Researchers conducted a study to examine the effects of mindfulness-based stress reduction (MBSR) on psychological, biological, and MRI measures in individuals with multiple sclerosis (MS). The study aimed to investigate the hypothesis that MBSR could regulate systemic and central nervous system inflammation by exerting top-down neurocognitive control over the forebrain limbic regions responsible for the neurobiological stress response.
The individuals diagnosed with MS were provided with an 8-week MBSR program at no cost. The volunteers participated in assessments before and after the course, which involved evaluating patient-reported outcomes (PROs), hair cortisol levels, blood-based markers of inflammatory gene expression, and structural MRI scans. The conserved transcriptional response to adversity (CTRA) score, representing a combination of inflammation, interferon response, and immunoglobulin expression, was calculated using 53 predetermined blood gene expression markers. The MRIs utilized 1.0-mm isotropic T1-weighted and fluid-attenuated inversion recovery imaging protocols, and the data were analyzed using the longitudinal CAT12 structural pipeline, including subcortical and cortical atlas parcellations.
The study involved 23 participants with relapsing-remitting MS. The median age of the participants was 45 (± 11), and all were female. Their Expanded Disability Status Scale (EDSS) scores averaged 2.0 (± 1.2). None of the participants experienced new clinical or MRI disease activity during the 12-week observation period. Approximately 57% of the participants were treated with B–cell–depleting agents. An overwhelming 91% of the participants completed the MBSR course. The results demonstrated improvements, with effect sizes greater than 0.8, in various PROs when comparing pre-and post-MBSR measures. These PROs encompassed stress, anxiety, depression, fatigue, loneliness, well-being, and interoceptive awareness. All exhibited significant enhancements (all P < .01). No notable changes were observed in average hair cortisol levels, structural MRI scans, or the CTRA associated with MBSR completion. However, utilizing mixed-effect analyses that accounted for age, race, body mass index, medical therapy, and time, it was found that alterations in inflammatory gene expression (CTRA, n = 12) correlated inversely with changes in patient-reported stress (P < .0001), loneliness (P = .002), hair cortisol (P = .01), and specific aspects of interoceptive awareness. Exploratory mixed-effect regression analyses employing parcellated MRI data (n = 17) revealed that higher CTRA values were associated with larger left (P = .02) and smaller right (P = .02) anterior insula cortical thickness. However, CTRA did not consistently demonstrate associations with other structural volumes in the limbic region.
MBSR exhibited significant improvements across multiple PROs, addressing the silent yet debilitating symptoms experienced by individuals with MS. Objective assessments of inflammatory and interferon gene expression substantiated these PROs and showcased correlations with insular volumes.
