TY - JOUR
T1 - A randomized trial of stress management for the prevention of new brain lesions in MS
AU - Mohr, David C.
AU - Lovera, Jesus
AU - Brown, Ted
AU - Cohen, Bruce
AU - Neylan, Thomas
AU - Henry, Roland
AU - Siddique, Juned
AU - Jin, Ling
AU - Daikh, David
AU - Pelletier, Daniel
N1 - Funding Information:
D. Mohr receives research funding from the NIH. J. Lovera has honoraria for consulting and speaking from Biogen Idec, Serono, and Teva. T. Brown has served as a consultant for Acorda, Biogen, EMD Serono, and Teva Neuroscience and has received honoraria from Acorda, Pfizer, and Teva and has been funded by research grants from Lilly Inc., Acorda, and Teva Neuroscience. B. Cohen has received payments for consulting or speaking honoraria from Accorda, Astellis, Bayer, Biogen-Idec, EMD Serono, Genentech, Novartis, Pfizer, and Teva Neuroscience. He has received research support through Northwestern University from Biogen-Idec, EMD Serono, Novartis, Roche, and an Unrestricted Educational Grant in support of a CME program (through Northwestern University) from Teva Neuroscience. T. Neylan has received research support (supply of investigative medication) from Actelion and Glaxo Smith Kline. R. Henry, J. Siddique, L. Jin, and D. Daikh report no disclosures. D. Pelletier receives research support from the National Institutes of Health, NINDS ( R01NS062885 ). Go to Neurology.org for full disclosures.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2012/7/31
Y1 - 2012/7/31
N2 - Objectives: This trial examined the efficacy of a stress management program in reducing neuroimaging markers of multiple sclerosis (MS) disease activity. Methods: A total of 121 patients with relapsing forms of MS were randomized to receive stress management therapy for MS (SMT-MS) or a wait-list control condition. SMT-MS provided 16 individual treatment sessions over 24 weeks, followed by a 24-week post-treatment follow-up. The primary outcome was the cumulative number of new gadolinium-enhancing (Gd+) brain lesions on MRI at weeks 8, 16, and 24. Secondary outcomes included new or enlarging T2 MRI lesions, brain volume change, clinical exacerbation, and stress. Results: SMT-MS resulted in a reduction in cumulative Gd+ lesions (p = 0.04) and greater numbers of participants remained free of Gd+ lesions during the treatment (76.8% vs 54.7%, p = 0.02), compared to participants receiving the control treatment. SMT-MS also resulted in significantly reduced numbers of cumulative new T2 lesions (p = 0.005) and a greater number of participants remaining free of new T2 lesions (69.5% vs 42.7%, p = 0.006). These effects were no longer detectable during the 24-week post-treatment follow-up period. Conclusions: This trial indicates that SMT-MS may be useful in reducing the development of new MRI brain lesions while patients are in treatment. Classification of evidence: This study provides Class I evidence that SMT-MS, a manualized stress management therapy program, reduced the number of Gd+ lesions in patients with MS during a 24-week treatment period. This benefit was not sustained beyond 24 weeks, and there were no clinical benefits.
AB - Objectives: This trial examined the efficacy of a stress management program in reducing neuroimaging markers of multiple sclerosis (MS) disease activity. Methods: A total of 121 patients with relapsing forms of MS were randomized to receive stress management therapy for MS (SMT-MS) or a wait-list control condition. SMT-MS provided 16 individual treatment sessions over 24 weeks, followed by a 24-week post-treatment follow-up. The primary outcome was the cumulative number of new gadolinium-enhancing (Gd+) brain lesions on MRI at weeks 8, 16, and 24. Secondary outcomes included new or enlarging T2 MRI lesions, brain volume change, clinical exacerbation, and stress. Results: SMT-MS resulted in a reduction in cumulative Gd+ lesions (p = 0.04) and greater numbers of participants remained free of Gd+ lesions during the treatment (76.8% vs 54.7%, p = 0.02), compared to participants receiving the control treatment. SMT-MS also resulted in significantly reduced numbers of cumulative new T2 lesions (p = 0.005) and a greater number of participants remaining free of new T2 lesions (69.5% vs 42.7%, p = 0.006). These effects were no longer detectable during the 24-week post-treatment follow-up period. Conclusions: This trial indicates that SMT-MS may be useful in reducing the development of new MRI brain lesions while patients are in treatment. Classification of evidence: This study provides Class I evidence that SMT-MS, a manualized stress management therapy program, reduced the number of Gd+ lesions in patients with MS during a 24-week treatment period. This benefit was not sustained beyond 24 weeks, and there were no clinical benefits.
UR - http://www.scopus.com/inward/record.url?scp=84866069919&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84866069919&partnerID=8YFLogxK
U2 - 10.1212/WNL.0b013e3182616ff9
DO - 10.1212/WNL.0b013e3182616ff9
M3 - Article
C2 - 22786596
AN - SCOPUS:84866069919
VL - 79
SP - 412
EP - 419
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 5
ER -