Mindfulness Interventions May Boost MS Patient Outcomes

By Richard Mark Kirkner

Mindfulness-based interventions such as day wellness programs have the potential to improve mood and overall emotional awareness in people with multiple sclerosis (MS), according to preliminary results of two small, early-phase studies presented at the 2020 virtual meeting of the Consortium of Multiple Sclerosis Centers.

A pilot study of 25 subjects with newly diagnosed relapsing MS, 16 of whom participated in a 10-week mindfulness-based intervention (MBI) in London, Ont., reported that participants afterward had improved measures for coping, depression, and stress.

A longer-term study of 48 participants who took a 6-week mindfulness course in Sacramento found 2-year patient-reported outcomes correlated with 1-year outcomes, although the 6-week course had to be shut down because of the COVID-19 outbreak.

10-week mindfulness-based intervention

The Ontario study compared patient scores in a variety of wellness metrics between the 16 patients who participated in the MBI and 9 controls randomized to standard of care alone. The key inclusion criteria was a new diagnosis of relapsing MS in the past year. Twelve patients in the MBI group completed the study while all nine controls did. Primary outcomes included patient scores on the Brief COPE scale, a self-reported measure of coping strategies, and the Hospital Anxiety and Depression Scale (HADS).

“The MBI group improved significantly on the COPE measure when compared with the control group (= .024) as well as on the HADS depression subscale (P = .007) pre- and post intervention,” wrote Sarah A. Morrow, MD, MS, of the London (Ont.) Health Sciences Center, and colleagues, in describing the post-MBI results. However, the study found no significant difference between the two groups over time on the HADS anxiety subscale (P = .179).

The study also evaluated secondary outcomes, including measures of perceived stress, cognitive function, fatigue, and quality of life. After the intervention, the study found significant improvement on the Perceived Stress Scale
(P = .015) and “a trend towards improvement” on the Short Form–36 quality-of-life scale (P = .073) and MS Neuropsychological Screening Questionnaire (P = .066), Dr. Morrow and colleagues reported.

“This pilot study demonstrates that an MBI improves coping, depression and perceived stress in newly diagnosed persons with relapsing MS,” Dr. Morrow and colleagues stated.

Top image credit: Benjavisa Ruangvaree Art/Shutterstock

6-week mindfulness course

The study at the MS Achievement Center (MSAC) of Dignity Health in Citrus Heights, Calif., aimed to evaluate patient-reported outcomes of MS patients who participated in a 6-week mindfulness course that addressed emotional wellness. The participants were asked to complete four outcome measures in January 2020 as part of the annual participation in the MSAC programs. Those measures included the MS Impact Scale–29 (MSIS-29), MS Self-Efficacy Scale (10 items, MSSE), Godin Leisure-Time Exercise Questionnaire that measures physical activity in the previous week (GTLEQ), and Quality of Life in Neurological Disorders (Neuro-QoL) that measures and monitors the physical, mental, and social effects of neurologic conditions.

“One-year and 2-year comparison data of patient-reported outcomes from MSAC members have indicated correlations between self-efficacy, anxiety, ability to participate and positive affect [per MSSE and Neuro-QoL],” wrote Tiffany Malone, MSW, MSCS, and colleagues. “Additionally, increased MSIS-29 scores directly correlate with anxiety while inversely correlating with self-efficacy and GTLEQ.”

Ms. Malone and colleagues also noted that mean depression scores, reported from the Neuro-QoL measure, were unchanged over a 2-year reporting period, but the comparisons didn’t specifically measure the patients’ participation in the mindfulness course.

“Due to the COVID-19 pandemic, the MS Achievement Center was, unfortunately, forced to close all in-person programming, and the 6-week mindfulness course was not able to be completed,” Ms. Malone said in an interview. “ Therefore, follow-up data is not available.”

Dr. Morrow disclosed relationships with Biogen, Novartis, Celgene, EMD Serono, Roche, and Sanofi Genzyme. Ms. Malone has no relationships to disclose.
Dr. Tiffany Malone