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Mindfulness training shows promise for MS patients

Posted 04.20.2015 | by AMRA

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Multiple Sclerosis (MS) is an autoimmune disease that damages the integrity of nerve cells in the brain and spinal cord resulting in a variety of sensory and motor deficits and often leading to mobility impairment, pain, and fatigue. MS patients frequently suffer from depression and anxiety, and there is some evidence that stress may play a role in precipitating tissue damage. MS can manifest as either a relapsing and remitting disease with symptoms that wax and wane, or as a progressive disease with a degenerative course.

Bogosian et al. [Multiple Sclerosis Journal] completed a pilot study of the effectiveness of a mindfulness-based intervention (MBI) for reducing distress in patients with progressive MS. The intervention, adapted from Mindfulness-Based Cognitive Therapy (MBCT) and tailored to the specific needs of MS patients, was delivered via eight teleconferenced one-hour group sessions. Meditations were kept brief (10-20 minutes) and the mindful movement component was eliminated.

Forty British patients with progressive MS were randomly assigned to either the MBI or a waitlist control. They completed a variety of self-report measures at baseline, immediate post-intervention, and three-month follow-up. The cohort was 90% Caucasian and 55% female (average age = 53 years).

The MBI participants reported significantly lower rates of distress at immediate post-intervention (moderate effect size) and three-month follow-up (large effect size) compared to the waitlist controls. They also reported significantly greater reductions in depression and the psychological impact of their MS (moderate to large effect sizes) at both assessment points. Anxiety was significantly lower (moderate effect size) at three month follow-up, but not at post-intervention.

Group differences in physical symptoms (e.g., pain and fatigue) tended to be non-significant except for pain […]

April 20th, 2015|News|

MBSR’s Impact on Ulcerative Colitis Flare-Ups

Posted: 03.27.2014 | by AMRA

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Ulcerative colitis is an inflammatory bowel disease that is a chronic autoimmune disorder of the colon. Despite the best medical management, ulcerative colitis patients often experience episodic flare-ups with symptoms that include abdominal pain, diarrhea, and rectal bleeding. Flare-ups are sometimes triggered by stress, and there is a great deal of interest in stress-reduction interventions that might improve quality of life and reduce flare-ups, and defining those ulcerative colitis subpopulations that might benefit most from such techniques.

Jedel et al. [Digestion] studied MBSR’s effectiveness in preventing ulcerative colitis flare-ups in a randomized, double-blind study. Fifty-five moderately severe ulcerative colitis patients in remission were assigned to either MBSR or a placebo (lectures and videos on mind/body medicine). Moderate severity of disease status was defined by a Mayo Ulcerative Colitis Disease Activity Index of 6–12. Measures taken at baseline, post-treatment, and 6 and 12-month follow-up included inflammation markers (calprotectin, C-reactive protein, and cytokines), stress markers (ACTH, cortisol), measures of perceived stress and IBD quality of life, and measures of mood and mindfulness (MAAS).

There was no difference in the number or severity of flare-ups or the length of the inflammation-free interval prior to flare-ups between groups, but MBSR participants who flared had significantly better quality of life and lower perceived stress than control subjects who flared (quality of life was also higher for MBSR participants regardless of whether or not they flared). There were no group differences on measures of mood or mindfulness, possibly due to a ceiling effect in this mentally healthy cohort.

MBSR participants with the highest number of gastrointestinal symptoms at baseline benefited the most. MBSR participants with the highest perceived stress and/or […]

March 27th, 2014|News|

MBCT for Long-Term HIV+ Patients

Posted from archive: 11.04.2013 | by AMRA

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While human immunodeficiency virus (HIV) infection has become a manageable chronic illness, long-term patients, especially those who contracted the virus before the advent of the newer treatments, still experience shortened life spans and remain subject to a variety of complications, iatrogenic side-effects, and an overall poorer quality of life.

Gonzalez-Garcia et al. [AIDS and Behavior] studied the psychological and immunological effects of the Mindfulness Based Cognitive Therapy (MBCT) program on long-term HIV+ patients to discover whether MBCT could lessen their burden of illness. All participants became HIV+ prior to 1996 and had received combined antiretroviral treatment for at least five years. The researchers randomly assigned forty patients to either MBCT or a treatment-as-usual control, assessing participants at baseline, 8 weeks, and 20 weeks.

After intervention, MBCT participants had a higher quality of life, reduced perceived stress, fewer depressive and anxiety symptoms, and higher CD4 immune cell counts. All of these effects were both large and significant, with improvements being either maintained or amplified at follow-up. For example, MBCT participants had mean Beck Depression Inventory (BDI-II) scores of 25.1 at baseline, 10.1 at 8 weeks, and 7.1 at 20 weeks, while control scores remained virtually unchanged (21.3 at baseline and 19.0 at 20 weeks).

Similarly, MBCT CD4 cell counts rose from 555 cells/mL at baseline to 614 at 8 weeks and 681 at 20 weeks, while control counts gradually declined. MBCT participants showed large quality of life improvements in energy, emotional reactions, social isolation, and physical mobility, and a moderate improvement in sleep, while there were no comparable improvements in the control group. The very low (5%) MBCT drop out rate suggests MBCT is […]

January 23rd, 2014|News|

Findings from the 11th Scientific Conference of the UMASS Center for Mindfulness

Posted from archive: 05.14.2013 | by AMRA

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Nearly 450 researchers, MBSR teachers, and clinicians assembled for the 11th Annual International Scientific Conference of the Center for Mindfulness in Medicine, Healthcare and Society this April in Norwood, Massachusetts. Presentations by Norman Farb, Ph.D., Wendy Hasenkamp, Ph.D., David Creswell, Ph.D., Eileen Luders, Ph.D. and David Vago, Ph.D. focused on the neuropsychological correlates of mindfulness. Each of the researchers presented data from past studies along with new findings from as yet unpublished work.

Norman Farb presented MRI data on two opposing neural systems: the interoceptive pathway where bodily awareness is represented, and the default network which is often associated with self, referential narrative awareness and mind wandering. He presented studies showing that MBSR training is associated with increased recruitment of the interoceptive awareness pathway along with increased connectivity of the posterior insula (a key component of that pathway) to the prefrontal cortex. This increased connectivity had both state and trait features.

Wendy Hasenkamp’s MRI research showed how different neural networks are deployed during different moments of focused meditation, depending on whether focus is established, the mind wanders off focus, the mind becomes aware of wandering, or the mind re-establishes its focus. She identified activity in the brain’s default network during mind wandering, activity in a neural salience network with awareness of mind wandering, and activity in a neural executive network for shifting and maintaining focus. More experienced meditators had increased resting-state functional connectivity between the right insula and the dorsolateral prefrontal cortex, and between the ventromedial prefrontal cortex and the bilateral inferior parietal lobe, suggesting increased functional connectivity within and between attentional networks. Experienced meditators also showed decreased ventromedial prefrontal activity while shifting […]

January 1st, 2014|News|

Body Scan, Yoga, and Sitting Meditation Affect Immune Function in Older Adults

Posted from archive: 03.11.2013 | by AMRA

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Gallegos et al. [Journal of Alternative and Complementary Medicine] performed new, more detailed analyses of the results of a prior, unpublished, study. That study of 100 older MBSR participants (ages 65+) showed an unexpected decrease in antibody response to an immune challenge when compared with a wait list control. Conversely, previous studies with younger adults showed that MBSR had improved their immunity.

The current study explored the relative contributions of separate MBSR components (yoga, sitting meditation, informal meditation, body scan, and perceived social support) to a variety of biological and psychological measures, including insulin-like growth factor (IGF-1), which is associated with increased longevity, an interleukin (IL-6) associated with inflammation, two antibodies (IgM and IgG) associated with immune response, and self-ratings of positive affect. The researchers provoked an immune response by injecting participants with keyhole limpet hemocyanin (KLH), a carrier protein used in vaccinations.

Yoga and sitting meditation both increased IGF-1 levels, while perceived social support lowered IL-6 levels. Yoga had a significant beneficial effect on positive affect. The body scan and yoga both contributed to the decreased antibody response to KLH immunization. Can MBSR impair immunity in older adults? More research is needed for it is possible, for example, that the observed antibody decrease was offset by increases in macrophages and lymphocytes.

Reference:

Gallegos, A. M., Hoerger, M., Talbot, N. L., Krasner, M. S., Knight, J. M., Moynihan, J. A., & Duberstein, P. R. (2013). Toward identifying the effects of the specific components of mindfulness-based stress reduction on biologic and emotional outcomes among older adults. The Journal of Alternative and Complementary Medicine, 19(10), 787-92. [PMID: 23383976]

[Link to abstract]

December 28th, 2013|News|