Short-and Long-Term Impact of Mindfulness-Based Stress Reduction for People with MS: A Randomized Clinical Trial

Background: People with MS have an increased risk of stress-related emotional disorders. Mindfulness training is often used as a therapeutic intervention to manage stress and enhance emotional wellbeing, yet few trials exist for MS and few have used an active control.

Objectives: To assess the feasibility of mindfulness-based stress reduction (MBSR) for people with MS, evaluate preliminary clinical efficacy of MBSR compared to a time and attention control, and explore the durability of outcomes over a 12-month follow-up. 

Methods: We conducted a single-blind, randomized, parallel group intervention of MBSR (n=33) vs. education control (n=29) for adults with any type of MS and Expanded Disability Status Scale ≤ 8.0. Primary outcomes included perceived stress and emotional wellbeing. Exploratory outcomes included resilience, the Paced Auditory Serial Addition Test 3’, and PROMIS measures of anxiety, depression, fatigue, and pain interference. Primary assessments were made at baseline, post-intervention (8 weeks), and 12 months after completion of the intervention.  Intention to treat analyses of mean within-group and between-group effects from baseline to 8 weeks and baseline to 12 months were assessed by paired t-tests and analyses of covariance, respectively.

Results: Both groups experienced significant within-group average reductions in perceived stress at 8 weeks (MBSR: -5.29 points, 95% CI -2.46, -8.12; Education: -3.89 points, 95% CI: -1.9, -5.86) and at 12 months. Emotional wellbeing significantly improved for both groups at 8 weeks (MBSR: 11.74 points, 95% CI: 4.50, 18.98; Education: 9.14 points, 95% CI: 3.36, 14.93), but changes were no longer significant at 12 months. No significant between-group differences were found at either time point. Most secondary outcomes were significant for within-group change at 8 weeks and 12 months but were not significantly different in between-group comparisons.  

Conclusions: Both MBSR and group education led to short- and long-term improvements in mental wellbeing, providing high impact for relatively short interventions. Findings suggest that a variety of activities may lead to stress-reduction, and that social engagement is a potential mechanism of change worth further exploration. This study is registered at www.clinicaltrials.gov, NCT02340754.