Neural correlates of cognitive performance in type 2 diabetes mellitus patients following yoga practice a randomized controlled trial

Abstract

T2DM is a chronic metabolic disorder characterized by an impaired ability of peripheral newlinetissue to regulate glucose homeostasis in response to insulin (Roberto and Crisafulli, 2017). It newlinehas detrimental effects on many organ systems and is known for its systemic impact on a wide newlinerange of complications. T2DM causes significant long-term morbidity with late diabetic newlinecomplications of the eyes, kidneys, and nervous system as well as an increased risk of newlinearteriosclerosis (Harris et al., 1992). One such clinical manifestation that is receiving increasing newlineattention is cognitive impairment (CI) which is also termed as diabetic cogno-pathy (Kodl and newlineSeaquist, 2008). newline T2DM is an independent risk factor for mild cognitive impairment (MCI). According to a newlinerecent systematic review and meta-analysis, the prevalence of MCI in people with T2DM is newline45%, and it is lower in patients older than 60 years than in those under 60 years (You et al., newline2021). In Indian state of Karnataka, 50.5% of those with T2DM have MCI (Bhaskar et al., newline2019). In people with T2DM, impairments can occur in multiple cognitive domains, including newlineattention, memory, executive function (EF), processing speed, problem solving and abstract newlinethinking (Akisaki et al., 2006; Danna et al., 2016). newline Electroencephalography (EEG) is a non-invasive technique in which electrodes are placed newlineon the scalp to measure the electrical activity of the brain. A recent systematic review revealed newlinethat the characteristics of cortical activity of individuals with T2DM are similar to that of newlineindividuals with MCI and/or AD (Kanthi et al., 2022). For instance, the spectral power of lower newlinebrain frequencies dominates over the higher frequencies, which is similar to the characteristics newlineobserved in MCI and AD (Benwell et al., 2020). Similarly, coherence analysis shows that the newlineT2DM patients with amnestic MCI (aMCI) demonstrate a reduced alpha and theta bands newlinecompared to cognitively healthy T2DM patients (Bian et al., 2014). newlineii newline Yoga is a well-known lifestyle intervention that ha