Posted 08.16.2018 | by AMRA
Multiple sclerosis is a central nervous system disorder in which the body’s immune system attacks the fatty layer of insulation surrounding nerve cells. Symptoms may include visual and sensory disturbances, muscle weakness and discoordination, fatigue, pain, and problems with mood and cognition. Stress can worsen these symptoms, and stress management can reduce the risk of the illness spreading to other brain regions.
Senders et al. [Multiple Sclerosis Journal] tested the feasibility of using Mindfulness-Based Stress Reduction (MBSR) with multiple sclerosis patients, and whether MBSR worked better than an active control intervention in improving psychological symptoms and wellbeing.
The researchers randomly assigned 67 patients with multiple sclerosis (average age = 53 years, 77% female, 97% Caucasian) to a standard 8-week MBSR intervention or to an education control group matched for time and attention. The control group curriculum covered topics such as medication, symptom management, financial planning, knowing one’s rights, and connecting with resources.
The groups were assessed on a variety of self-report measures of psychological symptoms, stress, and wellbeing at baseline, immediately after program completion, and at twelve months post-intervention.
Attention and cognition were assessed using a serial addition task in which participants listened to an audio recording of single digits presented at three-second intervals. Participants had to add each newly presented digit to the previously presented one. Participant expectations for the success of their respective interventions were assessed at baseline, with MBSR assignees having significantly higher expectations.
In regard to feasibility, 85% of the MBSR patients attended at least 6 of the 8 group sessions, thus meeting the author’s standard for course completion. They completed their at-home meditation on 55% of the assigned days for an average of 38 minutes per meditation.
There were only two MBSR-related adverse events: a case of muscle cramps after a body scan meditation, and a case of anxiety and migraine following the six-hour retreat. It was unclear if these were due to MBSR activities or random occurrences.
In terms of psychological outcomes, MBSR and educational group participants both showed significant improvements on measures of perceived stress, emotional wellbeing, anxiety, depression, fatigue, resilience, and serial addition proficiency immediately after the intervention.
While improvement scores were generally higher for MBSR participants, group differences failed to reach statistical significance. Within-group effect sizes for MBSR ranged from d = 0.56 on the serial addition task to d = 0.77 on anxiety. Within-group effect sizes for the control group ranged from d = 0.28 on the serial addition task to d = 0.75 on anxiety. Improvements on stress, anxiety, depression, fatigue, and resilience remained significant at 12-month follow-up for both groups.
The results showed that MBSR was a safe and feasible intervention for multiple sclerosis patients. Both interventions showed improvements on psychological measures up to a year after the intervention. Although MBSR improvements tended to be slightly larger than the active control, the difference did not reach statistical significance.
The study’s small sample size may have lacked sufficient statistical power to reveal significant differences between groups. The absence of a no-treatment control and a mindfulness measure makes it impossible to tell whether improvements were spontaneous, due to group support effects, or associated with the specific content of the interventions.
Senders, A., Hanes, D., Bourdette, D., Carson, K., Marshall, L. M., & Shinto, L. (2018). Impact of mindfulness-based stress reduction for people with multiple sclerosis at 8 weeks and 12 months: A randomized clinical trial. Multiple Sclerosis Journal.