increases in brain gray matter density were observed in the MT group in the posterior cingulate cortex (p < .05). Conclusion: Findings have implications for broadening treatment options for older adults with insomnia symptoms, and novel neuroimmune mechanisms are elucidated. Contact: David Black,
[email protected]
OA09.03 Preliminary Clinical Trial of Integrative Therapy for Patients with Severe Tinnitus: Findings from an NIDCD-Funded R21
OA09.02 LB A Randomized Controlled Trial of a Mindfulness-Based Intervention for Metabolic Health in Obese Adults
(1) Duke School of Medicine, Durham, North Carolina, USA (2) East Carolina University, Greenville, North Carolina, USA (3) Duke University Health System, Durham, North Carolina, USA
Jennifer Daubenmier (1), Elissa Epel (2), Patricia Moran (1), Jean Kristeller (3), Michael Acree (1), Peter Bacchetti (4), Margaret Kemeny (4), Mary Dallman (4), Robert Lustig (4), Carl Grunfeld (4), Douglas Nixon (5), Jeffery Milush (4), Veronica Goldman (1), Michaela Kiernan (6), Susan Noworolski (4), Barbara Laraia (7), Frederick Hecht (1) (1) University of California San Francisco, Osher Center, San Francisco, CA, USA (2) University of California, San Francisco, COAST Center, San Francisco, CA, USA (3) Indiana State University, Terre Haute, IN, USA (4) University of California, San Francisco, CA, USA (5) George Washington University, Washington, DC, USA (6) Stanford University, Palo Alto, CA, USA (7) University of California, Berkeley, Berkeley, CA, USA Purpose: To estimate the long-term effects of adding mindfulness-based eating and stress management practices to a dietexercise program on metabolic risk factors in obesity. Methods: We randomized 194 adults (BMI > 30; 80% female) to a diet-exercise program with or without mindfulness-based eating and stress reduction components. Programs were matched for diet-exercise guidelines. Both arms received 17 group sessions over 22 weeks and were followed for 18m from intervention initiation. Intent-to-treat analyses were conducted with all available data. Results: Participants in the standard (n = 94) and mindfulness (n = 100) arms had similar baseline mean BMIs (35.6 and 35.4), fasting glucose levels, insulin resistance as assessed by homeostatic model assessment (HOMA), and triglyceride/HDL ratios. Change in weight (standard vs. mindfulness) was - 4.4% vs. - 5.5% at 6m (p = .19) and - 3.6% vs. - 5.3% at 18m (p = .21). Change in fasting glucose was 0.74 vs. - 0.17 mg/dl at 6m (p = .46) and 3.11 vs. - 0.44 mg/dl at 18m (p = .017), change in HOMA was 0.00 vs. - 0.28 at 6m (p = .32) and 0.50 vs. - 0.11 at 18m (p = .08), and change in triglyceride/HDL ratio was - 0.15 vs. - 0.58 at 6m (p = .019) and 0.09 vs. - 0.33 at 18m (p = .036). In secondary analyses, we found evidence that metabolic outcomes differed among the 3 mindfulness-group instructors. For example, ANOVA for 18m weight change by instructor group was significant (p = .049). Follow-up tests revealed that weight change for participants led by instructor A was - 3.3% vs. - 7.3% for those led by instructors B & C (95% CI: - 0.5, - 7.8, p = .03). Conclusion: We observed clinically significant improvements in metabolic health indices related to insulin resistance and lipids consistent with improvement of the metabolic syndrome and a non-statistically significant trend toward improved weight loss maintenance in the mindfulness arm. Mindfulness enhancements to diet-exercise programs may improve long-term metabolic health in obesity. Contact: Frederick Hecht,
[email protected]
Ruth Wolever (1), Natalia Dmitrieva (1), Rebecca Price (1), Garrett Hazelton (2), Elizabeth Bechard (3), Amy Walker (1), Debara Tucci (1)
Purpose: Tinnitus is a common problem for which there is no universally effective treatment, and an estimated 1.2 million individuals are not able to benefit at all from current, widely used treatment strategies. Sound-based and educational therapies’ (SBE) are the focus of most approaches but appear to be inadequate for those with significant non-auditory aspects of tinnitus (e.g., anxiety, depression, interference with daily life). Given the emergent evidence of Integrative Medicine (IM) to enhance mood, decrease distress and empower patients to cope more effectively, this NIDCD-funded R21 evaluated the possibility that an IM approach targeting treatment of the non-auditory aspects of tinnitus is more effective in alleviating tinnitus symptoms when added to current commonly applied SBE therapies, compared with SBE alone. Methods: Participants (N = 49) with debilitating tinnitus [i.e., Tinnitus Handicap Inventory (THI) score ‡ 38] were randomized in a 1:3 ratio to either SBE (n = 15) or SBE + IM (n = 34) groups followed over 9 months (i.e., pre-, immediate post-, and 3 mo post-intervention). Using intention-to-treat principles, we employed a 2-level mixed effects model to examine the effect of intervention group on intercept and THI change over time. Results: As expected, baseline THI scores (B = 62.0, SE = 4.8, p £ .001) did not differ by group (p > .10), and both groups significantly improved over the course of the study (B = - 2.7, SE = 0.7, p £ .001). Moreover, compared to SBE alone, those in the SBE + IM group exhibited even greater improvement (B = - 1.7, SE = 0.8, p £ .05). In addition, the study tested the feasibility and acceptability of the IM approach, as measured by enrollment, adherence to various treatment components, and by patient report of satisfaction with each component. While enrollment targets were surpassed with excellent adherence in the experimental group, retention was problematic, particularly in the control group. Conclusion: Although SBE alone significanlty reduces tinnitus symptoms, the addition of IM treatment to SBE results in further symptom reduction. Contact: Ruth Wolever,
[email protected]
OA09.04 Management of Gulf War Syndrome Symptoms with Acupuncture: Findings of a Wait-List Controlled RCT Lisa Conboy (1), Meredith St. John (1), Rosa Schnyer (2) (1) New England School of Acupuncture, Newton, MA, USA (2) University of Texas, Austin, TX, USA Purpose: Gulf War Illness (GWI), or chronic multisymptom illness (CMI), is a complex illness characterized by a diverse clinical presentation, that may include fatigue, sleep and mood disturbances, cognitive dysfunction, and musculoskeletal pain.
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