Background Patient-reported outcomes are important for clinical research and care, yet administering and scoring questionnaires requires considerable effort and time. The Patient Reported Outcomes Measurement Information System (PROMIS) could considerably reduce administrative obstacles and lessen survey burden for participants. Objective Assess feasibility and validity of PROMIS compared to commonly used legacy measures for multiple sclerosis (MS). Methods Cross-sectional survey; 133 participants with confirmed MS completed legacy surveys and PROMIS Computerized Adaptive Tests (CATs) for depression, anxiety, pain, fatigue, and physical function. A multitrait-multimethod analysis was conducted and verified with confirmatory factor analysis. Results Correlations between PROMIS and corresponding legacy measures were large (0.67 to 0.87). Multitrait-multimethod criteria were generally well met, providing good evidence of validity of PROMIS measures. PROMIS surveys asked fewer questions and required substantially less time to complete than legacy scales. Conclusions Results provide evidence of construct validity of PROMIS for use with MS. Several aspects of PROMIS CATs make them an important resource, including: 1) less time required to complete, 2) reduced missing data, and 3) automatic scoring referenced to the general population. Findings support the use of PROMIS in MS research and may have broader implications for clinical care, as well.

Emotional well-being improved with both MBSR and education. Spontaneous improvement cannot be ruled out as an explanation for findings and additional studies that evaluate the impact of mindfulness training to improve emotional health are warranted.

Background. Mind-body therapies are used to manage physical and psychological symptoms in many chronic health conditions. Objective. To assess the published evidence for using mind-body techniques for symptom management of multiple sclerosis. Methods. MEDLINE, PsycINFO, and Cochrane Clinical Trials Register were searched from inception to March 24, 2012. Eleven mind-body studies were reviewed (meditation, yoga, biofeedback, hypnosis, relaxation, and imagery). Results. Four high quality trials (yoga, mindfulness, relaxation, and biofeedback) were found helpful for a variety of MS symptoms. Conclusions. The evidence for mind-body medicine in MS is limited, yet mind-body therapies are relatively safe and may provide a nonpharmacological benefit for MS symptoms.

We conducted a survey to study the prevalence and types of complementary and alternative medicine (CAM) therapies used by multiple sclerosis (MS) patients in Oregon and southern Washington. We mailed questionnaires to 5316 people using the mailing list of the Oregon Chapter of the National Multiple Sclerosis Society (NMSS). The survey enquired about demographic and clinical characteristics, use of various CAM and conventional therapies for MS by the respondents, and the respondents' self-perceived benefit ratings for the various therapies. We received 2026 responses (38%). Eighty-four percent of the respondents reported using one or more CAM therapies at some time after diagnosis of MS (CAM users), the most common being diet (59%), nutritional supplements (46%), herbal treatments (36%), and mind-body therapies (32%). CAM therapies rated as very beneficial included yoga; meditation; Swank, vegetarian and low-fat/low-cholesterol diets; and vitamin B12. Respondents also used conventional exercise (86%) and disease-modifying therapies (77%). Our survey confirms the common use of various CAM therapies by MS patients. CAM therapies such as low-fat diets, essential fatty acid supplements, yoga, and meditation appear to be frequently used and considered very beneficial by a significant number of MS patients and may warrant further exploration.

Complementary and alternative medicine (CAM) use is high among people with multiple sclerosis (MS), yet there are no reports on the association between CAM use and health-related quality of life (HRQL) in MS. To examine this relationship, a cross-sectional survey and SF-12 was used to collect demographic and HRQL data from 1667 survey respondents. Factors examined for their association with CAM use included, age, gender, race, self-reported disease severity, disease-modifying drug (DMT) use, MS duration, MS type, education level, physical and mental well-being. Multiple regression analysis revealed that female gender, high education level, longer MS duration, lower physical well-being and not using DMT were independent factors associated with both 'ever' and 'current' CAM use. The finding that a drop in physical component score (PCS) of the SF-12 is independently associated with an increased odds of 'ever' CAM use, 'current' CAM use, and 'past' CAM reflect an association of CAM use with PCS regardless of time of use. Although, temporality of this relationship cannot be established, as this was a cross-sectional study, a longitudinal study is warranted so that we can establish if HRQL is predictive for CAM use in MS.

Stressful life events are associated with worsening neurological symptoms and decreased quality of life in multiple sclerosis (MS). Mindful-consciousness can alter the impact of stressful events and has potential to improve health outcomes in MS. This study evaluated the relationship between trait mindfulness and perceived stress, coping, and resilience in people with MS. Quality of life was assessed as a secondary outcome. 119 people with confirmed MS completed the Five-facet Mindfulness Questionnaire, Perceived Stress Scale, Brief Coping Orientation for Problem Experiences, Connor-Davidson Resilience Scale, and the SF-36. Greater trait mindfulness was significantly associated with decreased psychological stress, better coping skills, increased resilience, and higher quality of life. After controlling for confounders, mindfulness accounted for 25% of the variation in perceived stress scores and 44% of the variation in resilience scores. Results support further investigation of mindfulness training to enhance psychological resilience and improve wellbeing for those living with MS.

This pilot study showed that young people involved in a community early intervention program adhered to an activity-based lifestyle program which included mindfulness meditation, yoga and nutrition education, warranting further evaluation with a larger sample size.

Multiple sclerosis is the most common chronic disabling disease in the central nervous system in young to middle aged adults. Depression is common in multiple sclerosis (MS) affecting between 50–60% of patients. Pilot studies in unipolar depression report an improvement in depression when omega-3 fatty acids are given with antidepressants. The objective of this study was to investigate whether omega-3 fatty acid supplementation, as an augmentation therapy, improves treatment-resistant major depressive disorder (MDD) in people with MS. We performed a randomized, double-blind, placebo-controlled pilot study of omega-3 fatty acids at six grams per day over three months. The primary outcome was a 50% or greater improvement on the Montgomery-Asberg Depression Rating Scale (MADRS). Thirty-nine participants were randomized and thirty-one completed the 3-month intervention. Improvement on MADRS between groups was not significantly different at the 3-month end point with 47.4% in the omega-3 fatty acid group and 45.5% in the placebo group showing 50% or greater improvement (p = 0.30). Omega-3 fatty acids as an augmentation therapy for treatment-resistant depression in MS was not significantly different than placebo in this pilot trial. Omega-3 fatty acid supplementation at the dose given was well-tolerated over 3 months.Trial RegistrationClinicalTrials.gov NCT00122954