Eva Dale  0:00  
From the heart of the Ohio State University on the Oval, this is Voices of Excellence from the College of Arts and Sciences, with your host, David Staley. Voices focuses on the innovative work being done by faculty and staff in the College of Arts and Sciences at The Ohio State University. From departments as wide ranging as art, astronomy, chemistry and biochemistry, physics, emergent materials, mathematics and languages, among many others, the college always has something great happening. Join us to find out what's new now.

David Staley  0:33  
I'm joined today via Zoom by Ruchika , Professor of Psychology and Director of the Center for Cognitive and Behavioral Brain Imaging at The Ohio State University, College of the Arts and Sciences. Her research interests broadly focus on understanding neuroplasticity in the context of healthy aging and neurological disorders, specifically multiple sclerosis. Welcome to Voices, Dr. Prakash.

Ruchika Prakash  0:59  
Thank you, Dr. Staley. It is quite an honor to be here and talking with you on our Voices of Excellence podcast here at ASC.

Speaker 1  1:08  
Well, and I'd like to begin with the work of your lab, the Clinical Neuroscience Lab; tell us about some of the work that you're engaged in, you and your team are engaged in.

Ruchika Prakash  1:16  
Sure. I think it's really important to specify that the work that I do takes a village, and really a team of dedicated post doctoral scientists, doctoral students, undergraduate students and lab managers to accomplish the work that we do. So broadly, my lab is interested in looking at how different mind body approaches, and we define mind body approaches pretty broadly, so we look at the effects of mindfulness meditation, that has been the focus of our work for the last, I would say, decade or so since I've been here at Ohio State, but also exercise training, how these mind body approaches influence what is called cognitive functioning. So, this is the way we think, the way we focus our attention, the way we remember things, and how it changes the neural connections within the brain as a result of that training. So, we have a number of studies ongoing, which are called these clinical trials for behavioral interventions, where we systematically look at how these mind body interventions can actually improve your functioning, both behaviorally, but also neurally.

David Staley  1:32  
You use the word mindfulness. Define what you mean by mindfulness for us, please.

Ruchika Prakash  2:32  
Absolutely. How long do you have, because I've given, I've given hour long webinars on just defining this construct of mindfulness. You know, mindfulness, when I first got started here back in 2009, I would give these talks to community audiences, and I would say, oh, so how many of you have heard the term mindfulness? And maybe, like, two hands would go up, and now I could ask this term, and literally, every single person has heard of the term mindfulness. And you know it's being used by our politicians, there are books being written, and we know we all could use mindfulness at the Capitol Hill, but TSA agents at the airport are talking about, hey, be mindful. I'm like, well, TSA agents and mindfulness don't really go well together, but it's a term that is really being used in the public, and we're just talking a lot about mindfulness, especially with these past two years of the pandemic. But the work that we do in our lab, we run clinical trials of mindfulness meditation, but our work really is predicated on this one definition of mindfulness, which was given by Jon Kabat-Zinn and he's considered to be the founding figure responsible for taking a lot of the Buddhist traditions of mindfulness and packaging into these nice mind body interventions, and he defines mindfulness as involving... it's an inherent characteristic of us as humans, and it's all about paying attention, but the way that we pay that attention, it's purposeful and it's intentional, and we're paying that intentional attention to the present moment experiences, but doing so in a framework that promotes acceptance, that promotes non judgment. So, it has these two components of being able to focus your attention on the experiences of the present moment, but as you're focusing your attention, doing so in a way that is non judgmental, doing so in a way that is accepting of your present moment experiences.

David Staley  4:32  
Well, I don't know how to frame this. Is mindfulness something new to psychological methods or to the field of psychology? I mean, obviously mindfulness as a as a practice has been around for a while. Is this something new in psychology?

Ruchika Prakash  4:45  
So, yes and no. So the term, as you can imagine, and this idea of mindfulness, this present moment awareness, has been around for centuries, and it really has been there in Buddh traditions as well. Was, I think, in Hindu traditions, talking about just being aware of present moment experiences. But, I would say it is more in since the 1980s that we have been scientifically and systematically studying what is this construct of mindfulness, and how could we use it, and how could we leverage it to promote mental health as well as physical health? And in fact, this first set of studies were done in the 1980s to systematically look at how could we take these mindfulness based approaches and package it in a way that is A., secular, B., it's scientific, and that we could carefully, really define our constructs and do it in a way that others could replicate it as well. The study started really in the 1980s, but I would say it's only been in the last less than a decade or so where studies have really picked up, and now you can see mindfulness being studied systematically almost at every university. But even when I got started in this work, back in 2007 during my doctoral training, there were a handful of researchers that were doing this work, but now it is being systematically investigated, you know, at senior citizen centers, at schools, at hospitals, at organizations, right, a while back I had heard that Google has a CEO of mindfulness and Amazon has a CEO of mindfulness. So, I think it's really going everywhere, but I would say that it's, you know, about a decade or so old, where we've been very rigorously examining how mindfulness meditation can help improve mental health as well as physical health. 

David Staley  6:35  
Well, tell us about some of the specific research that you've done in this area. 

Ruchika Prakash  6:40  
Sure, so I'll tell you a little bit about the work that we've done with healthy older adults and healthy aging. And right now it's really active, because we are in the midst of an, actually, not even in the midst, at the tail end, of a five year NIA, which is the National Institute on Aging, it's one of the Institutes of Health of NIH. We have a five year, or one where we have been looking at the effects of mindfulness meditation, which is almost a 12 month intervention that we're doing, how mindfulness meditation can improve sustained attention, reduce mind wandering, and strengthen the neural circuitry that supports attention in healthy older adults, and we have about 150 older adults who are going through this study. And you know, as you can imagine, the pandemic really made a big impact on how the study was done, so we had to pivot right away. We were in the midst of data collection when the pandemic shutdowns happened, so it's been quite a journey to do that study, but leading up to that... so we don't have the results of that study, hopefully by next year we're going to have the results of this five year study, but what led up to that is that we were looking at, in a pilot study, examining if mindfulness meditation, when you compare it to what's called an active control group, can improve attentional control and reduce mind wandering in healthy older adults, and I'll define a few of these things for you in just a moment. So, when I talk about attentional control, so even this conversation that you and I are having, or for our audience listening in on this podcast right at any given moment, there's a lot of information that is being thrown at us, and we decide, based on our goals or based on something very salient, what we're going to focus on. So, right now, our goal is to have this conversation, but there are lots of other things that are happening, right? I have a deadline today at 5pm, so I could be thinking about that, or I could be thinking about all of the festivities of this past weekend with my kids, and so our mind is wandering at all times, but that impacts our ability to focus our attention. So, attentional control is all about filtering out irrelevant information and focusing on the relevant information. Another component of this could be, let's say the fire alarm goes off at my house, so I need to pay attention to that rather than focusing on this conversation. So, it's both, you know, there are different ways in which things capture our attention. And so, what we were interested in seeing is, could mindfulness training, right - where we are promoting this attention to the present moment experiences - could mindfulness training improve attentional control and reduce what's called mind wandering? And mind wandering is a really interesting construct. I've gotten interested in this and fascinated by it for quite some time, and mind wandering is really this idea that instead of focusing on the task in front of us, we're thinking about the past, or we're thinking about the future, but we're really not focused on the present moment. And in fact, you know, mind wandering actually could be a good thing. We always say we get most creative when we're engaging in mind wandering. We get... I always say I get my best research ideas when my mind is off, thinking in all of these different directions. And in fact, research suggests that about 30 to 50% of our waiting time is spent in mind wandering. But we also know that mind wandering has consequences, and for those of us who teach undergraduate students, but also graduate students and older adults, we know when they're not focused on tasks, their comprehension goes down, and there are studies that suggest that. We've also systematically looked at when older adults are engaging in mind wandering in the context of the tasks that we do inside in our lab, their performance suffers. So, we wanted to see if engagement in mindfulness practices could reduce mind wandering, and what our results showed was that older adults who engaged in mindfulness meditation as compared to older adults who went through a different kind of training, they showed reductions in mind wandering, and the way we assess mind wandering is two different ways. One is that we give really long, boring tasks to people. So, imagine sitting in front of a computer screen and pressing the X and the M key for 30 minutes, right? 

David Staley  10:56  
Oh, dear.

Ruchika Prakash  10:57  
I know, right?  It's a very simple task, nothing complicated whatsoever about it. But now imagine doing it for 30 minutes. Of course, your mind would wander, so during this 30 minute task, and I exaggerate when I say 30 minutes, it's 22 minutes.

David Staley  11:12  
 That's long enough.

Ruchika Prakash  11:13  
 It really is long enough. But in these 22 minutes, quasi randomly, we present these probes that will come up all of a sudden, and we'll ask people, hey, just before this probe went up, was your mind on task, or was it off task? And so, that's one way we see the proportion in which they saying that they were engaging in mind wandering. And then the other way, which is more of an indirect marker of mind wandering, but it's often used within the aging literature, is when you are responding to these things, we record your response time, right? It's the variability in response time. So sometimes when you're super fast, sometimes when you're super slow, that is an indirect marker of mind wandering. So what we found is that what mindfulness helps with is that it helps reduce mind wandering, both when we ask people about these self report probes, hey, is your mind wandering, but you can imagine that, since it's self report, people could be telling you what you want to hear, is that, yes, after training, my mind is wandering less, but also they showed reductions in this variability in response time or we call that response time variability. So, that was really exciting. So mind wandering goes down with mindfulness meditation, and I'm a clinical psychologist, so for me, the more interesting question is, did it improve your attention? And now, if it had, that would have been the first result I would have told you, but that was not the case. Both mindfulness meditation group and the people who were in the active control group, their attention kind of improved slightly, or it did not change. But what we did notice, because, you know, one of the important questions with a lot of these interventions is, and I'm really interested in Alzheimer's disease, but one of the questions that we have is, could it slow the cognitive decline that happens either as a result of aging or as a result of neurodegenerative disorders? 

David Staley  13:05  
You anticipated one of my questions.

Ruchika Prakash  13:08  
That's awesome. So, what we did find is that mindfulness meditation improved attentional control only for older adults who had very high baseline cognitive capacities. And the way we defined it is using this construct of working memory, and I won't get into too many details, but - and this is the result of a pilot study with 74 people, so I always say, and in our papers we write, is that interpret this with caution, and this is a result that definitely needs to be replicated.

David Staley  13:39  
74 is not a very large number in such studies?

Ruchika Prakash  13:42  
It's not, I mean, even, you know, again, we're talking about generalizing to an older adult population, and there's a large number of older adults living in the United States, and we had 74 participants. Even the big study that we've been doing, right, like the five year study, that's with 150 older adults. And I'll tell you about some of the future directions of this work, but it's it's what we call a pilot study. It's small, but it's very typical in the way we do studies, and there's a whole NIH stage model of behavioral interventions through which you generate causal conclusions about whether your intervention improves functioning or not, and one of the first stages of this work is doing a pilot study with a smaller set of participants. But our pilot study, basically what we found was that mindfulness meditation improved attentional control for people, for older adults with high baseline cognitive capacity. So, the relationship to Alzheimer's is that people are interested in using mindfulness meditation for individuals with Alzheimer's disease or individuals with mild cognitive impairment, but our results as well as the, you know, the clinical work that I've done, and I practice mindfulness on my own as well, and what it seems to suggest is that when you think about mindfulness meditation, you really have to think about it from the context of a preventative intervention. So, this is something that we need to be engaging on early in life before the cognitive symptoms have set in, to really leverage it to improve our cognitive functioning, as opposed to doing it much later in life, when cognitive symptoms have been set and you start noticing the decline in cognitive functioning. But like I said, this was a pilot study, and we'll see if we replicate these results in our larger trial that's ongoing right now, but that's been one of our main studies that we've done in the last five years, and we published it more recently in 2020 in terms of some of our results.

Eva Dale  15:41  
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David Staley  16:06  
Well, I know your work has also involved the relationship between aerobic fitness and cognitive functioning, and I'd like to hear... like to hear a little bit more about this research. 

Ruchika Prakash  16:15  
Sure, you know, it's always interesting with research, because when you start building a line of research, the other line takes a little bit of a hit. So, we haven't done too much aerobic fitness work, I would say, in a while, but we just wrapped up a randomized clinical trial where we looked at physical activity interventions, but I'll tell you a little bit about the aerobic fitness work. So, this is work that we've done with individuals with multiple sclerosis, and also some work with older adults, where we looked at cardiorespiratory fitness, and this is really the amount of oxygen that your body can consume during a full blown workout that you are doing when your heart rate is really up, and it's often used as a metric for how fit you really are. And so, some of the work that we did with individuals with multiple sclerosis, and this is all correlational, so with some of the mindfulness work we've done, we can actually say that it's mindfulness meditation that actually improves X, Y and Z, but in here, it's a simple correlation. And for our listeners, it's important to note that correlation does not imply causation. And so, in this correlation of work, what we found is that aerobic fitness was associated with better processing speed, this is how fast can you respond to certain things. But we also looked at the integrity of the gray matter areas, as well as the white matter track. So when you look at the brain, right, it has this gray matter which is basically cell bodies of your neurons that connect where the processing happens, and then the white matter tracks, which are the axons, which is how the information communicates across the brain regions. And what we found was that aerobic fitness was associated with higher gray matter volume, so more gray matter tissue, basically, and better integrity, like better tracked integrity of the white matter connections with individuals with multiple sclerosis. Well, let me tell you a little bit about some of the work that we've been doing with a physical activity intervention, and this is an intervention that we just wrapped up last year, and are working on finalizing the results. We don't have the results yet, but this was a study which was building off of this aerobic fitness work that we were doing, and we called it tracking health in Multiple Sclerosis study. The study started six years ago, not five years ago, and so at that time, we were all going through this Fitbit fad, right? 

David Staley  18:42  
Right.

Ruchika Prakash  18:42  
Like we were always tracking our steps and being like, oh, like, we could get to 10,000 steps. But in lots of different populations, including multiple sclerosis, there really wasn't any evidence that, A.,if you track to your physical activity, you actually did get better, like you actually did show improvements in your steps, and with that would translate to better functioning. And so, what we did was that we recruited individuals with multiple sclerosis and randomized them into what's called a step tracking group, so basically gave them a Fitbit, and then we had an active control group called the water tracking group, and they tracked water, and we worked with a startup company where they designed bottles and as you are drinking, it updates on real time how much water you're consuming. And the whole goal of that study was to A., see if you have people track their behavior, does that improve their behavior, both for the physical activity group and the water tracking group, because we all wear these smart watches and Fitbits, and we think, and you know, it, of course, improves our behavior for the first five or six days, but the question is, can you maintain it? So this was a six month intervention, and a lot of individuals with MS lead very sedentary lives, and so the idea was, could we get them to improve their physical activity so that they could go into the next step of or the next category of being physically active, and if they did, they improved their health as a result of tracking. Did that improvement in health behavior translate to improvements in cognitive functioning? So, we had about 75 people that we randomized into this study, and we've collected all of the data, and we're in the process of reducing down all the data, pre registering our analytic plan, and then hopefully by the end of the summer, we will have those results.

David Staley  20:31  
I understand this is correlation or causation, but as I get older, should I maintain my physical activity?

Ruchika Prakash  20:37  
I was gonna say absolutely, my... you know there's lots of data, there's causal as well that does suggest that increasing your overall levels of physical activity does improve your cognitive health, your brain health, as well as your emotional health. So, I always say absolutely, make sure that we... and not just for older adults, right? In fact, I think there has been this interesting renewed focus, and it's possibly because I'm entering midlife - I'm not entering, I'm in denial, I have entered midlife -  and I think that there is this renewed focus on this developmental period that has been ignored for a very long time, is midlife, is I think... a lot of the behaviors that we engage in midlife will have an impact in our old age. So, it's not that as we're getting older that's when we should be exercising, but we really should be thinking about exercising and making it a way of life pretty early on, even among kids. There's really strong evidence about exercise training and how being physically fit is associated with gains in cognitive and affective health for young kids. So, I always say, I think it's good to take a developmental approach and making sure that we are staying fit and physically active.

David Staley  21:52  
Well, and physically active, especially for older adults, I mean, are we talking, you know, a stroll in the neighborhood, or are you talking something a little more vigorous, you know, playing squash or soccer, like I like to do?

Ruchika Prakash  22:04  
Yeah, I was gonna say that's a really good question, and that's a question that I get often. And sometimes I think that's defined by, what benefits are you looking for, right? Because we don't have conclusive evidence in terms of the dose of the physical activity. So, if I engage in 30 minutes of low intensity - so there's the dose component and there's also the intensity component, right, how much should I get my heart rate up? So, if you are just taking a stroll, and you have your dog with you, and if it's anything like my dog, who stops like 50 times - and I let her, because I've heard that the more you let your dog stop and take their breaks, then that's good for their spatial cognition, but I digress - yes, if you're taking just a stroll, then you're not getting your heart rate up. But if you're, let's say, getting on the elliptical and going a little bit fast, you can be engaging in what's called moderate intensity exercise, and if you're on the other side, if you are playing tennis or if you are going on a run,  we really get into vigorous intensity exercises. So, those are two components that are always important to think about when you're engaging in physical activity. So, the jury is still out. I think we don't have all of the answers with respect to the benefits, but for example, for cardiovascular health, for your heart health, they do say that what you really do need is moderate intensity to vigorous intensity exercises. So, physical activity, just a stroll in your neighborhood, is not going to be enough for that, so you really need to get your heart rate up. For a lot of the cognitive benefits that we're seeing, for that too, you need something called moderate intensity exercises. But one thing that I always like to say with this is that there's this literature on physical activity, right, so how much you should be engaging in exercise, but there's also this literature and what's called sedentary behavior. So, there are people who would get their exercise first thing in the morning, but then for ten hours, or eight hours, they would be sitting in front of the computer and not moving whatsoever, and there's lots of good research coming out that not only is being physically active really important, but also reducing the amount of time that you are engaging in sedentary behavior - it's funny, I say this after being on my chair for like three hours since morning already, I have a standing desk, but that's really good, like I got a standing desk when the pandemic started, use it for six months and then stop using it. I know, right? This is the story of our lives, so but I'm saying all of this so that when listeners are hard on themselves for not following lifestyle behaviors and healthy behaviors, know that there's a lifestyle intervention researcher who does the same exact things. So, every now and then, you just have to intentionally commit to leading a physically active life and also reducing the amount of sedentary behavior. But I say, you know, a walk is better than sitting on the couch. So if, even if you are just taking a stroll in the neighborhood, that's more than what you would do if you don't do that. So if that's what you can accomplish, then go ahead with just that.

David Staley  25:08  
I'm curious to know how you ended up in psychology, as opposed to some other field. Why psychology?

Ruchika Prakash  25:14  
Absolutely, and I'll give you the most cliched response that is ever heard about for a psychologist. So, my field of psychology is what's called clinical psychology, and I'm a licensed clinical psychologist, and really entered the field wanting to help people and wanting to make a difference in terms of what I did, and I know that mental health has always been such a priority for me, and just knowing what kind of mental health crises that we have at all times. And it's interesting, when I first started, I thought I wanted to be a clinical psychologist, mostly doing clinical work, but then I got hooked on with the research bug, and then I spent most of my time thinking about research and conducting research studies. But, I would like to think that the work that I'm doing is hopefully making an impact, and in the longer run, will make an impact, because I do think that when it comes to mental health interventions, we do need rigorous science to say, how are these interventions improving or not improving the mental health of our participants, our clients, and what can we do to promote pathways towards health? So yeah, that's what got me interested into psychology.

David Staley  26:28  
Tell us what's next for your research?

Ruchika Prakash  26:30  
Quite a lot of things. 

David Staley  26:33  
Excellent. 

Ruchika Prakash  26:34  
So this pandemic has been hard in so many different ways, but in addition to the stress of the pandemic, what really came forward in the last two years were the racial inequities that we see everywhere in our society, whether it's local neighborhoods, whether it's our school districts, whether it's academia, the way we do our research studies. You know, I'm interested in Alzheimer's disease, I'm interested in looking at how could we design interventions that can delay the onset of cognitive symptoms for older adults. And when you look at some of the work that we have done, but also the field has done, we have really poor representation of minoritized adults in our studies. And you know, this is something that we all have realized in the last two years is that we as a field of psychology, but I think broadly speaking, I can speak for academia, is that we have not done a good job of including minoritized participants, minoritized students, minoritized faculty in our conversations about, how do we design these studies that could benefit the broader population? So one of my big lines of research, both in the lab but also in the center, is to do our work with, of course, non-Hispanic, white participants, but also have a greater proportion of representation from minoritized older adults. So in this past year, one of the reasons why our trial is going on a little bit longer than we anticipated is that we got additional funding from National Institute on Aging to recruit a larger number of minoritized older adults into our study. Because anytime we do these studies, the majority population is non-Hispanic whites, which is understandable because you know that's the majority population, but we have very little representation of the experiences of minoritized participants, and so our study right now is doing a wave of recruitment of just minoritized older adults to try and see do our results generalize to a broader population, because the United States as a country is diversifying, and if we're not taking in the experiences, the perspectives and the needs of our diverse population, I think we're doing a disservice. We're generating theories, we're generating models that are not applicable. So, I think a big line of work for my lab, as well as what we're doing in the center in terms of neuroimaging studies, is going to have a greater representation of participants from minoritized groups. So, that's definitely one thing that we're doing across all of our work. The second line of work, or relatedly, what I'm interested in doing, is to try and see, how can we disseminate the work that we have been doing in these laboratory based control trials to a wider population, right? The pandemic really brought forth the mental health concerns that our communities are facing, and how can we take some of the work that we've been doing in our lab and design interventions that are more broadly available, that can be disseminated with much more ease? And I think with using Zoom platforms, having asynchronous platforms where we can disseminate things to a much wider audience, is where I would like for things to go next, because in our lab, we can include a hundred, 150 participants. But when we do things over Zoom, or when we when we have plans of launching an asynchronous mindfulness platform. We really could target having this be impacting a thousand to two thousand people, and so I'm interested in scaling up the interventions that we're doing.

David Staley  30:10  
Ruchika Prakash, thank you.

Ruchika Prakash  30:12  
Thank you. It was quite fun to have this conversation with you.

Eva Dale  30:16  
Voices from the Arts and Sciences is produced and recorded at The Ohio State University, College of Arts and Sciences Technology Services Studio. Sound engineering by Paul Kotheimer. Produced by Doug Dangler. I'm Eva Dale. 

Transcribed by https://otter.ai