Mindfulness Training Seen to Aid Cognitive, Emotional Well-being in Pilot Study

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by Patricia Inacio, PhD |

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Four weeks of mindfulness meditation helped to improve thinking skills and a sense of emotional balance in people with multiple sclerosis (MS), and to a greater extent than cognitive training given to a separate patient group, a pilot clinical trial reports. 

These results were detailed in two studies,“Mindfulness training for emotion dysregulation in multiple sclerosis: A pilot randomized controlled trial,” published in the journal Rehabilitation Psychology, and “Effects of 4-week mindfulness training versus adaptive cognitive training on processing speed and working memory in multiple sclerosis” published in the journal Neuropsychology

Both studies were led by Ruchika Shaurya Prakash, PhD, an associate professor of psychology at The Ohio State University, and funded by a National MS Society award given to Prakash, the society reported in a news release.

Estimates show that, compared to the general population, people with MS have significantly higher rates of depression and anxiety, and these emotional changes negatively affect both cognition (thinking and memory abilities) and quality of life. 

Researchers are looking for better ways to help patients address these mental health issues. 

A research team led by Prakash explored the therapeutic benefits of mindfulness with MS patients in a pilot trial. Mindfulness is a type of meditation that focuses on perceptions, by generating awareness and acceptance of moment-to-moment experiences. The technique aims to lessen reactions to pain or distress caused by changes in a patient’s health. 

The study (NCT02717429) randomized 61 patients to three groups: one was given four weeks of mindfulness-based training (MBT), another four weeks of adaptive computerized cognitive training (aCT), and the final group served as controls on a waiting list. 

Mindfulness practice consisted of two hours of in-person sessions each week, and homework assignments performed daily for 40 minutes. Exercises included breathing awareness, body scanning, and sitting meditation. Participants were asked to focus on thoughts, emotions, and sensations. 

Two hours of weekly in-person sessions, and 40 minutes of daily homework were also given patients in the aCT group.  Cognitive training homework consisted of reading and video games exercises focused on processing speed, attention, working memory, and executive function.

Cognitive impairment, namely in processing speed and working memory, were evaluated using the Brief Repeatable Battery of Neuropsychological Test (BRB-N), Symbol Digit Modalities Test (SDMT), and the Paced Auditory Serial Addition Test (PASAT) before and after the training program. 

Mindfulness training was seen to significantly improve processing speed compared to both the aCT and control groups. 

Greater gains in working memory were also observed in the MBT group and linked to changes in awareness. Measures of cognition taken at the study’s start (baseline measures) did not seem to influence changes in processing speed or working memory.

Among patients in the aCT group, practice time and level of game difficulty were not associated with cognitive gains.

Emotional control was evaluated using self-reported and behavioral measures. Researchers observed that compared to control and aCT group patients, those given mindfulness training showed a greater ability to regulate their emotions. 

“Mindfulness training was associated with reduced emotion dysregulation compared with the adaptive cognitive training and the waitlist control group,” the researchers wrote.

Feelings of worry and acts of rumination, or repeatedly thinking about problems or fears to the point of paralysis, were also lesser in the mindfulness training group compared to patients in the control group.

Results showed no differences in approaches used to regulate emotions, or in overall quality of life between the groups. 

These findings suggest that lifestyle, behavioral, and psychosocial approaches such as mindfulness can be important tools to promote emotional and cognitive health in MS patients. 

“Our pilot study provides preliminary support for MBT to reduce self-reported emotion dysregulation in PwMS [people with MS]. Given the widespread prevalence of mental health disturbances in this population, MBT can serve as a promising rehabilitation tool for PwMS,” the researchers wrote.

They noted, however, that “given the pilot nature of this study, it is important for future, well-powered trials to investigate these effects using multiple measures of the same construct and assess potential mechanisms of training-related gains.”

Prakash is offering free mindfulness webinars via Ohio State’s Clinical Neuroscience Lab through June 10 to assist people during the COVID-19 pandemic.

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