Bulletin on Mind-Body Medicine Research

THE MIND Bulletin on Mind-Body Medicine Research is a regularly publication by the Mind-Body Medicine Research Council (MBMRC) that has been founded in 2022.

ISSN: 2940-3243

Issue 2023/2

Editorial I

The Physiological Basis of Mind-Body Medicine

by Maja Figura1 and Tobias Esch2

1Technische Universität Dresden, Faculty of Medicine Carl Gustav Carus, Institute and Polyclinic of Occupational and Social Medicine, Health Sciences/Public Health, 01069 Dresden, Germany

2Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

Mind-body medicine (MBM) is a modern form of stress medicine (Esch & Stefano, 2010; Esch & Stefano, 2022). It was developed by the American cardiologist and professor of medicine at Harvard Medical School, Herbert Benson (M.D.). As a counterpart to Walter B. Cannon's discovery of the body’s “fight or flight” response  (Cannon, 1915), Benson coined the term relaxation response (RR), a physiological response reaction of the body to stress (Cannon, 1915). Techniques that elicit a RR are the basis of virtually all MBM interventions (MBI) (Esch et al., 2018). Together with Integrative Medicine, MBM forms Complementary and Integrative Health (Esch & Brinkhaus, 2020). According to the approach of salutogenesis, the self-healing potential is used to build up and facilitate individual resources (Esch, 2020). Thus, MBM offers the opportunity to make an important contribution to individual health care by helping people to help themselves (Dineen-Griffin et al., 2019).
Based on the idea that thoughts and emotions have an impact on health, MBM effects manifest, e.g., at the psychoneuroimmunological level (Magan & Yadav, 2022). Psychoneuroimmunology is an interdisciplinary field of research that focuses on the role of neuro-immune interactions in coping with stressors (Ader, 2007; Godoy et al., 2018). Stress results from an interplay of biological and adaptive processes (Godoy et al., 2020). These processes involve a variety of different brain areas that can interpret events as real or potential threats. This is followed by a rapid activation of the autonomic nervous system via the sympathetic-adreno-medullary (SAM) axis and the hypothalamic-pituitary-adrenal (HPA) axis (Figure 1) (Stefano et al., 2005).

Figure 1. The stress response simplification based on Godoy et al. (2018).

SAM = sympathetic-adreno-medullary axis, 

HPA = hypothalamic-pituitary-adrenal axis


In addition to the classical stress mediators cortisol and (nor-) adrenaline, a wide range of neuroendocrine signaling molecules areinvolved. These lead to an adaptation of the cardiovascular system such as increased heart rate, blood pressure and immune response. Short-term stress seems to increase the ability to perform. Problems arise when permanent and/or excessive stress occurs (Chrousos & Gold, 1992; Esch et al., 2002; Esch & Stefano, 2010). Chronic stress can lead to suppression of protective immune responses and exacerbation of pathological immune responses (Dhabhar, 2014).

The balance between type 1 and type 2 cytokines changes and chronic inflammation is induced. The number, transport, and function of immune protective cells increases. By suppressing type 1 cytokines and protective T cells and increasing function of defensive T cells, susceptibility to certain cancers may increase (Esch et al., 2002). The body’s physiological stress response is also suspected to have negative effects on the disease progression of viral infections such as SARS-CoV-2 (Peters et al., 2021).
How the effects of chronic stress can drive aging processes is evident at the molecular genetic level, as seen, e.g., in our chromosomes (Dobos & Paul, 2019). In a study by Mathur et al. (2016), a minimal association was found between perceived psychological stress and a decrease in telomere length.

Telomeres are regions of repetitive nucleotide sequences associated with specialized proteins at the ends of linear chromosomes. They protect the end regions of chromosomal DNA from progressive degradation and ensure the integrity of linear chromosomes via preventing DNA repair systems from confusing the outermost ends of the DNA strand with a double-strand break (Jacobs, 2013). Hence, telomeres are non-coding DNA segments that serve a protective role during DNA transcription: A small number of base pairs at the ends of a chromosome are lost during each transcription, resulting in an overall shortening of the chromosome after many duplications. Telomeres thus have a function as a bumper that prevents functional coding segments from being truncated during duplication. This buffer grows shorter during the lifetime of a cell, and its cycles of transcription and replication. Hence, although telomeres are routinely replenished by telomerase, their gradual attrition over the lifespan may contribute to aging and disease (Esch et al., 2018; Mathur et al, 2016). Thus, short-term, and chronic stress can have an impact on cell aging and chromosomal integrity. At the cellular level, this may favor age-related diseases such as Alzheimer’s, cardiovascular disease, type II diabetes or even general muscular atrophy (Esch et al., 2018; Ludlow et al., 2013; Stefano et al., 2005).
It has been shown that telomere length is influenced not only by individual genetic predisposition, harmful noxae, and oxidative or psychological stress, but also by the individual’s own health behavior (Bär & Blasco, 2016). At the same time, the probability of the occurrence of mental and somatic illnesses is increased (Esch, 2003). Especially the use of MBIs has proven to be particularly effective in stress reduction in this context (Bhasin et al., 2013; Black et al., 2013; Esch, 2020; Esch & Stefano, 2022; Niles et al., 2014).
MBIs contribute to the restoration of the balance between sympathetic and parasympathetic nervous system. In the process, the catecholamine and cortisol hormone equilibrium is adjusted. While psychological stress declines and a positive state of mind is re-established, both conditions, as described, are associated with an effect on telomeres (Epel et al., 2004). The length of telomeres appears positively changed already over short periods of time (Ornish et al., 2013; Puterman et al., 2015). Moreover, recent study results suggest that lifestyle interventions also have a positive effect on mitochondrial bioenergetics, insulin secretion, and a reduction in inflammatory processes (Stefano at al., 2019). Dysfunctional mitochondrial processes thus lead to impaired energy translocation in the brain and neuropsychiatric symptoms (Büttiker et al., 2022). Therefore, lifestyle interventions and MBIs include RR as a parameter of metabolic “correction”, thus also causing cognitive and mental “awareness” (Stefano at al., 2019).
Taken together, the mind affects the body – and this may happen even on cellular, chromosomal, and mitochondrial levels.


Ader, R. (2007). Psychoneuroimmunology (4 ed.). Elsevier Academic Press.


Bär, C., & Blasco, M. A. (2016). Telomeres and telomerase as therapeutic targets to prevent and treat age-related diseases. F1000Res, 5. https://doi.org/10.12688/f1000research.7020.1


Bhasin, M. K., Dusek, J. A., Chang, B. H., Joseph, M. G., Denninger, J. W., Fricchione, G. L., Benson, H., & Libermann, T. A. (2013). Relaxation response induces temporal transcriptome changes in energy metabolism, insulin secretion and inflammatory pathways. PLoS One, 8(5), e62817. https://doi.org/10.1371/journal.pone.0062817


Black, D. S., Cole, S. W., Irwin, M. R., Breen, E., St Cyr, N. M., Nazarian, N., Khalsa, D. S., & Lavretsky, H. (2013). Yogic meditation reverses NF-κB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial. Psychoneuroendocrinology, 38(3), 348-355. https://doi.org/10.1016/j.psyneuen.2012.06.011


Büttiker, P., Weissenberger, S., Esch, T., Anders, M., Raboch, J., Ptacek, R., Kream, R. M., & Stefano, G. B. (2022). Dysfunctional mitochondrial processes contribute to energy perturbations in the brain and neuropsychiatric symptoms. Front Pharmacol, 13, Article 1095923. https://doi.org/10.3389/fphar.2022.1095923


Cannon, W. B. (1915). Bodily changes in pain, hunger, fear, and rage: An Account of Recent Researches into the Function of Emotional Excitement. D Appleton & Company.


Chrousos, G. P., & Gold, P. W. (1992). The concepts of stress and stress system disorders. Overview of physical and behavioral homeostasis. JAMA, 267(9), 1244-1252.


Dhabhar, F. S. (2014). Effects of stress on immune function: the good, the bad, and the beautiful. Immunologic Research, 58(2), 193-210. https://doi.org/10.1007/s12026-014-8517-0


Dineen-Griffin, S., Garcia-Cardenas, V., Williams, K., & Benrimoj, S. I. (2019). Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice. PLoS One, 14(8), Article e0220116. https://doi.org/10.1371/journal.pone.0220116


Dobos, G., & Paul, A. (2019). Mind-Body-Medizin: Integrative Konzepte zur Ressourcenstärkung und Lebensstilveränderung (2 ed.). Urban & Fischer.


Epel, E. S., Blackburn, E. H., Lin, J., Dhabhar, F. S., Adler, N. E., Morrow, J. D., & Cawthon, R. M. (2004). Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA, 101(49), 17312-17315. https://doi.org/10.1073/pnas.0407162101


Esch, T. (2003). Die Bedeutung von Stress für das Herz-Kreislauf-System: Stress-assoziierte kardiovaskuläre Erkrankungen und nicht-medikamentöse Therapieverfahren. Apothekenmagazin, 21, 8-15.


Esch, T. (2020). Self-healing in health-care: Using the example of mind-body medicine. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 63(5), 577-585. https://doi.org/10.1007/s00103-020-03133-8


Esch, T., & Brinkhaus, B. (2020). Neue Definitionen der Integrativen Medizin: Alter Wein in neuen Schläuchen? Complement Med Res, 27(2), 67-69. https://doi.org/10.1159/000506224


Esch, T., & Stefano, G. B. (2010). The neurobiology of stress management. Neuro Endocrinol Lett, 31(1), 19-39.


Esch, T., & Stefano, G. B. (2022). The BERN framework of Mind-Body Medicine: Integrating self-care, health promotion, resilience, and applied neuroscience. Front Integr Neurosci, 16, Article 913573. https://doi.org/10.3389/fnint.2022.913573


Esch, T., Benson, H., Fricchione, G., & Stefano, G. (2002). An overview of stress and its impact on immunological disease. Modern Aspects of Immunobiology, 2, 187-192.


Esch, T., Kream, R. M., & Stefano, G. B. (2018). Chromosomal processes in Mind-Body Medicine: Chronic stress, cell aging, and telomere length. Med Sci Monit Basic Res, 24, 134-140. https://doi.org/10.12659/msmbr.911786


Godoy, L. D., Rossignoli, M. T., Delfino-Pereira, P., Garcia-Cairasco, N., & de Lima Umeoka, E. H. (2018). A Comprehensive overview on stress neurobiology: Basic concepts and clinical implications. Front Behav Neurosci, 12, Article 127. https://doi.org/10.3389/fnbeh.2018.00127


Jacobs, J. J. (2013). Loss of telomere protection: consequences and opportunities. Front Oncol, 3, 88. https://doi.org/10.3389/fonc.2013.00088


Ludlow, A. T., Ludlow, L. W., & Roth, S. M. (2013). Do telomeres adapt to physiological stress? Exploring the effect of exercise on telomere length and telomere-related proteins. Biomed Res Int, Article 601368. https://doi.org/10.1155/2013/601368


Magan, D., & Yadav, R. K. (2022). Psychoneuroimmunology of meditation. Ann Neurosci, 29(2-3), 170-176. https://doi.org/10.1177/09727531221109117


Mathur, M. B., Epel, E., Kind, S., Desai, M., Parks, C. G., Sandler, D. P., & Khazeni, N. (2016). Perceived stress and telomere length: A systematic review, meta-analysis, and methodologic considerations for advancing the field. Brain Behav Immun, 54, 158-169. https://doi.org/10.1016/j.bbi.2016.02.002


Niles, H., Mehta, D. H., Corrigan, A. A., Bhasin, M. K., & Denninger, J. W. (2014). Functional genomics in the study of mind-body therapies. Ochsner J, 14(4), 681-695.


Ornish, D., Lin, J., Chan, J. M., Epel, E., Kemp, C., Weidner, G., Marlin, R., Frenda, S. J., Magbanua, M. J. M., Daubenmier, J., Estay, I., Hills, N. K., Chainani-Wu, N., Carroll, P. R., & Blackburn, E. H. (2013). Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study. Lancet Oncol, 14(11), 1112-1120. https://doi.org/10.1016/s1470-2045(13)70366-8


Peters, E. M. J., Schedlowski, M., Watzl, C., & Gimsa, U. (2021). To stress or not to stress: Brain-behavior-immune interaction may weaken or promote the immune response to SARS-CoV-2. Neurobiol Stress, 14, Article 100296. https://doi.org/10.1016/j.ynstr.2021.100296


Puterman, E., Lin, J., Krauss, J., Blackburn, E. H., & Epel, E. S. (2015). Determinants of telomere attrition over 1 year in healthy older women: stress and health behaviors matter. Mol Psychiatry, 20(4), 529-535. https://doi.org/10.1038/mp.2014.70


Stefano, G. B., Esch, T., & Kream, R. M. (2019). Behaviorally-mediated entrainment of whole-body metabolic processes: Conservation and evolutionary development of mitochondrial respiratory complexes. Med Sci Monit, 25, 9306-9309. https://doi.org/10.12659/msm.920174


Stefano, G., Benson, H., Fricchione, G., & Esch, T. (2005). The Stress Response - Always Good And When It Is Bad. International Scientific Literature. ISBN: 8390923157


Editorial II

A Brief Account of the Very Early History of Pandemics

by George B. Stefano1,2

Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, 120 00 Prague, Czech Republic

The history of infectious disease outbreaks and plagues among human populations is long, as recorded in centuries-old religious and secular texts, as well as through Indigenous oral histories (Edinborough et al., 2017; Huremović, 2019; Stefano, 2021). One early account is of a plague that ravaged parts of North Africa and Greece in the late 5th century BCE. Known as the Athenian Plague, it was detailed at the time by the Greek historian, Thucydides, in his History of the Peloponnesian War. Over the course of a week or more, a series of gruesome symptoms would travel from head to toe – from “inflammation of the eyes”, bloody throat, violent retching, breakouts of “pustules and ulcers”, and diarrhea, among others. For those who recovered, a reported loss of memory left them not knowing “themselves or their friends” (Thucydides, 2003). Greatly devastating the population of Athens, it has been recently suggested that it may have been an ancient outbreak of the Ebola virus (Chastel, 1996).


In the late 1st century CE, the Antonine Plague, documented by the Greek physician, Galen, spread westward from the Middle East across vast swaths of the Roman Empire, including Rome. Claiming millions of lives, and setting the stage for the eventual fall of the empire, it is likely to have been a smallpox pandemic (Fears, 2004). Later, the Justinian Plague, caused by Yersinia Pestis, ravaged 6th century populations, and is believed to have originated either in North Africa or Central Asia. Over time, it spread across the Roman Empire via well-worn trading routes. The 14th century saw the arrival of a global bubonic plague, the Black Death, which traveled along the Silk Road from China in the 1330s and into Europe in the following years. Its death toll is estimated to have been 150 million lives lost, significantly reducing the global population (Huremović, 2019). The Black Death was documented in religious texts, and greatly influenced writers and painters of the time.


Huremović D. (2019). Brief history of pandemics (Pandemics throughout history). Psychiatry of Pandemics: A Mental Health Response to Infection Outbreak, 7–35. https://doi.org/10.1007/978-3-030-15346-5_2


Edinborough, K., Porčić, M., Martindale, A., Brown, T. J., Supernant, K., & Ames, K. M. (2017). Radiocarbon test for demographic events in written and oral history. Proceedings of the National Academy of Sciences, 114(47), 12436-12441. https://doi.org/10.1073/pnas.1713012114


Stefano G. B. (2021). Historical Insight into infections and disorders associated with neurological and psychiatric sequelae similar to long COVID. Medical science monitor: international medical journal of experimental and clinical research, 27, Article e931447. https://doi.org/10.12659/MSM.931447


Thucydides (2003). The history of the Peloponnesian War (R. Crawley, Trans.). BoD–Books on Demand. https://www.gutenberg.org/files/7142/7142-h/7142-h.htm  (Original work published 431 BC)


Chastel, C. E. (1996). The dilemma of xenotransplantation. Emerging infectious diseases, 2(2), 10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639821/pdf/8964060.pdf


Fears J. R. (2004). The plague under Marcus Aurelius and the decline and fall of the Roman Empire. Infectious disease clinics of North America, 18(1), 65–77. https://doi.org/10.1016/S0891-5520(03)00089-8



The BERN Framework of Mind-Body Medicine

by Tobias Esch1 and George B. Stefano1,2

Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, 120 00 Prague, Czech Republic

In the University Outpatient Clinic for Integrative Health Care and Naturopathy at Witten/Herdecke University, which emerged from the Institute for Integrative Health Care and Health Promotion (IGVF), the so-called BERN program has been taught to patients since 2019.

The BERN concept, a health promotion program is based on the concept of Mind-Body Medicine (MBM), which was developed at Harvard Medical School in Boston. MBM focuses on enhancing our understanding of how the interactions between the brain, mind, body, and behavior can be utilized to improve health and well-being (Esch, 2020).

The evidence base of the BERN program has recently been published by Tobias Esch and George Stefano in an article in Frontiers in Integrative Neuroscience (Esch & Stefano, 2022).

In this narrative review, the fundamental principles of MBM are outlined and a logical framework for implementing interventions based on MBM are introduced. Additionally, the impact of MBM on the brain’s motivation and reward systems is explored, including potential involvement of mitochondria.

MBM can effectively enhance the health of individuals with chronic diseases, particularly those linked to lifestyle factors. It builds upon the concept of salutogenesis, which concentrates on determinants of health rather than disease and emphasizes the development of individual

resilience and coherence factors to reduce stress, alleviate disease burden, and enhance quality of life.

This approach incorporates well-known principles of self-healing and self-care. MBM interventions typically combine techniques for behavioral modification with cognitive strategies targeting stress regulation, exercise, relaxation, meditation, and nutrition. The acronym “BERN” (Behavior, Exercise, Relaxation, and Nutrition) is proposed as a summary of the operational framework for this approach.

Various BERN techniques exert their effects through shared autoregulatory circuits in the central nervous system (CNS) responsible for reward and motivation. These circuits rely on multiple neurobiological signaling pathways that involve common effector molecules, such as nitric oxide (NO). NO plays a critical role in reward physiology, stress reduction, and self-regulation by influencing various processes within brain cells, including those involving mitochondria, nuclei, and chromosomes. Furthermore, NO has been implicated in relevant outcomes, such as the placebo response.

In summary, MBM interventions typically follow the BERN model, aiming to enhance health, build resilience, and alleviate stress. The mechanisms underlying these processes involve the CNS reward systems and are associated with placebo and self-healing pathways.


Esch, T. (2020). Self-healing in health-care: Using the example of mind-body medicine. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 63(5), 577-585. https://doi.org/10.1007/s00103-020-03133-8


Esch, T., & Stefano, G. B. (2022). The BERN framework of Mind-Body Medicine: Integrating self-care, health promotion, resilience, and applied neuroscience. Front Integr Neurosci, 16, Article 913573. https://doi.org/10.3389/fnint.2022.913573



The Integration of AI in Mental Health Assessment: Leveraging Digital Biomarkers and Behavioral Data

by Maren M. Michaelsen1 and and Tobias Esch1

Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

Current psychiatric assessment methods are resource-intensive, requiring time-consuming evaluations by trained clinicians. AI offers the potential for scalable and cost-effective assessment of psychiatric diagnosis and symptom change (Barnett et al., 2018; Ćosić et al., 2021; Jacobson et al., 2019b; Pedrelli et al., 2020). AI algorithms can analyze large datasets collected from various sources, such as wearable devices, smartphones, and online platforms, to identify patterns and extract relevant features. This enables the identification of digital biomarkers associated with mental health conditions. AI techniques, such as machine learning and deep learning, can build predictive models based on these identified digital biomarkers, process complex data and detect subtle changes in behavior or physiological signals that may indicate symptom severity or predict relapse. Based on this, AI-powered technologies enable remote monitoring of individuals’ mental health. This can reduce the burden on patients and clinicians, as well as enhance accessibility to mental health care, e.g., by providing real-time insights and alerts to healthcare providers about changes in symptom severity or potential relapse. In addition, AI can support the development of personalized interventions by analyzing individual data and providing tailored recommendations or interventions based on an individual’s specific needs. For example, AI algorithms can identify behavioral anomalies or changes in real-time smartphone data and, as a consequence, trigger timely interventions, such as providing reminders, coping strategies, or connecting individuals with mental health support services. Finally, AI can assist clinicians in making more informed decisions by providing them with additional information and insights.

The field of research exploring digital movement patterns as potential biomarkers for mental diseases, such as depression and schizophrenia, as well as examining online shopping behaviors and environmental radius/GPS data, is rapidly growing (e.g., Jacobson et al., 2020; Jacobson et al., 2019a; Saeb et al., 2015). Research has explored the use of smartphone sensor data, such as GPS and usage sensors, as well as social contact data, in monitoring behavioral patterns indicative of depressive symptoms (Jacobson et al., 2019b; Pedrelli et al., 2020; Saeb et al., 2015). One study investigated the use of passive movement and light data collected from wearable devices to assess depression severity in patients with major depressive disorder (Jacobson et al., 2019b). By analyzing over a week of movement data, the researchers were able to significantly evaluate depression severity with high precision, both for self-reported and clinician-rated symptom severity. Another study re-analyzed public-use actigraphy data from patients with major depressive

or bipolar disorder and healthy controls, aiming to identify robust digital biomarkers for diagnostic status and changes in symptom severity (Jacobson et al., 2019a). The results indicated that participants’ diagnostic group status could be predicted accurately using features extracted from actigraphy data alone. Additionally, actigraphy data were found to predict symptom change over a two-week period (Jacobson et al., 2019a). Similarly, passive sensor data acquired from smartphones have shown promise in predicting social anxiety symptom severity. By collecting data on movement and social contact, Jacobson et al. (2020) were able to develop digital biomarkers that accurately predicted social anxiety symptom severity and distinguished it from depressive symptoms and affective states. In the case of schizophrenia, relapse rates are high even with appropriate treatment. Passive smartphone behavioral data presents an underutilized opportunity to monitor patients and identify warning signs of relapse. A study involving patients with schizophrenia utilized smartphone data collected through the Beiwe app to detect changes in mobility patterns and social behavior prior to relapse (Barnett et al., 2018). The researchers observed statistically significant anomalies in patient behavior during the days preceding relapse, suggesting the potential for real-time detection and intervention before symptom escalation occurs. In the context of COVID-19 recovery, the pandemic’s impact on mental health can have enduring consequences if left untreated. To address potential psychological and behavioral changes, the use of AI tools and prediction strategies in post-COVID clinics is proposed by Ćosić et al. (2021). They argue that the integration of AI into mental health recovery programs may enhance the global mental health of ex-COVID-19 patients by providing early identification of vulnerable individuals and enabling timely preventive interventions. The implementation of AI-based tools can augment existing resources and capabilities in diagnosing, preventing, and treating psychiatric disorders in the acute phase of the disease (Ćosić et al., 2021).

This body of research offers promising prospects for scalable, time-sensitive, and cost-effective strategies to improve the detection and treatment of mental diseases. However, further replication and validation studies are necessary to establish the reliability and generalizability of these findings. It is important to note that while AI shows promise in the field of mental health, it is not intended to replace human clinicians or care providers. Rather, AI technologies complement traditional clinical approaches by providing additional data-driven insights, enhancing efficiency, and enabling personalized and timely interventions.


Barnett, I., Torous, J., Staples, P., Sandoval, L., Keshavan, M., & Onnela, J.‑P. (2018). Relapse prediction in schizophrenia through digital phenotyping: a pilot study. Neuropsychopharmacology, 43(8), 1660–1666. https://doi.org/10.1038/s41386-018-0030-z


Ćosić, K., Popović, S., Šarlija, M., Kesedžić, I., Gambiraža, M., Dropuljić, B., Mijić, I., Henigsberg, N., & Jovanovic, T. (2021). AI-based prediction and prevention of psychological and behavioral changes in ex-COVID-19 patients. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.782866


Jacobson, N. C., Summers, B., & Wilhelm, S. (2020). Digital biomarkers of social anxiety severity: Digital phenotyping using passive smartphone sensors. J Med Internet Res, 22(5), Article e16875. https://doi.org/10.2196/16875


Jacobson, N. C., Weingarden, H., & Wilhelm, S. (2019a). Digital biomarkers of mood disorders and symptom change. NPJ Digital Medicine, 2. https://doi.org/10.1038/s41746-019-0078-0


Jacobson, N. C., Weingarden, H., & Wilhelm, S. (2019b). Using digital phenotyping to accurately detect depression severity. The Journal of Nervous and Mental Disease, 207(10). https://doi.org/10.1097/NMD.0000000000001042


Pedrelli, P., Fedor, S., Ghandeharioun, A., Howe, E., Ionescu, D. F., Bhathena, D., Fisher, L. B., Cusin, C., Nyer, M., Yeung, A., Sangermano, L., Mischoulon, D., Alpert, J. E., & Picard, R. W. (2020). Monitoring changes in depression severity using wearable and mobile sensors. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.584711


Saeb, S., Zhang, M., Karr, C. J., Schueller, S. M., Corden, M. E., Kording, K. P., & Mohr, D. C. (2015). Mobile phone sensor correlates of depressive symptom severity in daily-life behavior: An exploratory study. J Med Internet Res, 17(7), Article e175. https://doi.org/10.2196/jmir.4273

Antibiotics and Antiviral Agents Can Trigger Mitochondrial Dysfunction that Leads to Psychiatric Disorders

by George B. Stefano1,2

Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, 120 00 Prague, Czech Republic

Antibiotics and antiviral agents represent a diverse array of chemical agents that can be used to prevent and treat acute and chronic bacterial and viral infections. Unfortunately, many of these drugs have become less effective because these pathogens have developed a variety of resistance mechanisms. This requires us to develop new and different drugs that target unique aspects of bacterial and viral invasion and replication processes. By doing so, we may inadvertently create new drugs that influence other endogenous processes, including human behavior. This is because the structures of some of these new drugs may share critical shape features with naturally-occurring endogenous biochemicals and thus may interfere with their critical functions in vivo.



Many antibacterial agents are inherently toxic to the host. This may be due at least in part to the unique evolutionary relationships that link molecular mechanisms of mammalian mitochondria to primordial processes that developed originally in their bacterial progenitors. Mitochondria, which are cellular organelles that generate ATP in the mammalian host cell, are the descendants of enslaved bacteria. Mitochondrial ribosomal (r)RNA in healthy cells is a critical target for new drug development. Mitochondrial rRNA has a similar structure and function to that found in bacteria and incorporates mutations more rapidly than mammalian nuclear rRNA. Given its propensity to incorporate mutations, the mitochondrial rRNA and mitochondria themselves become prone to dysfunction. Antibiotics designed to target pathogens may also exhibit high-affinity interactions with mammalian mitochondria that result in adverse effects. Minocycline is an example of a drug that promotes ATP synthesis and calcium retention in brain cell mitochondria that may have a direct impact on one or more psychiatric disorders. Antimicrobial-induced mania, or antibiomania, is a term used to address changes in mental health status that result directly from the administration of antibiotic agents.

With this in mind, we and others have proposed that mitochondrial dysfunction may be among the core issues leading to psychiatric dysfunction induced by antibiotic treatment, including depression and autism. Antibiotic-induced dysfunctional mitochondria have recently emerged as one of the root causes of several psychiatric disorders. For example, a small percentage of patients treated with ciprofloxacin ultimately develop psychosis. Behavioral changes have also been observed in response to metronidazole, ofloxacin, procaine penicillin, and clarithromycin. These findings suggest that translation-targeting antibiotics should be used with extreme caution, especially in patients diagnosed with mitochondrial translation defects. The long-term effects of antibiotics on mitochondrial function and integrity have yet to be determined.

Although eukaryotic cells can recognize bacteria and respond with rudimentary host defense, the bacterium typically has the advantage. The prokaryotic bacterial organism has been evolving for millions of years and is capable of subverting the innate immune response. This capacity may in part be based on conserved common molecular mechanisms and intracellular components.

Antibiotic-mediated behavioral perturbations provide us with significant insight into the nature of mitochondria and their evolutionary history as enslaved bacteria. The large amount of oxygen consumed in the brain testifies to their ongoing critical activities. Given that bacterial pathogens and host cell mitochondria share common chemical communication mechanisms, antibiotic-induced mitochondrial dysfunction may be a critical feature of both micro-environmental and organism-level survival. Microbial colonization in the brain and/or comparatively high levels of antibiotics may ultimately alter the cellular energy supply and thus the frequency of antibiotic-induced behavioral disorders. Once the potential to initiate mitochondrial dysfunction has been achieved, the resulting cascading action may generate and support ongoing abnormal behaviors. Nonetheless, and despite the risk of damage to the host, antibiotics continue to serve important roles in the treatment of infectious diseases and medicine in general. In this scenario, alterations in behavior may emerge as a result of dysfunctional high-energy nerve cells. We speculate that, in susceptible individuals, as well as those maintained on high doses for extended periods, antibiotic use may convert an acute stress response into one that is more chronic in nature.


Antiviral Drugs

Most antiviral drugs inhibit replication via their actions that target specific enzyme activities (e.g., reverse transcriptase and polymerases). Several of these enzymes are similar to those involved in mitochondrial replication. This may result in dysfunction associated with energy-producing symbionts secondary to drug exposure as is the case for antibacterial agents as described above. Furthermore, several of these antiviral agents (e.g., azidothymidine, didanosine, nevirapine, trimethoprim-sulfamethoxazole, efavirenz, and tenofovir, to name a few) may directly target mitochondrial respiration, thus reducing ATP levels. The dual targeting activity of these antiviral and antibacterial compounds (i.e., interactions with both viruses and mitochondria) may be due to complementary stereospecific matching (shape) of the shared genetic material and their long evolutionary relationship with one another.

Similar to what we have described regarding antibacterial mitochondrial targeting, we might expect that some antiviral drugs may be capable of disrupting mitochondria. Thus, their capacity to alter cognitive function might also be surmised because of the associated high energy demands. Therefore, given these insights, additional studies will be needed to understand the impact of these drugs on human mitochondria and the implications with respect to human health. Importantly, the shared influence of these drugs on bacteria, viruses, and eukaryotic host cells may be based on the fact that these molecules have complementary shapes and use a shared biochemical language that has evolved simultaneously in different organisms. In and of itself, this intriguing finding may stimulate further inquiries designed to determine if pharmacological agents designed for one disorder may be efficacious in another. Additionally, this phenomenon offers novel insights into processes that contribute to the development and potential treatments for critical mental health issues, since they also have the potential to remain hidden in the affected host organism. Indeed, it may be ascertained they may also contribute to normal behavior.


Helpful References

Buttiker, P., Stefano, G. B., Weissenberger, S., Ptacek, R., Anders, M., Raboch, J., &  Kream, R. M. (2022). HIV, HSV, SARS-CoV-2 and Ebola share long-term neuropsychiatric sequelae. Neuropsychiatr Dis Treat, 18, 2229-2237. https://doi.org/10.2147/NDT.S382308


Büttiker, P., Weissenberger, S., Esch, T., Anders, M., Raboch, J., Ptacek, R., Kream, R. M., & Stefano, G. B. (2022) Dysfunctional mitochondrial processes contribute to energy perturbations in the brain and neuropsychiatric symptoms. Front Pharmacol, 13, Article 1095923. https://doi.org/10.3389/fphar.2022.1095923


Damiano, R. F., Guedes, B. F., de Rocca, C. C., de Pádua Serafim, A., Castro, L. H. M., Munhoz, C. D., Nitrini, R., Filho, G. B., Miguel, E. C., Lucchetti, G., & Forlenza, O. (2022). Cognitive decline following acute viral infections: literature review and projections for post-COVID-19. European Archives of Psychiatry and Clinical Neuroscience, 272(1), 139-154. https://doi.org/10.1007/s00406-021-01286-4


Fišar, Z., Ľupták, M., & Hroudova, J. (2021). Little in vitro effect of remdesivir on mitochondrial respiration and monoamine oxidase activity in isolated mitochondria. Toxicology Letters, 350, 143-151. https://doi.org/10.1016/j.toxlet.2021.07.015


Foo, J., Bellot, G., Pervaiz, S., & Alonso, S. (2022). Mitochondria-mediated oxidative stress during viral infection. Trends in Microbiology, 30(7), 679-692. https://doi.org/10.1016/j.tim.2021.12.011


Kramer, P., & Bressan, P. (2018). Our (mother’s) mitochondria and our mind. Perspectives on Psychological Science, 13(1), 88-100. https://doi.org/10.1177/1745691617718356


Lewis, W. (2003a). Defective mitochondrial DNA replication and NRTIs: pathophysiological implications in AIDS cardiomyopathy. American Journal of Physiology-Heart and Circulatory Physiology, 284(1), H1-H9. https://doi.org/10.1152/ajpheart.00814.2002


Lewis, W. (2003b) Mitochondrial dysfunction and nucleoside reverse transcriptase inhibitor therapy: experimental clarifications and persistent clinical questions. Antiviral Res, 58(3), 189-197. https://doi.org/10.1016/s0166-3542(03)00069-x


Lewis, W. (2003c). Mitochondrial DNA replication, nucleoside reverse-transcriptase inhibitors, and AIDS cardiomyopathy. Progress in cardiovascular diseases, 45(4), 305-318. https://doi.org/10.1053/pcad.2003.3b


Pinti, M., Salomoni, P., & Cossarizza, A. (2006). Anti-HIV drugs and the mitochondria. Biochimica et Biophysica Acta (BBA)-Bioenergetics, 1757(5-6), 700-707. https://doi.org/10.1016/j.bbabio.2006.05.001


Ramachandran, K., Maity, S., Muthukumar, A. R., Kandala, S., Tomar, D., Abd El-Aziz, T. M., Allen, C., Sun, Y., Venkatesan, M., Madaris, T. R., Chiem, K., Truitt, R., Vishnu, N., Aune, G., Anderson, A., Martinez-Sobrido, L., Yang, W., Stockand. J. D., Singh, B. B., … Madesh, M. (2022). SARS-CoV-2 infection enhances mitochondrial PTP complex activity to perturb cardiac energetics. IScience, 25(1), 103722. https://doi.org/10.1016/j.isci.2021.103722


Ritou, E., Satta, S., Petcherski, A., Daskou, M., Sharma, M., Vasilopoulos, H., Murakami, E., Shirihai, O.S., & Kelesidis, T. (2023). Blood immune cells from people with HIV on antiviral regimens that contain tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) have differential metabolic signatures. Metabolism, 141, Article 155395. https://doi.org/10.1016/j.metabol.2022.155395


Sanchez, E. L., & Lagunoff, M. (2015). Viral activation of cellular metabolism. Virology, 479, 609-618. https://doi.org/10.1016/j.virol.2015.02.038


Singh, A., Faccenda, D., & Campanella, M. (2021). Pharmacological advances in mitochondrial therapy. EBioMedicine, 65. https://doi.org/10.1016/j.ebiom.2021.103244


Stefano, G. B. (2021). Historical insight into infections and disorders associated with neurological and psychiatric sequelae similar to long COVID. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 27, Article e931447-1. https://doi.org/10.12659/MSM.931447


Stefano, G. B., Büttiker, P., & Kream, R. M. (2022). Reassessment of the blood-brain barrier: A potential target for viral entry into the immune-privileged brain. Germs, 12(1), 99-101. https://doi.org/10.18683/germs.2022.1310


Stefano, G. B., Esch, T., & Kream, R. M. (2019). Behaviorally-mediated entrainment of whole-body metabolic processes: Conservation and evolutionary development of mitochondrial respiratory complexes. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 25, 9306-9309. https://doi.org/10.12659/MSM.920174


Stefano, G. B., Kream, R. M., & Esch, T. (2023). Mobility coupled with motivation promotes survival: The evolution of cognition as an adaptive strategy. Biology, 12(1), Article 80. https://doi.org/10.3390/biology12010080


Stefano, G. B., Samuel, J., & Kream, R. M. (2017). Antibiotics may trigger mitochondrial dysfunction inducing psychiatric disorders. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 23, 101-106. https://doi.org/10.12659/msm.899478


Stoker, M. L., Newport, E., Hulit, J. C., West, A. P., & Morten, K. J. (2019). Impact of pharmacological agents on mitochondrial function: a growing opportunity?. Biochemical Society Transactions, 47(6), 1757-1772. https://doi.org/10.1042/BST20190280


Wang, F., Kream, R. M., & Stefano, G. B. (2020). Long-term respiratory and neurological sequelae of COVID-19. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 26, Article e928996-1. https://doi.org/10.12659/MSM.928996


NEW: Student’s corner

PhD Project: Digital Mindfulness Interventions in Oncology Work Environments

by Jil Herker1

Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany


Medical technologists in radiology (MTR) are exposed to high work demands. In an international double-blind study (Beschoner et al., 2022), 97% of German MTRs and employees in imaging technology reported experiencing moderate to severe stress. As a cause, 95% of respondents mentioned the level of workload. The shortage of specialists, as evidenced by the immediate need for 840 MTR positions nationwide, feeds into the stress factor workload. This shortage is unlikely to be alleviated in the near future since 25% of currently practicing MTRs will retire by 2030 for age reasons (Blum, 2019). Specifically, staff shortages, overtime, and direct contact with Covid-19 infected individuals/materials are considered as drivers of work stress for MTRs during the pandemic. Investigations and improvements of the stress experience are essential to conquer this potential health hazard (Koninklijke Philips, 2019).

MTRs in radiotherapy encounter numerous cancer patients every day to perform radiotherapy with them. This not only entails a high level of coordination and the resulting organizational stress. The emotional stress of the cancer patients also presents a challenge to the mental health of the MTRs. The skills of stress and emotion regulation as well as self-care are therefore important resources for MTRs to cope with everyday work and to stay healthy.


Research aim and method

The study “Mindfulness Interventions in Oncology Work Environments” is designed, first, to determine whether digital health promotion interventions are effective in reducing the experience of stress in MTRs. On the other hand, two apps – a digital, modern meditation intervention (7Mind app) and a digital, traditional breathing exercise intervention (Pranayama app) – will be used to explore effects on stress experience and health promotion, among other outcomes, in MTRs to draw conclusions on the feasibility and effectiveness of the components.

Prior to the intervention, all MTRs are made aware of the relevance of self-care in an approximately half-hour awareness-raising intervention during working hours, e.g. as part of an internal meeting. The intervention is offered twice per facility in order to ensure that work operations are maintained. Since no person-level randomization can take place due to structural conditions, the MTRs will be assigned to the intervention groups (7Mind app or Pranayama app) according to quasi-experimental

designs by location. Both groups are then given access to one of the two apps and are instructed to use it daily for 12 weeks. We recommended to use the app three times a day for 5-10 minutes, and allow practice at least once a day during working hours. Exclusion criteria include use of another meditation app, severe mental illness and sleep disorders requiring treatment. Included are MTRs who agree to app use (informed consent) and have access to their own smartphone.

The evaluation will be conducted through a mixed-methods design. Participating MTRs will be asked to answer standardized questionnaires about their stress experience, health behaviors, and other outcomes before and after the intervention. Prior to the intervention, experience with breathing/meditation exercises and app use experience will be collected in addition to demographic variables (age, gender, work experience). Similarly, participants will have a hair sample taken before and after the intervention. Likewise, a 15-minute heart rate variability (HRV) measurement will be taken via chest strap before and after the intervention. After the intervention, a qualitative survey about the experience with the intervention and the evaluation of its (long-term) effectiveness is conducted in individual interviews.


Expected results

Expected results are improvements in mindfulness, stress experience, resilience and work-related factors, job satisfaction and emotion regulation, as well as in the physiological measures HRV and hair cortisol.


Planned research following this intervention

 a) Extension of the evaluation to patients - e.g.: Do patients perceive a change in the MTRs and how does it affect them (train-the-trainer approach)?

 b) Expansion of the target group to include patients: Breast cancer patients (stress, high anxiety potential) receive daily radiation for 4 weeks and accompanying training (app).

 c) Change of existing offers to focus on the more effective component (breathing/meditation), development of breathing and/or meditation measures for integration into health behavior change



Beschoner, P., Jarczok, M., Kempf, M., Weimer, K., Geiser, F., Hiebel, N., Erim, Y., Morawa, E., Steudte-Schmiedgen, S., Albus, C., & Jerg-Bretzke, L. (2022). egePan-VOICE-Studie zur psychosozialen Belastung durch die Covid-19-Pandemie bei medizinisch-technischen Assistent:innen. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 68(3), 250–268. https://doi.org/10.13109/zptm.2021.67.oa15


Blum, K. (2019). Fachkräftemangel und Fachkräftebedarf in MTA-Berufen. Projekt des Deutschen Krankenhausinstituts (DKI) im Auftrag des Dachverbandes für Technologen/-innen und Analytiker/-innen in der Medizin Deutschland (DVTA). URL last accessed July 31, 2023. https://dvta.de/sites/default/files/2019_05_Fachkr%C3%A4ftemangel%20und%20Fachkr%C3%A4ftebedarf%20in%20MTA-Berufen_final.pdf


Koninklijke Philips N.V. (2019). Radiology staff in Focus - A Radiology services impact and satisfaction survey of technologists and imaging directors. URL last accessed July 31, 2023. https://www.philips.com/c-dam/b2bhc/master/Specialties/radiology/radiology-staff-in-focus/radiology-staff-in-focus.pdf


Mind-Body Exercise Corner 


by Maja Figura1

1Technische Universität Dresden, Faculty of Medicine Carl Gustav Carus, Institute and Polyclinic of Occupational and Social Medicine, Health Sciences/Public Health, 01069 Dresden, Germany


Compared to other relaxation methods, the body scan method is considered an entry-level exercise (Kabat-Zinn, 2005). In body scan, you direct the focus of attention to the different parts of the body, feel any sensation therein without judging them. When you let go of the sensations of each region, as well as all the thoughts associated with them, the tension decreases. If thoughts wander, attention is gently directed back to the body.



Lie comfortably on your back and cover yourself. With a conscious deep breath, direct your attention to your body. Notice the breath movements of the body. Begin to focus your attention on your left foot and then slowly move your awareness up the leg. Guide the breath in and out of the different regions, noticing the sensations. From the pelvis, switch to the right foot and move back to the pelvis. From there, focus your attention on the torso, moving through the lower back and abdomen, upper back, and chest to the shoulders. Next, focus on both of your hands and simultaneously move up both arms, back to the shoulders. Then notice the neck and all regions of the head. Finally, let the attention linger in the entire body. End this exercise with a conscious long exhalation.



With this systematic journey through the body, you develop your ability for focused self-awareness (Kabat-Zinn, 2005). Improvements in mindfulness and effectiveness against disturbing feelings could be demonstrated (D'Antoni et al., 2022; Gan et al., 2022) Further research is ongoing (e.g., Karunayake et al., 2022).

Practicing several times a week favors the course of conscious relaxation.


D'Antoni, F., Matiz, A., Fabbro, F., & Crescentini, C. (2022). Psychotherapeutic techniques for distressing memories: A comparative study between EMDR, Brainspotting, and Body Scan Meditation. Int J Environ Res Public Health, 19(3). https://doi.org/10.3390/ijerph19031142


Gan, R., Zhang, L., & Chen, S. (2022). The effects of body scan meditation: A systematic review and meta-analysis. Appl Psychol Health Well Being, 14(3), 1062-1080. https://doi.org/10.1111/aphw.12366


Kabat-Zinn, J. (2005). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness (15 ed.). Delta Trade Paperback.


Karunanayake, A. L., Solomon-Moore, E., & Coghill, N. (2022). Effectiveness of Anapana, Body Scan and Metta meditation techniques on chronic neck and shoulder region pain and disability in adult patients in Sri Lanka: Study protocol for a cluster clinic-level randomised controlled trial. Trials, 23(1), 940. https://doi.org/10.1186/s13063-022-06873-x


The Mind-Body Medicine Research Council (MBMRC)


At the present time, the Council consists of the following members:

Tobias Esch, M.D. (Co-Chair)
George B. Stefano, Ph.D. (Co-Chair)
Radek Ptáček, Ph.D., MBA
Maren M. Michaelsen, Dr. rer. oec. Dr. rer. medic. (Project Lead)


How to become a member of MBMRC

As the MBMRC has been founded in 2022, and due to its dedication to rigorous contributions on the basic research foundations of Mind-Body Medicine, the number of members is yet small. In the future, the council aims to invite outstanding researchers in the field to become MBMRC members. Membership implies no fee.

Call for Papers / Events


First Announcement: International Congress on Mind-Body Medicine Research


Explore the fascinating field of Mind-Body Medicine Research at the upcoming international congress, presented by the MBMRC! What to expect: The congress will bring together leading experts and renowned institutions. It promises to be an engaging event that sheds light on the latest developments in Mind-Body Medicine Research. Attendees can anticipate high-profile lectures, interactive panel discussions, and valuable networking opportunities in hybrid format.


Save the Date: Exact schedule and location of this exciting congress will be announced by end of the year. Through funds provided by the EDEN Foundation, our team is working diligently to ensure an accessible experience for all participants.


Further updates and information will follow in the upcoming editions of the newsletter and at the-mind.org. Be part of this congress, where we collectively explore the frontiers of Mind-Body Medicine and chart new horizons.


  • 18. Mind-Body Medicine Summer School, Essen, Germany, August 24-27, 2023
    The 18th Mind-Body Medicine Summer School will present Mind-Body Medicine interventions in a compact form as they are applied in the context of modern integrative medicine. All lectures and presentations of the Summer School are designed to promote dialogue and discussion and are not limited to the one-dimensional communication of the contents. Further instruments of mind-body medicine can be obtained in the workshops on site, which are designed for the active participation of all participants.
  •  6. Berlin Summer School for Integrative Medicine, Berlin, Germany, August 24-27, 2023
    The 6th Berlin Summerschool for Integrative Medicine offers a diverse and practice-oriented program as well as an exciting insight into the various therapies of integrative medicine. The focus lies on providing practical experience and scientific background for physicians, nurses, health care professionals and students in the clinical field. The basic aim is to present and critically discuss the current state of research in all lectures and workshops. They are held by lecturers with many years of experience.

Issue 2023/1


Personalized and One Medicine Coming Together

by George B. Stefano1,2

Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, 120 00 Prague, Czech Republic

In an earlier publication (see for detailed information and references [1]), we highlighted the contributions of new genetic and bioinformatics tools to the development of personalized medicine. We also considered how these developments might be used to accelerate advances and reduce healthcare costs based on the principles of One Medicine.

Personalized medicine focuses on the development and application of therapeutic strategies that are tailored to specific patient characteristics. One successful example of this direction is trastuzumab, which is a humanized monoclonal antibody used to treat patients diagnosed with advanced human epidermal growth factor receptor 2 (HER2)-positive breast cancers. Similarly, cetuximab and panitumumab are monoclonal antibody drugs that have been approved by the United States Food and Drug Administration as targeted treatment of epidermal growth factor-(EGFR) positive metastatic colon cancers.

While the introduction of these and related drugs has created a virtual revolution in clinical care, future development of personalized therapies will depend on increased knowledge and understanding of the unique features of each patient and each disease. Ongoing advances will rely on comparatively new and highly sophisticated methods used to explore genome sequences and gene expression both in health and disease states. Among these is whole genome sequencing (WGS), which is a process used to elucidate the sequence and chromosomal localization of the ~3 billion nucleotide pairs in the human genome. While the first near-complete human genome sequence was reported in 2004, several more recent methodologic advances, including whole exome sequencing and single nucleotide polymorphism (SNP) genotyping, have served to advance the field and accelerate discovery. As a group, these tools can be used to identify genetic variation (e.g., polymorphisms and potentially-damaging mutations) and thus may aid in the diagnosis and discovery of genetic diseases and their associated risks. These tools were originally quite time-consuming and prohibitively expensive to perform which precluded their use in routine clinical practice. However, in recent years, some inroads have been made toward using genomic information collected by these methods to develop personalized strategies that address the needs and concerns of physicians and patients.

While WGS and related techniques can provide information on gene structure and sequence, in some cases it may be more critical to evaluate patterns of gene expression. For example, cancers are now frequently classified based on their gene expression patterns rather than their location or tissue of origin. Microarray and RNA sequencing (RNAseq) are two techniques that have been used to evaluate gene expression in specific target cells and tissues. Microarray analysis relies on the quantitative evaluation and interpretation of binding interactions between cellular RNA isolated from target cells of interest and short fragments of nucleic acid sequences (probes) affixed to a surface. This technique has broad application beyond gene expression and is already in clinical use as a means to diagnose viral infections via unbiased detection of viral DNA or RNA genomes. By contrast, RNAseq is a more open-ended and flexible method for evaluating gene expression, as it can be used for simultaneous identification of both characterized and as yet uncharacterized transcripts from multiple sources (e.g., the numerous 

bacterial species that constitute the human gut microbiome). 

Both microarray and RNAseq generate vast amounts of data that require complex statistical evaluation by highly skilled bioinformaticians to generate patterns and clusters useful for further consideration. This has led and will continue to lead to new and more effective and specific therapies for cancer treatment.

While RNAseq remains primarily a research technique at this time, it will eventually enter the mainstream and will be used for clinical decision-making. Thus, physicians will need training so that they will have a clear understanding of this method and thus be capable of interpreting its outcomes.

Given the numerous anthropological, genealogical, and forensic applications of this technology, it is perhaps not surprising that most of the clinical emphasis has been placed on efforts to understand genomic variation and disease-associated gene expression patterns in humans. Thus, while other mammalian genomes have been fully sequenced, the clinical use of personalized strategies in veterinary medicine remains limited. Based on the principles of One Medicine, which is a field that focuses on diagnoses and therapeutic strategies that may be shared by human and veterinary medicine, an improved understanding of genetic variation and its relationship to disease processes in other mammalian species may be an overlooked source of critical clinical information. As a first principle, it is critical to recognize that cellular metabolic and biochemical pathways, growth factors, and signaling mechanisms are similar, if not identical, across many mammalian species. Thus, it is certainly not surprising to find that many diseases (e.g., cancer, diabetes, and arthritis) are frequently diagnosed in both human and animal species.

Future developments in the field of One Medicine will rest on our understanding of conformational matching. Many of our previous publications have highlighted the nature and evolution of structurally-matched ligand-receptor pairs. Based on this principle, we understand that variations will only be tolerated if they can be accommodated within pre-existing patterns. These constraints lead to the overall conservation of critical pathways while permitting the development of novel modalities (e.g., improved cognition).

Finally, recognition and application of the principles of One Medicine may ultimately serve to reduce healthcare costs. Toward this end, we will need to identify methods that facilitate the “retro-matching” of genomic and gene expression data to appropriate clinical pathologies. These and related strategies may provide us with cross-species information that predicts outcomes and adverse events. Taken one step further, genomic and gene expression data from plant species may ultimately be used to understand human nutrition and food intolerance based on our understanding of shared signaling pathways and conformational matching principles. Increased computing capacity and new developments in bioinformatics techniques will ultimately increase the economic feasibility of these directions. Similarly, healthcare costs will be reduced once personalized treatments have been developed that can be used for similar indications in both human and veterinary medicine.


[1] Stefano G. B. & Kream R. M. (2015). Personalized- and One-Medicine: Bioinformatics Foundation in Health and its Economic Feasibility. Med Sci Monit, 21, 201–204. https.//doi.org/10.12659/MSM.893207           


Mobility Coupled with Motivation Promotes Survival: The Evolution of Cognition as an Adaptive Strategy

by George B. Stefano1,2, Richard M. Kream2 and Tobias Esch1

1Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

2Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, 120 00 Prague, Czech Republic

In a recent publication [1], we present the hypothesis of an evolutionary and functional relationship between the occurrence and use of the catecholamine dopamine (DA) as a neurotransmitter (messenger)—particularly in invertebrates—and the catecholamines epinephrine (EP) and norepinephrine (NE), messengers that are found only in vertebrates. Interestingly, both are also involved in pathways leading to the production of endogenous morphine, another messenger substance. We assume that the use of EP/NE as messengers represents an evolutionary advantage and adaptation process, whereby this “metabolite” (its biochemical intermediates) is only used “in retrospect” as a neurotransmitter (evolutionary “retrofitting”); on the way to greater 

mobility, with a need to expand data storage (memory, cognition) within the scope of this expanded radius, additional messengers were needed. Moreover, challenges and “stress” coming with increased mobility (e.g., entering unfamiliar environments) had to be successfully met to ensure survival. The same applies to the synthesis of morphine, which is formed from tyramine and tyrosine via DA (mediated by enzymes that also interact with EP/NE) so that morphine can be chemically classified as an “end product” of a DA-opiate cascade. Morphine’s functional importance is the downregulation and termination of a motivational sequence from wanting (appetite) to avoiding (avoidance) to relaxation/quiescence (assertion). 


[1] Stefano, G. B., Kream, R. M., Esch, T. (2023). Mobility Coupled with Motivation Promotes Survival: The Evolution of Cognition as an Adaptive Strategy. Biology, 12(1):80. https://doi.org/10.3390/biology12010080



Personalized Medicine and Personalized Health Promotion Based on Motivation and Reward Proceedings
by Maren M. Michaelsen

1Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

As the number of patients with lifestyle-related chronic diseases continues to increase worldwide [1], the need for personalized medicine is growing. At the same time, the development and implementation of prevention and health promotion interventions to help individuals change their health behaviors is becoming increasingly important. While personalized medicine focuses on the development and application of therapeutic strategies tailored to specific patient characteristics, such as specific antibodies, personalized health promotion focuses on specific patient lifestyle characteristics, such as diet, exercise and relaxation behaviors (or stress management). Thus, supporting patients change specific negative health behaviors that they perform on a regular basis is the focus of contemporary health promotion. Examples of tools with this objective include technological applications such as fitness trackers that connect to mobile phone apps and suggest behaviors based on the measurement (e.g., walking more steps the next day). However, these technological advances are often available to clients before their effectiveness has been examined in research studies. In addition, the development of health behavior change techniques often occurs without an adequate theoretical basis about the psychological or neurobiological processes involved in health behavior change. This imposes the risk of decreasing patient engagement over time because extrinsic motivational incentives are not strong enough to build sustained engagement. 

To better understand patients’ engagement in health behavior change processes, in [2], we have analyzed the role of motivation and reward proceedings at different stages of behavior change processes. Our analysis is based on the triad of motivation and reward mechanisms, which include approach motivation (wanting) with its associated reward pleasure, aversive motivation (avoiding) with its associated reward relief, and assertion motivation (non-wanting) with its  

associated reward quiescence. In our Model of Engagement (Figure 1), individuals first proceed from being unaware of the benefits of a particular behavior change to becoming aware of the benefits. At these first two stages, individuals are not engaged in a health behavior change process (non-engagement). Once they begin contemplating about changing their behavior and move to the planning stage, they become motivationally engaged. The transition to the initiation stage, where the new behavior is performed for the first time and then continually performed until the new behavior is maintained (has become a habit), is characterized by executive engagement. Motivation and reward proceedings play distinct roles ate these stages. During non-engagement, assertive motivation is active because no need to change behavior is yet considered relevant. Parasympathetic activity and the release of endogenous opiates, oxytocin and related neurotransmitters are involved. During contemplation, planning, initiation and continued action, an individual progresses in response to appetitive motivational stimuli or appetitive motivational goals (see [2] for a distinction between stimulus-driven behavior and goal-directed behavior), involving, for example, the mesocortical dopamine pathway in the frontal cortex. An alternative to appetitive motivational salience is aversive motivational salience, which can lead to the same behavioral outcomes. However, because of the negative emotions involved (e.g., fear), appetitive motivational salience is preferred. In fact, repeated activation of appetitive motivational salience can lead to other positive resources [3], i.e., an upward spiral of positive emotions. At the maintenance stage, individuals are steered by assertive motivational salience, i.e., the desire to maintain the new status quo. This phase is characterized by the involvement of the hippocampus, which stores memories of past affect (rewards) from specific behaviors.

Figure 1: Model of Engagement
Figure 1: Model of Engagement

By applying motivational interviewing or other tools, it is possible to determine which stage of a particular health behavior change process an individual currently is at and what is needed to progress to another stage. For example, imagine a person who regularly watches Netflix series for relaxation in the evening and has just learned that breath awareness meditation leads to a physiologically better relaxation response. This person has just moved from the unawareness stage to the awareness stage. To progress to the contemplation stage, motivational cues are needed that activate appetitive motivational salience and thereby make the new behavior more attractive. This motivational cue could be the information that by replacing one episode

per day by a meditation session, the person might sleep better at night and thus experience increased sense of well-being. Various behavior change techniques can be chosen to convey this information, such as a nudging technique like social comparison (e.g., showing a short movie about a person who meditates and sleeps well at night), or a facilitating technique such as providing a flyer with an explanation (e.g., in a patient counseling session). Such behavior change techniques increase reward expectancy and are therefore likely to support lasting health behavior change when applied according to an individual’s current type of engagement. 


[1] World Health Organization. (2022). Fact sheets - Noncommunicable diseases. https://www.who.int/news-room/ fact-sheets/detail/noncommunicable-diseases

[2] Michaelsen, M. M., & Esch, T. (2021). Motivation and reward mechanisms in health behavior change processes. Brain Research, 1757. https://doi.org/10.1016/j.brainres.2021.147309

[3] Cappellen, P. van, Rice, E. L., Catalino, L. I., & Fredrickson, B. L. (2018). Positive affective processes underlie positive health behaviour change. Psychology & Health, 33(1), 77–97.


Combining App-based Behavioral Support with Electronic Nicotine Delivery System Devices for Smoking Cessation

by Cosima Hoetger1, Helen Schiek1

1Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

Worldwide, tobacco use causes over 7 million deaths annually [1]. As of 2022, over 35% of Germans report current use of cigarettes. Approximately 38% of current smokers report wanting to quit smoking [2]. However, about 80% of individuals who attempt to quit smoking without support relapse within a month; only 3% remain abstinent six month later [3]. Treatment methods outlined in medical guidelines are rarely used, and both the effectiveness of and adherence to these interventions remain low [4,5], necessitating the development of novel and effective smoking cessation methods. 

Electronic nicotine delivery systems (ENDS) have been found to be more effective in helping smokers quit than recommended cessation methods [6]. Their effectiveness can be further increased if coupled with a behavioral support component [7]. These findings highlight the need for smoking intervention efforts that target the physical as well as the psychological mechanisms of nicotine dependence. Recognizing the importance of holistic approaches to smoking cessation, the Berlin-based startup company Sanos Group developed an integrated smoking cessation intervention (‘nuumi’). The smoking cessation program is accessible via a smartphone app, thus allowing users to personalize their intervention experience by having control over the place and time they wish to interact with the app [8]. Additionally, digitalized interventions allow for further personalization of health-related information by tailoring content to users’ needs, e.g. via personalized text messages [9].

Nuumi offers an app-based behavioral support consisting of video and audio recordings and interactive exercises, coupled with a bluetooth-supported ENDS device. The behavioral support consists of the digitalized content of a health promotion course developed by Tobias Esch; the course framework is described elsewhere [10]. The digitalized course features content derived from four areas, including Behavior, Exercise, Relaxation, and Nutrition (BERN). In order to meet the specific needs of smokers motivated to quit, the course content has been tailored to help individuals overcome barriers frequently encountered during smoking cessation attempts. For example, smokers report greater stress levels relative to nonsmokers, and one of the most frequently reported reasons for continued smoking is the management of stress and negative emotions [11,12]. Stress and negative emotions can even increase during withdrawal [13], creating a barrier to successful smoking cessation [14]. App content and exercises draw from Mind-Body Medicine-based techniques designed to foster social, psychological, behavioral, and spiritual wellbeing [15] and decrease negative emotions 

including depressive symptoms, anxiety, and stress [16,17]. Nuumi users learn to effectively manage stress and negative emotions and learn to apply coping strategies when experiencing withdrawal symptoms. Instead of taking a one-size-fits-all approach, nuumi provides the opportunity of using the exercises to reflect on one’s own smoking history, identify individuals and situations that serve as triggers for cigarette cravings, and to recognize which individuals in one’s environment serve as an effective source of social support during one’s smoking cessation process. Simultaneously, users are asked to substitute an ENDS device equipped with a nicotine-containing liquid solution for their tobacco cigarettes. Over a period of several weeks, participants are provided with pods containing gradually decreasing concentrations of nicotine. Reducing nicotine content in tobacco products has been suggested to lead to a reduction of reinforcing effects, and a subsequent decrease in positive sensations typically associated with nicotine self-administration, both of which are key factors of nicotine dependence [18]. 

The scientific evaluation will be conducted by principal investigator Tobias Esch and his team of research associates including Cosima Hoetger and Helen Schiek at the Institute for Integrative Health Care and Health Promotion at Witten/Herdecke University. In early 2023, a two-arm parallel randomized controlled trial will be conducted among a sample of current tobacco cigarette smokers (n=250) who self-report having smoked more than 9 cigarettes per day for a period of at least 12 months, who are deemed to be dependent on nicotine as indexed by a score of >3 on the Fagerström test for Cigarette Dependence, and who are motivated to quit. Participants will be randomized to either an intervention group or a control group. While the intervention group will be given access to nuumi (i.e., app plus ENDS device), the control group will receive self-help cessation support consisting of a pamphlet provided by the German Federal Center for Health Education and a supply of nicotine patches. Biochemically verified abstinence, as indexed by saliva cotinine and carbon monoxide testing results will serve as the primary outcome. Secondary outcomes will include, but not be limited to, self-reported one-week point prevalence abstinence at six-month follow-up, treatment adherence, cravings, health-related quality of life, mindfulness, and perceived stress. If found to be effective, nuumi could constitute a cost-effective and convenient smoking cessation method for smokers motivated to quit. Long-term, nuumi could contribute to decreasing the risk of smoking-related morbidity and mortality.


[1] World Health Organization (2022). Tobacco: Key facts. Retrieved from https://www.who.int/news-room/factsheets/detail/tobacco

[2] Pashutina, Y., Kastaun, S., Ratschen, E., Shahab, L., & Kotz, D. (2021). ‘Externe Validierung einer Single-Item Skala zur Erfassung der Motivation zum Rauchstopp: Ergebnisse einer repräsentativen Bevölkerungsbefragung (DEBRA Studie)’, Sucht, 67(4), 171-180. https://doi.org/10.1024/0939-5911/a000719

[3] Benowitz, N. L. (2009). ‘Pharmacology of nicotine: addiction, smoking-induced disease, and therapeutics’, Annual Review of Pharmacology and Toxicology, 49, 57-71. https://doi.org/10.1146/annurev.pharmtox.48.113006.094742

[4] Kotz, D., Batra, A., & Kastaun, S. (2020). ‘Smoking cessation attempts and common strategies employed: a Germany-wide representative survey conducted in 19 waves from 2016 to 2019 (the DEBRA study) and analyzed by socioeconomic status’, Deutsches Ärzteblatt/ International, 117(1-2), 7-13. https://doi.org/10.3238/arztebl.2020.0007

[5] Mersha, A. G., Eftekhari, P., Bovill, M., Tollosa, D. N., & Gould, G. S. (2021). Evaluating level of adherence to nicotine replacement therapy and its impact on smoking cessation: a systematic review and meta-analysis. Archives of Public Health, 79(1), 1-14. https://doi.org/10.1186/s13690-021-00550-2

[6] Hartmann-Boyce, J., Lindson, N., Butler, A. R., McRobbie, H., Bullen, C., Begh, R., Theodoulou, A., Notley, C., Rigotti, N. A., Turner, T., Fanshawe, T. R., & Hajek, P. (2022). Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews, 11. https://doi.org/10.1002/14651858.CD010216.pub7

[7] Hajek, P., Phillips-Waller, A., Przulj, D., Pesola, F., Myers Smith, K., Bisal, N., ... & McRobbie, H. J. (2019). A randomized trial of e-cigarettes versus nicotine-replacement therapy. New England Journal of Medicine, 380(7), 629-637. https://doi.org/10.1056/NEJMoa1808779

[8] Boland, V. C., Mattick, R. P., McRobbie, H., Siahpush, M., & Courtney, R. J. (2017). ‘“I’m not strong enough; I’m not good enough. I can’t do this, I’m failing”: a qualitative study of low-socioeconomic status smokers’ experiences with accessing cessation support and the role for alternative technology-based support’, International Journal for Equity in Health, 16(196). https://doi.org/10.1186/s12939-017-0689-5

[9] Whittaker, R., McRobbie, H., Bullen, C., Rodgers, A., Gu, Y., & Dobson, R. (2019). ‘Mobile phone text messaging and app-based interventions for smoking cessation’, Cochrane Database of Systematic Reviews, 10, 10. https://doi.org/10.1002/14651858.CD006611.pub5

[10] Esch, T. & Stefano, G. B. (2022). The BERN framework of mind-body medicine: Integrating self-Care, health promotion, resilience, and applied neuroscience. Frontiers in Integrative Neuroscience, 16, 913573. https://doi.org/10.3389/fnint.2022.913573

[11] Kassel, J. D., Stroud, L. R., & Paronis, C. A. (2003). Smoking, stress, and negative affect: correlation, causation, and context across stages of smoking. Psychological Bulletin, 129(2), 270-304. https://doi.org/10.1037/0033-2909.129.2.270

[12] Zvolensky, M. J., Stewart, S. H., Vujanovic, A. A., Gavric, D., & Steeves, D. (2009). Anxiety sensitivity and anxiety and depressive symptoms in the prediction of early smoking lapse and relapse during smoking cessation treatment. Nicotine & Tobacco Research, 11(3), 323-331. https://doi.org/10.1093/ntr/ntn037

[13] Hughes, J. R., Higgins, S. T., & Hatsukami, D. (1990). Effects of abstinence from tobacco. Research Advances in Alcohol and Drug Problems, 317-398. https://doi.org/10.1007/978-1-4899-1669-3_10

[14] Robinson, J. D., Li, L., Chen, M., Lerman, C., Tyndale, R. F., Schnoll, R. A., ... & Cinciripini, P. M. (2019). ‘Evaluating the temporal relationships between withdrawal symptoms and smoking relapse’, Psychology of Addictive Behaviors, 33(2), 105-116. https://doi.org/10.1037/adb0000434

[15] National Center for Complementary and Integrative Health. (2021). Complementary, Alternative, or Integrative Health: What’s In a Name? Retrieved from https://www-nccih-nih-gov.proxy.library.vcu.edu/health/complementaryalternative-or-integrative-health-whats-in-a-name

[16] Miller, K. M., Chad-Friedman, E., Haime, V., Mehta, D. H., Lepoutre, V., Gilburd, D., ... & Yeung, A. (2015). The effectiveness of a brief mind-body intervention for treating depression in community health center patients. Global Advances in Health and Medicine, 4(2), 30-35.

[17] Park, E. R., Traeger, L., Vranceanu, A. M., Scult, M., Lerner, J. A., Benson, H., ... & Fricchione, G. L. (2013). The development of a patient-centered program based on the relaxation response: the Relaxation Response Resiliency Program (3RP). Psychosomatics, 54(2), 165-174. https://doi.org/10.1016/j.psym.2012.09.001

[18] Higgins, S. T., Bergeria, C. L., Davis, D. R., Streck, J. M., Villanti, A. C., Hughes, J. R., ... & Miller, M. E. (2018). ‘Response to reduced nicotine content cigarettes among smokers differing in tobacco dependence severity’, Preventive Medicine, 117, 15-23. https://doi.org/10.1016/j.ypmed.2018.04.010

Mind-Body Exercise Corner 

Breath Awareness Meditation

Breath awareness meditation is a type of meditation that involves focusing on the breath as a way to quiet the mind and bring greater awareness to the present moment. It is a simple and effective practice that can be done by anyone, anywhere, at any time.

To practice breath awareness meditation, find a comfortable and upright seated position, with your spine straight and your feet planted on the ground. Begin by closing your eyes and taking a few deep breaths, allowing yourself to fully relax and let go of any tension in the body.

Then, bring your attention to the sensation of the breath as it moves in and out of the body. Notice the sensation of the breath as it enters the nostrils, fills the chest, and expands the belly. Notice the coolness of the air as it enters the body, and the warmth as it leaves.

As you focus on the breath, your mind will inevitably wander. When this happens, gently redirect your attention back to the breath. Do not judge or criticize yourself for being distracted. Simply acknowledge the thought and return to the breath.

Breath awareness meditation can be practiced for as little as a few minutes at a time, and can be gradually increased as you become more comfortable with the practice. It is a powerful tool for cultivating mindfulness, reducing stress and anxiety, and promoting overall well-being.

The Mind-Body Medicine Research Council 

Exploring the Details of Body and Mind That Account for a Healthy Life in an Uncertain World
by Maren M. Michaelsen1, George B. Stefano1,2, Tobias Esch1

1Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

2Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, 120 00 Prague, Czech Republic

Pandemic, war, climate change, artificial intelligence – Our world and our lives are full of challenges that require a high level of psychological resistance and coping. Since the mind and the body are interconnected, it is important to develop, implement, evaluate and understand measures at both levels for a healthy and thriving society.

The Mind-Body Medicine Research Council (MBMRC) aims to analyze these aspects in their details. The MBMRC is hosted by the Institute for Integrative Health Care and Health Promotion (IGVF), Faculty of Health/School of Medicine at Witten/Herdecke University, Germany. The institute focuses its attention on improving primary health care and increasing the effectiveness of health promotion efforts for patients. While the implications of our research findings certainly contribute to improving health outcomes at the population level, our focus remains on the individual and their personal resources as well as the pathways through which protective (salutogenetic) factors – including, but not limited to, resilience, self-efficacy, self-care and -healing, and the motivation to improve one’s personal health behaviors – can be activated and strengthened.

For this, we apply basic and applied sciences, from neurobiology to general health research, including integrative as well as Mind-Body Medicine (MBM). Tobias Esch, a university professor, researcher, and physician, serves as the institute’s director and has founded the university’s outpatient clinic in general medicine, thus 

closing the gap between rigorous research and patient-focused practice, and ensuring that the research conducted remains clinically relevant to patients.

Our research efforts are driven by a team of researchers and health care practitioners from a wide spectrum of disciplines who work closely and effectively with one another. Witnessing the successful fusion of research and practice at the institute has led us to pursue additional and similarly fruitful collaborations. 

In this endeavor, we seek to uncover life processes involved in healthy living and longevity, including molecular and neurobiological aspects, as well as the applied sciences of MBM. In order to deepen and expand as well as for internationalization in this area, our institute has created the MBMRC composed of outstanding scientists and research affiliates, who contribute their respective expertise in specific and complementary ways to the institute. 

The timeliness of this Council and its educational and research mission also may be ascertained by the stressful times we all find ourselves (pandemics, global warming etc.). Thus, as a body, the Council hopes to alleviate the associated stress of our time by generating knowledge in medical research and disseminating it to our communities. The mind, in particular, is the harvester of both internal and external stimuli, which can be harnessed for health and longevity.


At the present time, the Council consists of the following members:

Tobias Esch, M.D. (Co-Chair)

George B. Stefano, Ph.D. (Co-Chair)

Maren M. Michaelsen, Dr. rer. oec. (Project Lead)


How to become a member of MBMRC

As the MBMRC has just been founded, the number of members is yet small. In the future, the council aims to invite outstanding researchers in the field of mind-body medicine to become MBMRC members. Membership implies no fee.

Call for Papers / Events 

  • Special Issue „Neurobiological Aspects of Motivation and Positive Mood” in Biology (IF: 5,2) - Cancelled!

  • Conference “The Science of Tai Chi & Qigong as whole-person health – Advancing the integration of mind-body practices in contemporary health care, Boston, USA, Sept 18-19, 2023
    The Call for Abstracts and Call for Sessions will open in February 2023.