrontal region of the brain in women with psychological distress
Summary
Relaxation training has been reported to improve various stressrelated symptoms (Bastani et al, 2005; Rausch et al, 2006). Despite its increasing usage and reported therapeutic efficacy in mild psychological distress (Poirier-Bisson et al, 2013; Kisely et al, 2015), the underlying neurobiological mechanisms of relaxation training need further investigations. Changes in the prefrontal region may be related to the efficacy of relaxation training since dysfunctional top-down emotional regulation of the prefrontal region has been reported in psychological distress conditions (Hains and Arnsten, 2008; Ghosal et al, 2017). The GABA levels and CBF were recovered in relation to improved emotional regulation after cognitive-behavioral training in individuals with psychological distress (Guglietti et al, 2013; Tang et al, 2015, 2016; Ghosal et al, 2017), suggesting a close association with stress-related symptoms. We assumed that the GABA levels and CBF might be neural correlates underlying the effects of relaxation training in psychological distress
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