The Effectiveness of Mindfulness-Based Stress Reduction on Psychological Distress and Cognitive Functioning in Patients with Multiple Sclerosis: a Pilot Study

Abstract

Patients with multiple sclerosis (MS) often suffer from psychological distress and cognitive dysfunctioning. These factors negatively impact the health-related quality of life. Only recently behavioral therapeutic approaches are being used to treat psychological distress in MS. The aim of the present pilot study was not only to investigate the effectiveness of mindfulness-based stress reduction (MBSR) on psychological distress but also to explore whether it can improve cognitive functioning among patients with MS. Outpatients of the MS Center of the Radboud University Medical Center (Radboudumc) were invited to participate in an MBSR training. Psychological and cognitive measures were administered pre- and post-intervention. Twenty-five MS patients completed the MBSR training and psychological measures, of which 16 patients completed the cognitive tests. Significant improvements were found in depressive symptoms, quality of life, fatigue, mindfulness skills, and self-compassion. Of the cognitive tests, performance on a visual spatial processing test significantly improved after the intervention. Overall, this pilot study showed promising results of the effects of MBSR on reducing psychological distress, and it suggests MBSR might improve cognitive functioning in MS patients. Future randomized controlled trials should be conducted to confirm the possible effectiveness of MBSR—and its long-term effects—on psychological and cognitive functioning in MS patients.

Trait Mindfulness and Wellness in Multiple Sclerosis

“…Mindfulness-based interventions have been incorporated into complimentary alternative medical treatment programs for PLWMS and are now recommended in the NICE guidelines for MS. After completing a course in Mindfulness Based Stress Reduction, PLWMS experience increased QoL, fewer depressive symptoms and less fatigue. 9 Current data document clear associations among mindfulness sub-facets and factors affecting HRQoL. Specifically, the ability to act with awareness, maintenance of an open and non-judgemental perspective and the ability to describe experience demonstrate potential for influencing HRQoL, mood, perceived cognitive deficits and fatigue.…”

Impact of mindfulness-based stress reduction for people with multiple sclerosis at 8 weeks and 12 months: A randomized clinical trial

“…Mindfulness-based interventions have shown benefit for a variety of symptoms associated with MS (anxiety, depression, pain, fatigue, physical function)(6,7); but their use with MS populations has been limited. Of the mindfulness-based intervention studies that have been conducted in MS, all have suggested the potential for improvements in emotional wellbeing, including anxiety, depression, stress, and mental health quality of life (8)(9)(10)(11)(12)(13)(14)(15). However, to date, only one trial has used an active control and was conducted with MS patients with depression; Carletto et al and showed that the mindfulness intervention was associated with reduced Beck Depression Scores at 6 months (16).…”

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

“…To date, the feasibility of MBIs as an intervention for MS patients has been demonstrated in several studies (see Table 1 ). The studies comprised different types of MS patients, and incorporated a variety of MBIs, including even telemedicine, Skype, and/or online training (Grossman et al, 2010 ; Senders et al, 2014 ; Bogosian et al, 2015 ; Kolahkaj and Zargar, 2015 ; Frontario et al, 2016 ; Nejati et al, 2016 ; Blankespoor et al, 2017 ; Gilbertson and Klatt, 2017 ; Hoogerwerf et al, 2017 ; Simpson et al, 2017 ). 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 ).…”

“…There is some evidence to support positive effects of MBIs on cognition, including selective and executive attention, working memory, executive functions and cognitive flexibility, in healthy subjects (extensively reviewed by Chiesa et al, 2011 ). The effect of MBIs on cognition in MS patients has not been studied extensively, albeit its effect was explored in a number of pilot studies with variable results (Frontario et al, 2016 ; Blankespoor et al, 2017 ; Simpson et al, 2017 ). The first assessed the effects of a telemedicine mindfulness intervention in patients with MS in a randomized-controlled way and found that the Symbol Digit Modalities Test (SDMT) improved more in MS patients who underwent the intervention as compared to the control group who only had a one-time instruction (Frontario et al, 2016 ).…”

“…In agreement with previous findings, significant improvements were found in depressive symptoms, QoL and fatigue. Moreover, improvement on a visual spatial processing test was reported after the intervention (Blankespoor et al, 2017 ). Also, Grossman et al ( 2010 ) studied cognitive function, although this was not a primary nor key secondary outcome.…”