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DOI: 10.1055/a-1997-8697
Psychoneurophysiologische Wirkmechanismen der Selbstheilung

Summary
Selbstheilung lässt sich der Mind-Body-Medizin (MBM) zuordnen und umfasst eine Reihe von Mind-Body-Therapien (MBT) mit Hilfe derer Individuen selbstwirksam und -regulativ in die physiologischen Gleichgewichtssysteme des Organismus eingreifen. In diesem Beitrag werden die bis dato bekannten neurophysiologischen Wirkmechanismen der MBT aus patho- und salutogenetischer Perspektive integrativ-systemisch dargestellt. Top-down wirkende MBT (z.B. Meditation, Hypnose) dürften dabei über zentralnervöse Aktivitätsveränderungen und damit verbundener Beruhigung der Stresssystemaktivität (u.a. Cortisol, sympatho-vagale Balance) zu Reduktionen von Entzündungsaktivität führen. Bottom-Up wirkende MBT (z.B. Yoga, Qigong) setzen wiederum an der peripheren Körperphysiologie an und wirken über die kontrollierte Atemarbeit und über körperliche Praktiken positiv auf stressverarbeitende Systeme und Immunaktivität. Das robusteste Ergebnis zu den Wirkmechanismen der Selbstheilung stellt die Verringerung von stressbedingter Entzündung dar. Dabei zeigt sich, dass die Messung von genomischen im Vergleich zu zirkulierenden und über die Zeit mehr schwankenden Immunparametern zu verlässlicheren Ergebnissen führt. Dies lässt die in diesem Forschungsbereich mehrheitlich verwendeten randomisierten kontrollierten Studien (randomized controlled trial, RCT)-Studien als zu statisch und normativ erscheinen. Das Integrative Einzelfalldesign zur Untersuchung von biopsychosozialer Komplexität unter Alltagsbedingungen ist aufgrund der Analyse engmaschiger Zeitreihen und von tiefenpsychologischen Interviewanalysen in der Lage, die Mechanismen der Selbstheilung sehr valide zu erfassen.
Keywords
Selbstheilung - meaning-response - Mind-Body-Medizin - Mind-Body-Therapien - neurophysiologische Mechanismen - Psychoneuroimmunologie - Integrative EinzelfallstudiePublication History
Article published online:
31 March 2023
© Karl F. Haug Verlag in Georg Thieme Verlag
KG
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Literatur
- 1 Esch T. Der Nutzen von Selbstheilungspotenzialen in der professionellen Gesundheitsfürsorge am Beispiel der Mind-Body-Medizin. Bundesgesund-heitsbl 2020; 63: 577-585 DOI:10.1007/s00103-020-03133-8
- 2 Taylor AG, Goehler LE, Galper DI. et al. Top-down and bottom-up mechanisms in mind-body medicine: development of an integrative framework for psychophysiological research. C.Explore (NY) 2010; 6: 29-41 DOI:10.1016/j.explore.2009.10.004
- 3 Moerman DE, Jonas WB. Deconstructing the placebo effect and finding the meaning response. Ann Intern Med 2002; 136: 471-476 DOI:10.7326/0003-4819-136-6-200203190-00011
- 4 Benson H, Beary JF, Carol MP. The relaxation response. Psychiatry 1974; 37: 37-46 DOI: 10.1080/00332747.1974.11023785
- 5 Porges SW. The polyvagal theory: phylogenetic substrates of a social nervous system. Int J Psychophysiol 2001; 42: 123-146 DOI: 10.1016/ s0167-8760(01)00162-3
- 6 Damasio A. Descartes’ Error: Emotion, Reason, and the Human Brain. New York: Putnam; 1994
- 7 Muehsam D, Lutgendorf S, Mills PJ. et al. The embodied mind: A review on functional genomic and neurological correlates of mind-body therapies. Neurosci Biobehav Rev 2017; 73: 165-181 DOI: 10.1016/j.neubio-rev.2016.12.027
- 8 Sterling P, Eyer J. Allostasis: A new paradigm to explain arousal pathology. In: Fisher S, Reason J, Eds. Handbook of life stress, cognition and health New York: John Wiley & Sons; 1988: 629-649
- 9 Schulz KH, Heesen C, Gold SM. Das Stresskonzept von Allostase und Allo-static Load: Einordnung psychoneuroimmunologischer Forschungsbefunde an Beispielen zur Autoimmunität und Onkologie. Psychother Psycho-som Med Psychol 2005; 55: 452-461 DOI: 10.1055/s-2005-866939
- 10 Lenart-Bugla M, Szczesniak D, Bugla B. et al. The association between allostatic load and brain: A systematic review. Psychoneuroendocrinology 2022; 145: 105917 doi: 10.1016/j.psyneuen.2022.105917
- 11 Tsigos C, Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res 2002; 53: 865-871 DOI: 10.1016/s0022-3999(02)00429-4
- 12 Ingrosso DMF, Primavera M, Samvelyan S. et al. Stress and Diabetes Mellitus: Pathogenetic Mechanisms and clinical outcome. Horm Res Paediatr. 2022 doi: 10.1159/000522431
- 13 Cohen S, Janicki-Deverts D, Doyle WJ. et al Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci U S A 2012; 109: 5995-5999 DOI: 10.1073/pnas.1118355109
- 14 Dantzer R, O'Connor JC, Freund GG. et al From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci 2008; 9: 46-56 DOI: 10.1038/nrn2297
- 15 Chrousos GP, Gold PW. The concepts of stress and stress system disorders. Overview of physical and behavioral homeostasis. JAMA 1992; 267: 1244-1252
- 16 Park C, Rosenblat JD, Brietzke E. et al Stress, epigenetics and depression: A systematic review. Neurosci Biobehav Rev 2019; 102: 139-152 DOI: 10.1016/j.neubiorev.2019.04.010
- 17 Cole SW. Elevating the perspective on human stress genomics. Psychoneuroendocrinology 2010; 35: 955-962 DOI: 10.1016/j.psyneu-en.2010.06.008
- 18 Pepper GV, Bateson M, Nettle D. Telomeres as integrative markers of exposure to stress and adversity: a systematic review and meta-analysis. R Soc Open Sci 2018; 5: 180744 DOI: 10.1098/rsos.180744
- 19 Waise TMZ, Dranse HJ, Lam TKT. The metabolic role of vagal afferent innervation. Nat Rev Gastroenterol Hepatol 2018; 15: 625-636 DOI: 10.1038/s41575-018-0062-1
- 20 Tracey KJ. The inflammatory reflex. Nature 2002; 420: 853-859 DOI: 10.1038/nature01321
- 21 Thayer JF, Sternberg E. Beyond heart rate variability: vagal regulation of allostatic systems. Ann N Y Acad Sci 2006; 1088: 361-372 DOI: 10.1196/annals.1366.014
- 22 Tracey KJ. Physiology and immunology of the cholinergic antiinflammatory pathway. J Clin Invest 2007; 117: 289-296 DOI: 10.1172/JCI30555
- 23 Kaniusas E, Kampusch S, Tittgemeyer M. et al. Current Directions in the Auricular Vagus Nerve Stimulation I – A Physiological Perspective. Front Neurosci 2019; 13: 854 DOI: 10.3389/fnins.2019.00854
- 24 Weber CS, Thayer JF, Rudat M. et al. Low vagal tone is associated with impaired post stress recovery of cardiovascular, endocrine, and immune markers. Eur J Appl Physiol 2010; 109: 201-211 doi: 10.1007/s00421-009-1341-x
- 25 Holzer P, Farzi A. Neuropeptides and the microbiota-gut-brain axis. Adv Exp Med Biol 2014; 817: 195-219 DOI: 10.1007/978-1-4939-0897-4_9
- 26 Rhee SH, Pothoulakis C, Mayer EA. Principles and clinical implications of the brain-gut-enteric microbiota axis. Nat Rev Gastroenterol Hepatol 2009; 6: 306-314 DOI: 10.1038/nrgastro.2009.35
- 27 Yarandi SS, Peterson DA, Treisman GJ. et al. Modulatory Effects of Gut Microbiota on the Central Nervous System: How Gut Could Play a Role in Neuropsychiatric Health and Diseases. J Neurogastroenterol Motil 2016; 22: 201-212 DOI: 10.5056/jnm15146
- 28 Kelly JR, ennedy PJ, Cryan JF. Breaking down the barriers: the gut micro-biome, intestinal permeability and stress-related psychiatric disorders. Front Cell Neurosci 2015; 9: 392 DOI: 10.3389/fncel.2015.00392
- 29 Dinan TG, Cryan JF. Microbes, Immunity, and Behavior: Psychoneuroimmunology Meets the Microbiome. Neuropsychopharmacology 2017; 42: 178-192 DOI: 10.1038/npp.2016.103
- 30 Buric I, Farias M, Jong J. et al. What Is the Molecular Signature of Mind-Body Interventions? A Systematic Review of Gene Expression Changes Induced by Meditation and Related Practices. Front Immunol 2017; 8: 670 DOI: 10.3389/fimmu.2017.00670
- 31 Boccia M, Piccardi L, Guariglia P. The Meditative Mind: A Comprehensive Meta-Analysis of MRI Studies. Biomed Res Int 2015 2015; 419808 DOI: 10.1155/2015/419808
- 32 Lavretsky H, Datta T. Neurobiological Mechanisms of Mind-Body Medicine. Psychiatric Times 2022; 39: 22-24
- 33 You T, Ogawa EF. Effects of meditation and mind-body exercise on brain-derived neurotrophic factor: A literature review of human experimental studies. Sports Med Health Sci 2020; 2: 7-9 DOI: 10.1016/j.smhs.2020.03.001
- 34 Esch T, Stefano GB. The BERN Framework of Mind-Body Medicine: Integrating Self-Care, Health Promotion, Resilience, and Applied Neuroscience. Front Integr Neurosci 2022; 16: 913573 DOI: 10.3389/fnint.2022.913573
- 35 Zou L, Sasaki JE, Wei GX. et al. Effects of Mind-Body Exercises (Tai Chi/ Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. J Clin Med 2018; 7: 404 DOI: 10.3390/jcm7110404
- 36 Brown L, Rando AA, Eichel K. et al. The Effects of Mindfulness and Meditation on Vagally Mediated Heart Rate Variability: A Meta-Analysis. Psycho-som Med 2021; 83: 631-640 DOI: 10.1097/PSY.0000000000000900
- 37 Garcfa-Campayo J, Puebla-Guedea M, Labarga A. et al. Epigenetic Response to Mindfulness in Peripheral Blood Leukocytes Involves Genes Linked to Common Human Diseases. Mindfulness 2018; 9: 1146-1159 DOI: 10.1007/s12671-017-0851-6
- 38 Schutte NS, Malouff JM. A meta-analytic review of the effects of mindfulness meditation on telomerase activity. Psychoneuroendocrinology 2014; 42: 45-48 DOI: 10.1016/j.psyneuen.2013.12.017
- 39 Dasanayaka NN, Sirisena ND, Samaranayake N. The effects of meditation on length of telomeres in healthy individuals: a systematic review. Syst Rev 2021; 10: 151 DOI: 10.1186/s13643-021-01699-1
- 40 Laborde S, Allen MS, Borges U. et al. Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a metaanalysis. Neurosci Biobehav Rev 2022; 138: 104711 DOI: 10.1016/j.neu-biorev.2022.104711
- 41 Richer R, Zenkner J, Küderle A. et al. Vagus activation by Cold Face Test reduces acute psychosocial stress responses. Sci Rep 2022; 12: 19270 DOI: 10.1038/s41598-022-23222-9
- 42 Conlon MA, Bird AR. The impact of diet and lifestyle on gut microbiota and human health. Nutrients 2014; 7: 17-44 DOI: 10.3390/nu7010017
- 43 Vitetta L. Mind body medicine: a tangible link between the gut and the brain. Ann Transl Med 2020; 8: 64 DOI: 10.21037/atm.2019.12.80
- 44 Liu L, Wu X, Liu Q. et al. The effect of biofeedback training on intestinal function among patients with middle and low rectal cancer: a randomized controlled study. Ann Transl Med 2019; 7: 605 DOI: 10.21037/ atm.2019.09.62
- 45 Bower JE, Irwin MR. Mind-body therapies and control of inflammatory biology: A descriptive review. Brain Behav Immun 2016; 51: 1-11 DOI: 10.1016/j.bbi.2015.06.012
- 46 Black DS, Slavich GM. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann N Y Acad Sci 2016; 1373: 13-24 DOI: 10.1111/nyas.12998
- 47 Miller GE, Cohen S. Psychological interventions and the immune system: a meta-analytic review and critique. Health Psychol 2001; 20: 47-63 DOI:10.1037//0278-6133.20.1.47
- 48 Schubert C. Soziopsychoneuroimmunologie – Integration von Dynamik und subjektiver Bedeutung in die PNI. In: Schubert C, Hrsg. Psychoneuroimmunologie und Psychotherapie. 2. Aufl. Stuttgart New York: Schattauer; 2015: 374-405
- 49 Von Uexküll T, Wesiack W. Wissenschaftstheorie: ein bio-psycho-soziales Modell. In: Adler RH, Herrmann JM, Köhle K, Schonecke OW, Uexküll T v, Wesiack W, Hrsg. Psychosomatische Medizin. 5. Aufl München: Urban & Schwarzenberg; 1996: 13-52
- 50 Schubert C, Ott M, Hannemann J. et al. Dynamic Effects of CAM Techniques on Inflammation and Emotional States: An Integrative Single-Case Study on a Breast Cancer Survivor. Integr Cancer Ther. 2021 20. 1534735420977697 DOI: 10.1177/1534735420977697
- 51 Singer M, Ott M, Bliem HR. et al. Case Report: Dynamic Interdependencies Between Complementary and Alternative Medicine (CAM) Practice, Urinary Interleukin-6 Levels, and Fatigue in a Breast Cancer Survivor. Front Psychiatry. 2021 12 592379. DOI: 10.3389/fpsyt.2021.592379
- 52 Engel GL. The clinical application of the biopsychosocial model. Am J Psychiatry 1980; 137: 535-544 DOI: 10.1176/ajp.137.5.535
- 53 Engel GL. From biomedical to biopsychosocial. 1. Being scientific in the human domain. Psychother Psychosom 1997; 66: 57-62 DOI:10.1159/000289109
- 54 Schubert C. Geometrie der Seele. Wie unbewusste Muster das Drehbuch unseres Lebens bestimmen. München: Gräfe und Unzer; 2023