NCCIH Research Blog

NCCIH has recently published two Requests for Applications (RFAs):

• Phased Innovation Award for Mechanistic Studies to Optimize Mind and Body Interventions in NCCIH High Priority Research Topics (R61/R33)
• Innovation Award for Mechanistic Studies to Optimize Mind and Body Interventions in NCCIH High Priority Research Topics (R33)

These RFAs represent NCCIH’s new funding mechanisms to direct research attention toward investigating the mechanisms by which mind and body interventions might work, as well as strategies to optimize these interventions. Such interventions typically include meditation, spinal manipulation, massage, yoga, tai chi, hypnosis, and acupuncture.

You may wonder why it’s important to study the mechanisms or biological processes by which mind and body interventions work. Isn’t it enough to figure out if they work or not? A major challenge for mind and body interventions has been the relative lack of compelling efficacy and effectiveness evidence for specific medical conditions. For those interventions for which we have anecdotal or sporadic information, the effects are typically small or modest at best. Often, we have difficulty in determining if the interventions are substantially better than placebo effects.

In addition, it is particularly challenging to study the effects of mind and body interventions on chronic medical conditions due to their complexity. For example, most mind and body interventions not only engage multiple components of the nervous systems, such as the brain, spinal cord, or peripheral nerves, but also can impact the associated musculoskeletal system, internal organs, or vascular and endocrine systems directly through nerve regulations by somatosensory, motor, vagus, cranial, or other autonomic nervous systems, or indirectly through the circulation of blood. Similarly, most diseases and disorders, especially the chronic types of conditions, typically have deleterious changes in multiple pathways, or biological and physiological systems. Identifying a suitable match between the mechanisms or processes by which a mind and body intervention works and the pathophysiological mechanisms of a chronic condition or an intended clinical outcome could potentially improve the benefits of such an intervention substantially.

Mechanistic studies of mind and body interventions also offer an opportunity for further improvement or enhancement of the interventions per se. One strategy may focus on the intervention itself, with an effort to identify and enhance the active component(s) that may have the highest impact on the presumed mechanisms or processes while trimming down the component(s) with adverse effects or no impact. Another strategy is to consider other types of interventions, such as pharmacologic therapies, natural products, or devices that may impact the same mechanisms or processes of the targeted mind and body intervention. It is conceivable that combining an intervention that could influence the same mechanisms or processes of a physiological or pathological system could generate synergistic benefits—consequently offering an integrative approach to optimize the original effects of the mind and body intervention. There may be many other innovative strategies to utilize the mechanistic understandings in order to optimize mind and body interventions. The bottom line is that we hope to encourage more mechanistic investigations of mind and body interventions with a clear, ultimate goal and an executable plan to make them work better at the beginning of the study.

Join us for a Pre-Application Webinar on Wednesday, October 28, at 2 p.m. ET. The two RFAs represent a new undertaking at NCCIH. In order to help investigators better understand what NCCIH is looking for and to suggest some ideas and strategies to maximize your chance of a successful application, we will be hosting the webinar to introduce the RFAs. You will be able to ask questions during the Q & A portion of the webinar.

Thank you for your interest in these new and exciting areas of science. I look forward to your participation at the upcoming webinar.