From Our 2012 Archives
Stress Management May Prevent MS Brain Lesions
Multiple Sclerosis Patients Had Fewer New Brain Lesions During Treatment
By Salynn Boyles
Reviewed by Laura J. Martin, MD
Patients with multiple sclerosis who attended stress management therapy sessions for six months had fewer new brain lesions from disease flare-ups and slower disease progression during their treatment, Northwestern University researcher David C. Mohr, PhD, and colleagues found.
The findings, published in the July 11 issue of the journal Neurology, add to evidence that stress management can slow MS disease activity.
"People who got the stress management training had significant reductions in the incidence of new brain lesions while enrolled in the weekly sessions," Mohr tells WebMD.
But the improvement disappeared when the weekly sessions ended, suggesting that more sustained therapy may be needed, he says.
Stress Management and MS
Mohr says stress management therapy may be a useful addition to MS drugs. He has spent more than a decade researching the impact of depression and stress on MS progression.
The new study included 121 MS patients randomly assigned either to a stress management treatment group or to a group that got no stress management training.
The treatment group received 16 sessions delivered over a six-month period. Sessions focused on helping patients recognize and evaluate potentially stressful situations. They were also taught relaxation and meditation techniques to help them cope with stressful events that could not be avoided.
While the therapy sessions were under way, and for six months after the sessions ended, brain imaging was performed to identify new lesions associated with MS. The absence of new brain lesions is an important indication that an MS treatment is working.
During treatment, about half (55%) of patients who received the stress management therapy remained free of brain lesions, compared to 77% of patients who did not have the therapy.
And only 43% of the patients getting stress management therapy developed new brain lesions closely linked to disease activity, compared to 70% of patients in the non-therapy group.
The difference in new lesions was similar for patients who were and were not taking disease-modifying drugs to treat their MS.
'Focus on What You Can Control'
Mohr says the study was not large enough to prove that stress management therapy reduces MS symptoms.
"We don't know yet if this intervention translates into the clinical differences that are important to patients," he tells WebMD.
Diagnosed with MS in 2001, Michelle Clos doesn't need to wait for a bigger study.
Clos has practiced stress management for years and she now teaches strategies for coping with stress to other MS patients.
"When I was diagnosed, my doctor advised me to avoid stress, but gave me no tools to help me do that," she tells WebMD. "At first I tried to do everything, including working 60 hours a week to climb that corporate ladder. It took me about two years of feeling pretty terrible to recognize that I had to do things differently."
With the help of behavioral therapy, exercise, and meditation, Clos learned to focus on the things she could control and let everything else go.
"It wasn't easy," she says. "By nature I am an anxious person, but when I learned to let the worry go I began to feel better."
Psychologist and National MS Society spokesman Nicholas LaRocca, PhD, says patients need resources to help them deal with the stresses they face.
"Learning to deal with stress is important for all of us, and it is particularly important for people who have extra stress because of an MS diagnosis," he says.
LaRocca says although it remains to be seen if reducing stress can actually slow disease progression, it is clear that stress management can improve quality of life for patients with MS.
SOURCES: Mohr, D.C. Neurology, July 11, 2012. David Mohr, PhD, professor of preventive medicine, Northwestern Feinberg School of Medicine, Chicago. Nicholas LaRocca, PhD, vice president of healthcare delivery and policy research, National MS Society. Michelle Clos, MS patient and life coach, Dallas. News release: Northwestern University, Chicago.