Oral Presentation Australian and New Zealand Stroke Organisation Conference 2025

The impact of yoga-based mindfulness intervention on brain volumes in survivors of stroke: evidence from the SASS feasibility trial (123159)

Tharshanah Thayabaranathan 1 , Mohamed Khlif 2 , Amy Brodtmann 2 , Maarten A Immink 3 , Susan Hillier 4 , Nicola Giannotti 5 , Leeanne Carey 6 , Rene Stolwyk 7 , Monique F Kilkenny 1 8 , Dominique A Cadilhac 1 8
  1. School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
  2. School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
  3. College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
  4. IIMPACT, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
  5. School of Health Sciences, University of Sydney, Camperdown, New South Wales, Australia
  6. School of Allied Health, Human Service and Sport, LaTrobe University, Melbourne, VICTORIA, Australia
  7. School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
  8. Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia

Background: Preserving brain volume after stroke is crucial for cognition. Movement-based mindfulness (MBI) may help prevent post-stroke atrophy and cognitive decline, as seen in the general population.

Aims: To investigate the effects of a novel MBI program on brain volumes compared to attention control in survivors post-stroke.

Methods: Eligible participants (3-18 months post-stroke) recruited from the Australian Stroke Clinical Registry (April 2021-July 2023) were randomised into a co-designed MBI (tailored yoga and meditation) or attention control (lifestyle classes and socialisation) groups. All participants attended weekly 60-minute in-person group classes for 12 weeks. Baseline and post-intervention T1-weighted MRI scans were segmented using FreeSurfer (v7.4) longitudinal pipeline to measure total brain and hippocampal volumes. Mixed-effect random-intercept modelling was conducted determine within-group (pre/post) and between-group (group x time interaction) differences, adjusting for age and intracranial volume.

Results: Twenty-seven participants (mean age: 70 years, male: 70%) completed baseline and post-intervention neuroimaging assessments. The MBI group exhibited a smaller, non-significant, reduction in total brain volume (-0.46%, p=0.19) versus a significant decline in the attention control group (-0.93%, p=0.0029). Hippocampal volume showed relevant signals, with an increase in the MBI group (+0.25%, p=0.67) and a decrease in the attention control group (-0.57%, p=0.14). No significant between-group differences in total brain (p=0.27) or hippocampal volumes (p=0.19) were found.

Conclusion: Our findings suggest that MBIs may help preserve brain volumes in survivors of stroke living in the community. However, as this was a feasibility study and underpowered, adequately powered larger trials are needed to confirm efficacy.