Abstract
Introduction
Yoga, an ancient system of physical, mental, and spiritual practices, has increasingly garnered attention in clinical neuroscience. Recent randomised controlled trials (RCTs) suggest that integrating yogic techniques, such as breath regulation (pranayama), postural practices (asanas), and meditative focus, may enhance outcomes across neurological disorders. However, despite this promise, systematic adoption of yoga as an adjunct in neurology clinics remains rare.
Clinical Evidence in Neurological Diseases
Migraine
A 2023 open-label RCT in 80 migraine patients found that three months of pranayama training significantly reduced headache severity, frequency, and disability scores when added to conventional treatment. 1 The CONTAIN trial (n = 160) further supported these findings, showing a reduction of 3.5 migraine days per month and decreased medication usage in yoga participants. 2 A 2007 study also reported improved anxiety, depression, and quality of life with a three-month yoga module. 3
Parkinson’s Disease (PD)
A 2023 study demonstrated that a one month yoga intervention improved postural stability and reduced cortical inhibition (measured via short-interval intracortical inhibition (SICI) and contralateral silent period (cSP)), indicating neuroplastic effects in Parkinson’s Disease (PD) patients. 4
Mechanistic Plausibility
Yoga has been associated with enhanced parasympathetic activity and reduced sympathetic tone, suggesting a balancing effect on the autonomic nervous system. A systematic review indicated that yoga may reduce cortisol levels and modulate stress reactivity. 5 Furthermore, functional magnetic resonance imaging (fMRI)-based studies on pranayama have shown activation changes in the amygdala, insula, and medial prefrontal cortex, areas linked with emotion regulation and pain processing. 6
In PD, cortical disinhibition is an early feature. A reduction in SICI and cSP following yoga may indicate improved cortical excitability, which could aid motor control and support neurorehabilitation. 4
Patient Acceptability and Feasibility
Yoga sessions of 20–30 minutes, focusing on breath and gentle movement, are often well tolerated and promote adherence. A comprehensive overview by McCall et al. 7 similarly, highlights that yoga interventions across various acute and chronic health conditions are generally safe, show no reports of adverse effects, and demonstrate a positive trend for patient tolerance and feasibility, especially in reducing symptoms of anxiety, depression, and pain. 7
Benefits of Yoga in Neurology
Mind–Body Interventions
Yoga is part of a broader category of mind–body therapies that have shown efficacy in treating neurological conditions, such as migraines and fibromyalgia. These therapies often involve meditation, relaxation, and breathing techniques, which are integral to yoga practice. 8
Holistic Health Approach
Yoga encompasses physical, ethical, and meditative practices that promote mindfulness and intention. This holistic approach can be adapted for individuals of all ages and physical abilities, making it accessible and beneficial for a wide range of patients. 9
Therapeutic Potential
Yoga has been recognised for its therapeutic value in neurological disorders, including epilepsy, stroke, and Alzheimer’s disease. It offers physiological and psychological improvements, although further research is needed to validate these findings comprehensively. 10
Mechanisms of Action
Neurophysiological Effects
Yoga enhances top-down and bottom-up processing, which facilitates cognitive and emotional self-regulation. This can lead to improved attentional control, executive functioning, and parasympathetic nervous system engagement. 9
Pain Management
In cases of neuropathic pain, particularly following spinal cord injuries, yoga may regulate pain mechanisms and associated molecular pathways, offering a complementary approach to traditional pain management strategies. 11
Remaining Challenges
Despite promising evidence, limitations remain. Many studies are underpowered, lack blinding, or use heterogeneous yoga protocols, making replication difficult. Systematic reviews recommend the use of standardised interventions, and tools such as CheckList stAndardising the Reporting of Interventions For Yoga (CLARIFY) have been specifically developed to improve reporting quality and reproducibility in yoga research and clinical applications. 12 Operationally, neurology clinics may lack access to certified yoga therapists. Integration would require training physical therapists, adapting clinical spaces, and tracking outcomes via validated instruments (e.g., Headache Impact Test-6 (HIT-6), Migraine Disability Assessment Scale (MIDAS), Parkinson’s Disease Questionnaire-39 (PDQ-39)).
Call to Action
Clinicians should practice yoga modules in migraine and PD clinics with short, supervised sessions and collect outcome data.
Researchers must prioritise large-scale RCTs with neuroimaging and physiological endpoints to establish causality.
Policymakers should incorporate yoga into national neurology care guidelines and support certification pathways for therapists.
Conclusion
Yoga offers a low-cost, accessible adjunct for neurological care, with emerging evidence supporting its utility in migraine and PD. Mechanistic plausibility, patient acceptance, and pilot trial outcomes make a compelling case for integration. A structured rollout alongside rigorous evaluation can reposition yoga from a complementary wellness tool to a core component of neurorehabilitation.
Authors’ Contribution
The authors contributed in study design, data collection, statistical analysis, manuscript preparation and funds collection.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
The authors received no financial support for the research, authorship and/or publication of this article.
