Optimal doses of mind-body exercise on neuroinflammation in individuals with neuropsychiatric disorders: A systematic review and dose-response meta-analysis

BACKGROUND: Mind-body exercises (MBEs), including Tai Chi (TC), Qigong (QG), Yoga (YG), and Mindfulness-Based Stress Reduction (MBSR), show promise in neuropsychiatric rehabilitation by modulating neuroinflammation. This study systematically examines the effects of MBEs on neuroinflammation-related biomarkers in neuropsychiatric disorders, aiming to identify optimal modalities, dosages, and key moderators. METHODS: Databases were systematically searched for eligible RCTs from inception until February 2025. Data were analyzed using R packages ("meta," "multinma," "MBNMAdose," "GEMTC," "BUGSnet," "ggplot2") to assess the effects of MBEs on TNF-α, IL-6, IL-1β, IL-10, CRP, and BDNF in adults with neuropsychiatric disorders. RESULTS: Twenty-nine RCTs involving 2253 participants were included. MBEs significantly reduced IL-6 [standardized mean difference (SMD) = -0.47] and IL-1β [SMD = -0.90], while increasing BDNF [SMD = 1.08] and IL-10 [SMD = 0.87]. Effects on TNF-α [SMD = -0.33] and CRP [SMD = -0.12] showed a non-significant trend toward benefit. Dosages between 600 and 1000 MET-min/week yielded the most pronounced anti-inflammatory effects. Network meta-analysis ranked TC and MBSR as the most effective for reducing proinflammatory cytokines, while QG showed the greatest benefits for neurotrophic outcomes. Participant characteristics (age, population, clinical conditions) and MBE parameters (duration, frequency, session length) significantly moderated neuroprotective effects. CONCLUSION: MBEs effectively reduce proinflammatory cytokines (IL-1β, IL-6) and enhance anti-inflammatory cytokine (IL-10) and neurotrophic factor (BDNF) in neuropsychiatric disorders. The optimal dosage ranges from 600 to 1000 MET-min/week. Given the impact of participant characteristics and MBE parameters, personalized prescriptions may enhance clinical outcomes and long-term neuroprotective effects.