Online meditation training for people with multiple sclerosis: A randomized controlled trial

Cavalera, Cesare; Rovaris, Marco; Mendozzi, Laura; Pugnetti, Luigi; Garegnani, Massimo; Castelnuovo, Gianluca; Molinari, Enrico; Pagnini, Francesco

doi:10.1177/1352458518761187

Cited by 64 publications

(120 citation statements)

References 28 publications

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“…Twelve RCTs were identified as eligible for inclusion in the systematic review. [21][22][23][24][25][26][27][28][29][30][31][32] However, only eight studies reported endpoint data that could be included in the meta-analysis. 21-24 28-30 32 (figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…22 23 27 28 31 32 Three studies required a personal intake interview to take part, 26 27 30 two sought baseline evidence of impaired mental well-being. 21 28 Eight studies reported session content, 21-23 25-29 three gave minimal description, [30][31][32] one referred to the study protocol. 24 Seven studies described home practices.…”

Section: Intervention Characteristicsmentioning

confidence: 99%

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Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

Simpson

Ramparsad

et al. 2019

J Neurol Neurosurg Psychiatry

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Objective impairment of mental well-being (anxiety, depression, stress) is common among people with multiple sclerosis (PwMS). Treatment options are limited, particularly for anxiety. The aim of this study was to update our previous systematic review (2014) and evaluate via meta-analysis the efficacy of mindfulnessbased interventions (MBis) for improving mental wellbeing in PwMS. Methods Systematic searches for eligible randomised controlled trials (RCTs) were carried out in seven major databases (November 2017, July 2018), using medical subject headings and key words. Studies were screened, data extracted, quality appraised and analysed by two independent reviewers, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Mental well-being was the primary outcome. Random effects model meta-analysis was performed, with effect size reported as standardised mean difference (SMD). results Twelve RCTs including 744 PwMS were eligible for inclusion in the systematic review, eight had data extractable for meta-analysis; n=635. ethnicity, socioeconomic status, comorbidity and disability were inconsistently reported. MBis varied from manualised to tailored versions, lasting 6-9 weeks, delivered individually and via groups, both in person and online. Overall SMD for mental well-being (eight studies) was 0.40 (0.28-0.53), p<0.01, i 2 =28%; against active comparators only (three studies) SMD was 0.17 (0.01-0.32), p<0.05, i 2 =0%. Only three adverse events were reported. Conclusions MBis are effective at improving mental well-being in PwMS. More research is needed regarding optimal delivery method, cost-effectiveness and comparative-effectiveness. PrOsPErO registration number CRD42018093171.search strategy

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Section: Resultsmentioning

confidence: 99%

Section: Intervention Characteristicsmentioning

confidence: 99%

Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

Simpson

Ramparsad

et al. 2019

J Neurol Neurosurg Psychiatry

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“…Good sleep is pivotal to maintaining a critical level of physical, mental, and emotional well-being [1,2], including optimal cognitive functioning [3]. At any given time, 50% of the general population are affected with one or more sleep problems such as difficulty in falling or staying asleep, staying awake, or adhering to a consistent sleep/wake schedule [4].…”

Section: Introductionmentioning

confidence: 99%

Sleep Abnormalities in Multiple Sclerosis

Sakkas

Giannaki

Karatzaferi

et al. 2019

Curr Treat Options Neurol

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Purpose of review: This review summarizes the most well documented sleep disorders seen in patients with Multiple Sclerosis (MS), with a special focus on the impact on quality of life. Recent findings: Sleep abnormalities in patients with MS are a multifactorial and relatively complex issue affecting approximately 60% of the patients while the pathophysiology of these symptoms is not fully understood. Circadian rhythm disorders and increased levels of Pro-inflammatory Cytokines have been recognized as potential players in affecting sleep homeostasis in MS patients. Medication related side effects such as in immunotherapy and other factors such as lesion load can contribute to the disruption of normal sleep patterns. Summary: Most frequently encountered sleep disorders are insomnia, sleep-related movement disorders, sleeprelated breathing disorders and circadian rhythm disorders affecting both adults and paediatric MS populations. Aetiology still remains unknown with treatment options focusing on behavioural cognitive therapy, life style modification including improvement in sleep hygiene as well as melatonin supplementation. Given MS prevalence is still rising affecting millions of people, more personalized medicine applications should possibly form the key approach for improving patients' quality of life and quality years.

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“…A MBI has been shown to positively influence QoL, depression, anxiety and fatigue in MS patients in an RCT (intervention vs. waiting list control group) with a sample size of 150 patients and rigorous study design (pre- and post-intervention and 6 months follow-up) (Grossman et al, 2010 ). These beneficial effects have been confirmed in other RCTs that used an active control group (psychoeducational group) (Carletto et al, 2017 ; Cavalera et al, 2018 ). Moreover, sleep problems and illness perception improved to a greater extent in the intervention group than in the control group (Carletto et al, 2017 ; Cavalera et al, 2018 ).…”

Section: Mindfulnessmentioning

confidence: 53%

“…Moreover, sleep problems and illness perception improved to a greater extent in the intervention group than in the control group (Carletto et al, 2017 ; Cavalera et al, 2018 ). While the beneficial effects lasted for 6 months after conventional MBI (Carletto et al, 2017 ), the effects could not be maintained for 6 months with online mindfulness training (Cavalera et al, 2018 ).…”

Section: Mindfulnessmentioning

confidence: 99%

Into the Moment: Does Mindfulness Affect Biological Pathways in Multiple Sclerosis?

Willekens

Perrotta

Cras

et al. 2018

Front. Behav. Neurosci.

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Mindfulness was introduced in the Western world by Jon Kabat-Zinn in 1979. He defined it as “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.” Since then, research on mindfulness-based interventions (MBIs) has increased exponentially both in health and disease, including in patients with neurodegenerative diseases such as dementia and Parkinson's disease. Research on the effect of mindfulness and multiple sclerosis (MS) only recently gained interest. Several studies completed since 2010 provided evidence that mindfulness improves quality of life (QoL), depression and fatigue in MS patients. In addition to patient-reported outcome measures, potential effects on cognitive function have been investigated only to a very limited extent. However, research on laboratory biomarkers and neuroimaging, capable to deliver proof-of-concept of this behavioral treatment in MS, is mainly lacking. In this perspective, we illustrate possible neurobiological mechanisms, including the tripartite interaction between the brain, the immune system and neuroendocrine regulation, through which this treatment might affect multiple sclerosis symptoms. We propose to (1) include immunological and/or neuroimaging biomarkers as standard outcome measures in future research dedicated to mindfulness and MS to help explain the clinical improvements seen in fatigue and depression; (2) to investigate effects on enhancing cognitive reserve and cognitive function; and (3) to investigate the effects of mindfulness on the disease course in MS.

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Online meditation training for people with multiple sclerosis: A randomized controlled trial

Abstract: An online MBI could be an effective psychological treatment for the promotion of well-being in MS in short-term. However, the lack of lasting effects requires the development of new strategies to support long-term changes.

Cited by 64 publications

References 28 publications

Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

Sleep Abnormalities in Multiple Sclerosis

Into the Moment: Does Mindfulness Affect Biological Pathways in Multiple Sclerosis?

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