People with multiple sclerosis (MS) who underwent the four-week mindfulness training not only improved more compared to those who did nothing – they also improved compared to those who tried another treatment, adaptive cognitive training.
"This was a small pilot study, so we need to replicate the results, but these findings were very encouraging," said Ruchika Prakash, corresponding author of the research and associate professor of psychology at The Ohio State University. "It is exciting to find a treatment that may be helpful in more than one way for people with multiple sclerosis."
Multiple sclerosis is the most common neurological disease in young adults and is estimated to affect nearly 1m people in the US. It damages the central nervous system and can lead to a variety of physical, emotional and cognitive problems.
The study involved 61 people with MS who were placed in one of three groups: four-week mindfulness training, four-week adaptive cognitive training, or a waitlist control group that did nothing during the study period, but received treatment afterward.
Mindfulness-based training involves practicing paying attention to the present moment in a non-judgmental and accepting manner, Prakash said. Among the practices in the sessions, participants learned how to focus on the breath and to do mental "body scans" to experience how their body was feeling.
In the primary analysis of the study, led by former doctoral student Brittney Schirda, the researchers wanted to find out if mindfulness training helped multiple sclerosis patients deal with a common component of the disease: problems regulating their emotions.
"Studies suggest that 30% to 50% of MS patients experience some form of psychiatric disorder," Prakash said. "Anything we can do to help them cope is important for their quality of life."
Study participants completed a measure of emotional regulation at the beginning and end of the study. They were asked how much they agreed with questions like "When I'm upset, I lose control over my behaviour" and "I experience my emotions as overwhelming and out of control."
Results showed that people in the mindfulness training group reported they were more able to manage their emotions at the end of the study when compared to those in the other two groups.
This included the group that received adaptive cognitive training (ACT), which has shown promise for MS patients in other studies. This ACT programme used computerised games to help MS patients overcome some of their cognitive deficits that make every-day functioning more difficult, such as problems with paying attention, switching focus, and planning and organising.
"Our results provide promising evidence that mindfulness training can help MS patients deal with their emotions in a more constructive and positive way," Prakash said. In a secondary analysis of the same study, led by doctoral student Heena Manglani, participants were assessed on their processing speed and working memory, two cognitive functions that often decline in MS patients. They also completed additional measures of cognitive functioning.
Processing speed is the time it takes a person to complete mental tasks and is related to how well they can understand and react to the information they receive.
Findings showed that after four weeks of mindfulness training, MS patients showed significantly improved processing speed based on the tests used in the study – more so than those in the other two groups.
"This is an exciting finding because processing speed is a core cognitive domain impacted in multiple sclerosis," Prakash said. "We were somewhat surprised that this training intervention that we thought would mostly impact emotion regulation also enhanced processing speed."
Gains in working memory were similar in all three groups and there were no mindfulness-specific changes in other measures of cognitive functioning. One of the reasons that mindfulness training is so promising is because it is an easily accessible treatment for all patients.
"Anyone can use mindfulness – even individuals with limited mobility, who often find other training techniques, like exercise training, to be more challenging," Prakash said. Prakash and her team are now working on replicating this pilot study with a larger sample.
Rehabilitation Psychology abstract
Objective: People with multiple sclerosis (PwMS) report greater emotion dysregulation, which is associated with increased symptoms of depression and anxiety, and reduced quality of life. Given the transdiagnostic significance of emotion dysregulation, the current study was designed to assess the feasibility and treatment effects of mindfulness meditation in reducing emotion dysregulation for PwMS.
Method: Sixty-one PwMS were randomized to 1 of 3 groups: 4-week mindfulness-based training (MBT), 4-week adaptive cognitive training (aCT), or a waitlist control group. Using self-report and behavioral measures, we examined the effects of MBT on emotion dysregulation, use of emotion regulation strategies, experience of negative and positive affect, and overall quality of life.
Results: Mindfulness training was associated with reduced emotion dysregulation compared with the adaptive cognitive training and the waitlist control group (ηp² = .20). Relative to the waitlist group, the MBT group also demonstrated reductions on a composite score of preservative cognition, measuring rumination and worry (ηp² = .15). However, there was no differential use of emotion regulation strategies or between-groups differences in overall quality of life as a function of training.
Conclusions: Our pilot study provides preliminary support for MBT to reduce self-reported emotion dysregulation in PwMS. Given the widespread prevalence of mental health disturbances in this population, MBT can serve as a promising rehabilitation tool for PwMS.
Authors
Schirda, Brittney; Duraney, Elizabeth; Lee, H Kyu; Manglani, Heena R; Andridge, Rebecca R; Plate, Andre; Nicholas, Jaqueline A; Prakash, Ruchika Shaurya
Neuropsychology abstract
Objective: The aim of this pre-registered, secondary analysis of a pilot randomized controlled trial (NCT02717429) was to compare the impact of 4-week mindfulness-based training and adaptive cognitive training, with a waitlist control condition, on processing speed and working memory in people with multiple sclerosis (PwMS).
Method: Sixty-one PwMS were randomized to mindfulness-based training (MBT), adaptive computerized cognitive training (aCT), or a waitlist (WL) control group and completed the Brief Repeatable Battery of Neuropsychological Tests at pre- and posttraining. Training-related changes on the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT) were the primary outcomes of interest. Baseline cognitive status was examined as a moderator of treatment gains. Practice time, change in aCT game difficulty, and rate of change in state awareness across MBT were assessed as correlates of cognitive gains.
Findings: Compared with aCT and WL, mindfulness training significantly improved processing speed (ηp² = .14). Baseline cognitive status did not moderate change in processing speed (ηp² = .005) or working memory (ηp² = .014). Practice time and change in game difficulty were not significantly correlated with cognitive gains (all ps > .49). In the MBT group, rate of change in awareness was significantly associated with improvement in working memory (ρ = .52, p = .04).
Conclusions: In PwMS, 4 weeks of mindfulness meditation training improved processing speed above and beyond aCT and WL. More rapid change in awareness during mindfulness training may be associated with greater gains in working memory.
Authors
Manglani, Heena R; Samimy, Shaadee; Schirda, Brittney; Nicholas, Jacqueline A; Prakash, Ruchika Shaurya
[link url="https://news.osu.edu/mindfulness-training-shows-promise-for-people-with-ms/"]OSU material[/link]
[link url="https://psycnet.apa.org/search/display?id=17775686-b703-0827-6937-2af469264e62&recordId=1&tab=PA&page=1&display=25&sort=PublicationYearMSSort%20desc,AuthorSort%20asc&sr=1"]Rehabilitation Psychology abstract[/link]
[link url="https://psycnet.apa.org/search/display?id=6a2e36ea-61de-ea6d-87e8-656b16895933&recordId=1&tab=PA&page=1&display=25&sort=PublicationYearMSSort%20desc,AuthorSort%20asc&sr=1"]Neuropsychology abstract[/link]