Mindfulness-based stress reduction (MBSR) is associated with improvements in patient-reported outcomes of silent symptoms of multiple sclerosis (MS), according to study results presented at the 2023 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held from May 31 to June 3 in Aurora, Colorado.
As a low-risk intervention, MBSR is suggested to be a suitable therapy for systemic inflammation and the debilitating “silent symptoms” of MS, according to researchers. For the study, the researchers sought to examine psychological, biological, and MRI changes associated with mindfulness-based stress reduction in MS.
The researchers conducted an observational, unblinded study with 23 volunteer patients with MS who were all offered 8 weeks of MBSR treatment. The median age of participants was 45±11, and all patients were women. The average Expanded Disability Status Scale (EDSS) score was 2.0±1.2. Of all participants, 91% completed the 8-week course.
Inflammatory markers such as hair cortisol, inflammatory-gene expression markers, and structural magnetic resonance imaging (MRI) data were collected with assessments of patient-reported outcomes at baseline and at the end of treatment.
The conserved transcriptional response to adversity (CTRA) score, which represents a combination of inflammation, interferon response, and immunoglobulin expression, was calculated using 53 prespecified inflammatory blood gene expression markers.
The MRIs included 1.0-mm isotropic T1-weighted and fluid-attenuated inversion recovery imaging protocols, and the data were analyzed via the longitudinal CAT12 structural pipeline, including subcortical and cortical atlas parcellations.
MBSR was associated with significant improvements (P <.01) in patient-reported outcomes of stress, anxiety, depression, fatigue, loneliness, well-being, and interoceptive awareness. CTRA scores, hair cortisol, and structural MRI data collected pre-MBSR treatment did not differ from the post. However, CTRA was found to be inversely correlated with patient-reported stress (P <.0001), loneliness (P =.002), and hair cortisol (P =.01) in mixed-effect analyses.
Similarly, in an exploratory mixed-effect regression with parcellated MRI data (n=17), the researchers found a higher CTRA was associated with a larger left (P =.02) and smaller right (P =.02) anterior insula cortical thickness. They noted that CTRA was not consistently associated with other limbic structural volumes.
The researchers concluded that “MBSR was associated with improvements in multiple PROs [patient-reported outcomes] of the debilitating silent symptoms in MS.”
This article originally appeared on Neurology Advisor
Hemond CC, Deshpande M, Morales IB, et al. An Unblinded Observational Study of Mindfulness-Based Stress Reduction in MS: MRI and Biological Inflammatory Correlates of Patient-Reported Outcomes. Abstract presented at CMSC 2023; May 31-June 3, 2023; Aurora, CO. Abstract IMG06.