焦慮是年長者常見的負面行為，它的成因包含神經心理因素以及人格特質因素。過去文獻顯示，焦慮症患者有異常的心率變異 (heart rate variability, HRV) 指數，並且在調控負面情緒的相關腦區有較低的功能性以及結構性連結。淨化呼吸瑜珈 (Sudarshan Kriya Yoga, SKY) 是一種獨特的呼吸方式，先前的研究發現練習SKY可以改善HRV指數以及焦慮，然而其神經生理機制尚不明瞭。我們的實驗假說為規律練習SKY一個月也可以改善年長者的焦慮與HRV指數，且與腦中調控焦慮重要腦區杏仁核或其他腦區的活性變化、功能與結構連結有相關。本研究招募20位睡眠品質不佳的年長受試者，實驗進行兩個月，在三個時間點（T1、T2及T3）使用光學式心跳測量儀評估HRV、特質焦慮量表檢測焦慮分數和進行磁振造影來取得功能性與結構性影像。T1和T2之間為第一個月，不介入SKY；T2和T3之間為第二個月，介入SKY。結果顯示，介入SKY後，年長者特質焦慮分數顯著下降，而無介入SKY則無顯著差異。然而，HRV指數不管有無介入SKY皆無顯著差異，但可發現過高或過低HRV指數有正常化趨勢。磁振造影的區域同質性分析發現，左右腦杏仁核活性皆無顯著改變，但左腦緣上迴的活性在無介入SKY一個月時顯著下降，介入SKY一個月其活性變化量與特質焦慮變化量呈現正相關。進一步探討左腦緣上迴的功能性連結，發現其與右小腦第一小葉以及顳下迴之間的功能性連結與特質焦慮分數的變化呈現正相關。另外，不管有無介入SKY皆尚未影響神經束白質微結構。本研究結果顯示，年長者規律練習一個月SKY可降低焦慮，且改變左腦緣上迴活性及其功能連結。

Anxiety disorder patients have abnormal heart rate variability (HRV), functional connectivity (FC) and white matter density in brain regions related to anxiety. Practices of Sudarshan Kriya Yoga (SKY) improve HRV and relieve negative emotions. However, whether improvement of HRV and anxiety by SKY practicing is regulated by the structural and functional connectivity in related brain regions is unknown. In this study, 20 elders were recruited and undergo resting-state magnetic resonance imaging, HRV analysis and trait anxiety inventory. In the first month, they maintained a daily routine and designated as the stage of without SKY intervention. In the second month, they practiced SKY regularly at home and designated as the stage of with SKY intervention. Results showed that trait anxiety scores were decreased with SKY intervention and no significant difference in HRV parameters. In result of regional homogeneity (ReHo), the activity of left supramarginal gyrus was decreased without SKY intervention and △ReHo of left supramarginal gyrus is negatively correlated with △trait anxiety scores with SKY intervention. In FC result, △FC between left supramarginal gyrus and right cerebellum crus1 or inferior temporal gyrus was positively correlated with △trait anxiety scores. However, no significant changes in white matter microstructure with or without SKY intervention. These results demonstrated that regular practicing SKY for one-month improved anxiety probably through the increase of the activity of left supramarginal gyrus and its functional connectivity with brain regions involved in anxiety and semantic memory processing, visual perception, and motor control in the right brain.

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