{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:50:43Z","timestamp":1791895843794,"version":"4.3.4"},"reference-count":32,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["IIRPSG-2025-01-03486"],"award-info":[{"award-number":["IIRPSG-2025-01-03486"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Obesity and type 2 diabetes mellitus (T2DM) are associated with accelerated brain atrophy, white matter microstructural disruption, and resting-state functional network dysconnectivity in elderly adults, driven by converging vascular, neuroinflammatory, and insulin-resistance mechanisms. Yoga is a recognized mind-body intervention with documented benefits for glycaemic control, vascular health, and neurocognitive function; however, no study has yet employed multimodal MR neuroimaging to systematically characterize these brain alterations in an elderly obese-diabetic population or to evaluate yoga-induced neuroplasticity within this cohort. Methods This three-phase, prospective protocol will be conducted at Kasturba Hospital and the Center for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, India. Phase 1 is a case-control study (n\u00a0=\u00a080; 40 obese-diabetic, 40 obese-non-diabetic; age 60\u201380\u00a0years) employing carotid Doppler ultrasonography, T1-weighted voxel-based morphometry and region-of-interest segmentation (SPM12\/CAT12\/AAL3), diffusion tensor imaging with ROI-based tractography (ExploreDTI), and resting-state fMRI (CONN toolbox), alongside the Eriksen Flanker and N-Back cognitive tasks. Phase 2 involves the systematic development and expert content-validation of a structured, AYUSH-compliant yoga module tailored for elderly obese-diabetic adults. Phase 3 applies the validated module in a 6-month pre-post intervention, with objective adherence monitoring via triaxial accelerometry and repeat of the full Phase 1 neuroimaging and cognitive battery. Discussion This protocol addresses a critical gap in the yoga-neuroimaging literature by providing a multimodal, multi-phase framework to characterize neurovascular disease burden and evaluate structured yoga as a neurobiologically informed lifestyle intervention in a high-risk elderly population. Findings will inform AYUSH clinical guidelines, geriatric NCD prevention programs, and future randomized controlled trials.<\/ns3:p>","DOI":"10.12688\/f1000research.181680.1","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:14:06Z","timestamp":1779952446000},"page":"830","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["An MR-Neuroimaging Study of Structural and Vascular Brain Networks in Elderly Adults with Obesity and Diabetes who Practice Structural Yoga"],"prefix":"10.12688","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6267-7266","authenticated-orcid":false,"given":"Poovitha Shruthi","family":"Paramashiva","sequence":"first","affiliation":[{"name":"Division of Yoga, Centre for Integrative Medicine and Research Manipal Karnataka 576104 Manipal Academy of Higher Education"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Arun","family":"Maiya","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Manipal College of Health Professions Manipal Karnataka 576104 Manipal Academy of Higher Education"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3486-8740","authenticated-orcid":false,"given":"Rajagopal","family":"Kadavigere","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Imaging, Kasturba Medical College Manipal Karnataka 576104 Manipal Academy of Higher Education"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5963-3230","authenticated-orcid":false,"given":"Winniecia","family":"Dkhar","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Technology, Manipal College of Health Professions Manipal Karnataka 576104 Manipal Academy of Higher Education"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9345-9790","authenticated-orcid":false,"given":"Suresh","family":"Sukumar","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Technology, Manipal College of Health Professions Manipal Karnataka 576104 Manipal Academy of Higher Education"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref1","article-title":"Obesity and overweight.","year":"2025"},{"key":"ref2","article-title":"IDF Diabetes Atlas 10th edition.","year":"n.d"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1175-1178","DOI":"10.1007\/s00125-006-0219-2","article-title":"Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban South India - The Chennai Urban Rural Epidemiology Study (CURES-17).","volume":"49","author":"V Mohan","year":"2006","journal-title":"Diabetologia."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"459-467","DOI":"10.1161\/CIRCULATIONAHA.106.628875","article-title":"Prediction of clinical cardiovascular events with carotid intima-media thickness: A systematic review and meta-analysis.","volume":"115","author":"M Lorenz","year":"2007","journal-title":"Circulation."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1057-1064","DOI":"10.1212\/01.wnl.0000306313.89165.ef","article-title":"Central obesity and increased risk of dementia more than three decades later.","volume":"71","author":"R Whitmer","year":"2008","journal-title":"Neurology."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"711-719","DOI":"10.1007\/s00125-007-0602-7","article-title":"Hippocampal damage and memory impairments as possible early brain complications of type 2 diabetes.","volume":"50","author":"S Gold","year":"2007","journal-title":"Diabetologia."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1486-1493","DOI":"10.2337\/diacare.23.10.1486","article-title":"Circumscribed cognitive dysfunction in middle-aged adults with type 2 diabetes.","volume":"23","author":"C Ryan","year":"2000","journal-title":"Diabetes Care."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"21-30","DOI":"10.1016\/j.ebiom.2018.01.021","article-title":"Traumatic Brain Injury and Alzheimer\u2019s Disease: The Cerebrovascular Link.","volume":"28","author":"J Ramos-Cejudo","year":"2018","journal-title":"EBioMedicine."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1309-1314","DOI":"10.2337\/dc09-1923","article-title":"Progression of cerebral atrophy and white matter hyperintensities in patients with type 2 diabetes.","volume":"33","author":"J De Bresser","year":"2010","journal-title":"Diabetes Care."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"171-179","DOI":"10.4103\/ijoy.ijoy_182_23","article-title":"From Inner Balance to Visual Health: Unraveling the Therapeutic Role of Yoga in Optic Neuropathy and Ocular Manifestations \u2013 Narrative Review.","volume":"16","author":"P Tiwari","year":"2023","journal-title":"Int. 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Grant number: IIRPSG-2025-01-03486. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}