Mindfulness Based Stress Reduction in Multiple Sclerosis (MS)
This study focuses on stress, cognition, mood and fatigue and its effect on medication compliance. Medication compliance is measured by the weight of discarded needles. The investigators will be administering neuropsychological testing at baseline and the final visit. The subjects will complete self-report assessments during their 8 weeks in the study.
Group A will have additional weekly phone support for meditation, while Group B will have meditation training only.
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Investigator)
Primary Purpose: Supportive Care
|Official Title:||Mindfulness Based Stress Reduction in MS|
- Electronic measure of needle disposals (MEMS TrackCaps) [ Time Frame: Medication adherence will be measured by total number of missed doses, calculated from total needle disposals. The total number of missed doses across the six weeks will be compared between the two treatment groups at study end. ]During the six-week MSBR program, medication adherence will be monitored with a widely used electronic measure of needle disposals (MEMS TrackCaps) This method has been demonstrated to be more accurate in MS than data obtained from either self-report or interview. At one month intervals the patient will bring the needle container to the Study Coordinator. All patients who attend at least introduction session and one telephone session will be included in the analysis.
- Perceived Stress Scale-10 [ Time Frame: Baseline, 1 X between weeks 3-7, Week 8 ]A 10-item scale of global perceived stress, where each item is rated from 1 to 5 according to intensity of stressor.
- Holmes and Rahe Social Readjustment Rating Scale (SRRS [ Time Frame: Baseline, 1 X between weeks 3-7, Week 8 ]Stressful life events will be rated using the SRRS, which asks subjects to check if they have experienced any of a series of life events. We will use a modification of the scale used in previous MS research that eliminates several items specifically associated with MS disease activity (e.g., "major illness or injury", "sexual difficulties", "pregnancy"). The SRRS differentiates three types of stress: positive ("outstanding personal achievement"), major negative stress (death of family member), conflict and disruption in routine (e.g., family or job conflict, life changes).
- Chicago Multiscale Depression Inventory (CMDI) [ Time Frame: Baseline, 1 X betweeen Weeks 3-7, Week 8 ]CMDI is a self-report questionnaire designed specifically for use in MS and other medical patient groups. It has vegetative, mood, and evaluative scales consisting of 14 items each. The use of the CMDI makes it possible to separate out neurovegetative symptoms of depression which are a potential confound in medical populations such as MS
- State Trait Anxiety Inventory (STAI) [ Time Frame: Baseline, 1 X betweeen Weeks 3-7, Week 8 ]The STAI is a widely used measure of state and trait anxiety. We will focus on the measurement of state related anxiety in this study.
- Positive and Negative Affect Scale (PANAS) [ Time Frame: Baseline, 1 X between Weeks 3 - 7, Week 8 ]; Watson, Clark & Tellegen, 1989): State related positive and negative affect will be assessed by the well validated PANAS scales.
- Fatigue Severity Scale (FSS) [ Time Frame: Baseline, 1 X between Weeks 3 - 7, Week 8 ]The fatigue severity scale is a reliable and valid commonly used measure of the frequent symptom of fatigue in MS.
- MACFIMS neuropsychological battery [ Time Frame: Baseline and Week 8 ]At baseline and study end, an abbreviated version of the MACFIMS will be administered. This is a standard neurocognitive battery used with studies of MS subjects and includes the SDMT, PASAT, SRT, BVMT, and 9-hole peg test.
- Expanded Disability Status Scale (EDSS) [ Time Frame: Baseline and Week 8 ]Expanded Disability Status Scale is the oldest and probably the most widely utilized assessment instruments in MS for determination of neurological impairment in MS. It is the standard for characterization of MS patients and for outcomes of clinical trials. It will be used to characterize patients' level of disability.
- Physiologic Markers of Stress [ Time Frame: Baseline and Week 8 ]DHEA, epinephrine, and norepinephrine.
- Physiologic Maker of Stress [ Time Frame: Baseline, 1 X between Week 3 - 7, Weeek 8 ]cortisol
|Study Start Date:||May 2011|
|Study Completion Date:||November 2014|
|Primary Completion Date:||April 2013 (Final data collection date for primary outcome measure)|
Behavioral: Mindfulness based stress reduction (MBSR)
Please refer to this study by its ClinicalTrials.gov identifier: NCT01419301
|United States, New York|
|Stony Brook University|
|Stony Brook, New York, United States, 11786-8121|
|Principal Investigator:||Lauren B Krupp, M.D.||Stony Brook University|