A new study from Switzerland suggests that learning mindfulness meditation eased fatigue, depression and quality of life for multiple sclerosis (MS) patients compared with patients who received standard medical care.

The study was the work of Dr Paul Grossman, of the Department of Psychosomatic Medicine, in the Division of Internal Medicine at the University of Basel Hospital, and colleagues, and is published in the 28 September issue of Neurology, the medical journal of the American Academy of Neurology.

Grossman and colleagues recruited 150 patients with relapsing-remitting or secondary progressive multiple sclerosis, and randomly assigned them to receive either standard medical care (74 patients) or undergo eight weeks of training in mindfulness meditation (76 patients).

The mindfulness training comprised weekly classes of 2.5 hours, an all-day retreat, and 40 minutes per day of personal practice.

The approach of mindfulness meditation trains a person to develop non-judgemental awareness of the present moment, such as focusing the attention on sensory information rather than what it means. Thoughts of a judgemental nature, triggered memories and worries about the future, are nudged aside as attention is devoted to “here and now” sensations and messages.

The results showed that the patients who underwent the training had improved quality of life and reduced fatigue and depression after the course and also at a six-month follow up, compared to their counterparts who only received the standard medical care.

Very few patients pulled out of the training before it finished (only 5 per cent), and those who completed it improved on nearly every measure of fatigue, depression (symptoms of depression went down by over 30 per cent), and quality of life, whereas the patients who received the standard medical care declined slightly on most measures.

Some of the biggest improvements in the mindfulness group was among the 65 per cent or so patients who showed the highest levels of depression or fatigue before they started the course. By the end of the course this risk group had reduced by a third, and the proportion was sustained at the six-month follow up.

The other benefits of the mindfulness training were also still there at the six-month follow up, although in some cases the levels were lower than they were right after the end of the course. In the case of fatigue however, the results showed the reductions at the end of the course were at the same levels six months later.

In an accompanying editorial, Drs Jinny Tavee and Lael Stone of the Cleveland Clinic, Ohio, US, wrote that because the study did not compare the mindfulness group against another active group (using a different type of intervention), we cannot be certain that the benefits accrued specifically as a result of mindfulness training.

However, they did point out that this was the largest study of its type, it was well conducted and “solidly designed”, and it underlined the importance of directing treatment at quality of life issues in patients with MS.

The authors said the evidence supportrd the idea that patients with other chronic disorders that impair quality of life may also benefit from mindfulness training.

Grossman said in a statement that fatigue, depression, anxiety and impaired quality of life are common consequences of having MS:

“People with MS must often confront special challenges of life related to profession, financial security, recreational and social activities, and personal relationships, not to mention the direct fears associated with current or future physical symptoms and disability.”

But unfortunately, he explained, the treatments that help slow the disease have little effect in these areas.

“So any complementary treatments that can quickly and directly improve quality of life are very welcome,” he added.

He also explained that MS is an upredictable disease, where people can go for months feeling good and then have a relapse that stops them working or taking care of their family.

“Mindfulness training can help those with MS better to cope with these changes,” said Grossman.

“Increased mindfulness in daily life may also contribute to a more realistic sense of control, as well as a greater appreciation of positive experiences that continue be part of life,” he added.

“MS quality of life, depression, and fatigue improve after mindfulness training: A randomized trial.”
P. Grossman, L. Kappos, H. Gensicke, M. D’Souza, D.C. Mohr, I.K. Penner, and C. Steiner.
Neurology, Volume 75, Issue 13 : pp 1141-1149, published 28 September 2010.

Additional sources: American Academy of Neurology, .

Written by: Catharine Paddock, PhD