Research papers – stress management and multiple sclerosis

Stress management and multiple sclerosis

Paper: Do positive or negative stressful events predict the development of new brain lesions in people with multiple sclerosis? 

Journal: Psychol Med. 2014 Jan;44(2):349-59. 

Description: This study looked at whether different types of stressful events and perceived stress can predict brain lesion development in people with MS. The data was taken from a randomized controlled trial of 121 MS patients. The participants in the intervention group took part in Stress Management Therapy for MS and were tracked for 48 weeks. Every month, participants were asked to report stressful life events and rate their perceived levels of stress, anxiety and depression. MRI scans were carried out every eight weeks. The study found that there was an increased risk of developing new brain lesions on MRIs 4-9 weeks after a reported negative life event.  

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

Journal: Mult Scler. 2019, 25;4:610-617 

Description: In this randomized controlled trial, 139 participants were assigned to receive either an MS-specific online mindfulness meditation intervention or a psychoeducation intervention (the ‘control’ group). The researchers measured quality of life, depression, anxiety, sleep and fatigue. The mindfulness meditation group reported higher quality of life and lower depression, anxiety, and sleep problems at the end of intervention, compared to the control group. The authors suggest that mindfulness-based interventions could be effective for treating psychological problems in people with MS, although the results were not sustained after six months.  

Paper: Symptoms of post-traumatic stress disorder are common after being diagnosed with multiple sclerosis

Journal: Journal of Neurology, Neurosurgery & Psychiatry 2022, 93: A139-A140 

Description: The data for this study was taken from an online survey. Respondents were 1079 people with MS, most of whom were female (78%), with an average age of 48.3 years, and an average disease duration of 15.7 years. Over half of the respondents (58.1%) reported post-traumatic stress disorder (PTSD) type symptoms related to their MS. The way people received their diagnosis from a healthcare professional was identified as a significant trigger for PTSD symptoms.  

Paper: 8-week Mindfulness Based Stress Reduction induces brain changes similar to traditional long-term meditation practice – A systematic review 

Journal: Brain Cogn. 2016, 108:32-41 

Description: The studies included in this review had all looked at the effects of 8-week Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT) programs. Twenty-one fMRI studies and seven MRI studies were included. MRI and fMRI are types of scans used to take detailed images of the structure and functions of the brain. The review found strong evidence that MBSR and MBCT can lead to functional and structural changes in several areas of the brain, including changes in the amygdala linked to better emotional regulation.  

 Paper: Meditation programs for psychological stress and well-being: a systematic review and meta-analysis 

Journal: JAMA Intern Med. 2014, 174;3:357-68 

Description: This large study pooled the data from 47 randomized controlled trails with 3,320 participants with clinically diagnosed health conditions. The researchers found good evidence that mindfulness meditation programs can improve anxiety, depression and pain. There was also some less strong evidence to show that mindfulness meditation can improve stress and mental health-related quality of life.   

Paper: Associations among stressors across the lifespan, disability, and relapses in adults with multiple sclerosis 

Journal: Brain Behav. 2023,13:7:e3073 

Description: The data for this study came from a survey of 713 adults with MS. The survey measured the frequency and severity of self-reported life stressors such as such as neglect, poverty and divorce, and level of disability. The results showed that both childhood stressors (occurred before age 18) and adult stressors significantly contributed to level of disability. The authors suggest that the findings may inform conversations between healthcare professionals and people with MS around the importance of stress reduction techniques for improved clinical outcomes.  

 Paper: A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation 

Journal: Brain Behav Immun. 2013, 27;1:174-84 

Description: In this randomized controlled trial, 49 participants were assigned to either a mindfulness-based stress reduction (MBSR) group or to a Health Enhancement Program (HEP). Stress was induced via the Trier Social Stress Test (TSST), which creates stress by asking participants to give an interview-style presentation. Inflammation was created by putting an irritant on participants’ skin. The results showed that participants in both groups had self-reported reductions in distress and physical symptoms post-intervention. However, the MBSR training resulted in “a significantly smaller post-stress inflammatory response compared to HEP, despite equivalent levels of stress hormones.” The authors conclude that interventions such as MBSR may be beneficial in people with chronic inflammation.  

 Paper: Effects of Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Stress Reduction (MBSR) on symptoms and emotional competencies in individuals with multiple sclerosis 

Journal: Mult Scler Relat Disord. 2022, 67:104029 

Description: In this randomized controlled trial, 76 people with MS were assigned to either an 8-week Acceptance and Commitment Therapy group (ACT; a psychological therapy focussed on acceptance of emotions and commitment to make change), an 8-week Mindfulness-Based Stress Reduction (MBSR) treatment, or a wait-list control condition. After eight weeks, people in the MBSR and ACT groups had bigger improvements in MS symptoms than those in the control group. Improvements were seen in insomnia, fatigue, paresthesia (abnormal skin sensations), and skills around recognising and managing emotions.  

 Paper: Stress-induced brain activity, brain atrophy, and clinical disability in multiple sclerosis 

Journal: Proc Natl Acad Sci U S A. 2016, 22;113(47):13444-13449 

Description: In this study, the researchers used brain scans (fMRI) to see how the brains of people with MS and healthy controls reacted during a stressful mental task. The study found that in the MS group, people whose brains were more active during stress had less grey matter atrophy (brain shrinkage) and less physical disability. However, they also noted some similar stress-induced activity and grey matter atrophy in controls suggesting that MS is not the sole cause of these outcomes.  

Paper: How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing 

Journal: Front Hum Neurosci. 2018, 7;12:353 

Description: This review pooled the data from 15 studies to look at the mind-body effects of slow breathing techniques.  The review found that slow breathing techniques can enhance “autonomic, cerebral and psychological flexibility”. In turn, this can lead to positive changes such as increased feelings of comfort and relaxation, and reduced negative symptoms such as  anxiety and depression.