OBJECTIVES: This trial examined the efficacy of a stress management program in reducing neuroimaging markers of MS disease activity.
METHODS: A total of 121 MSers 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. This benefit was not sustained beyond 24 weeks, and there were no clinical benefits .Trial registration:ClinicalTrials.gov, number NCT00147446.
“Interesting? Who would have thought that reducing stress would have had an impact on MS disease activity? These results would need to be reproduced; the trial is relatively small (121 MSers) and could be a false positive. Nevertheless this is something that needs to be looked into in more detail. Who is up for stress management therapy?”