A randomized trial of stress management for the prevention of new brain lesions in MS
| Autor: | Thomas C. Neylan, Juned Siddique, Bruce A. Cohen, Ling Jin, Ted Brown, David C. Mohr, Jesus Lovera, Daniel Pelletier, David I. Daikh, Roland G. Henry |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
Neurology Time Factors Exacerbation Gadolinium Neurodegenerative law.invention Disability Evaluation Randomized controlled trial law Single-Blind Method medicine.diagnostic_test Rehabilitation Articles Middle Aged Magnetic Resonance Imaging Treatment Outcome 6.1 Pharmaceuticals Neurological Biomedical Imaging Cognitive Sciences Female Adult medicine.medical_specialty Multiple Sclerosis Physiological Clinical Trials and Supportive Activities Clinical Sciences Stress Autoimmune Disease Clinical Research Stress Physiological Internal medicine Behavioral and Social Science medicine Humans Retrospective Studies Neurology & Neurosurgery Chi-Square Distribution Cognitive Behavioral Therapy business.industry Multiple sclerosis Prevention Neurosciences Evaluation of treatments and therapeutic interventions Magnetic resonance imaging Retrospective cohort study medicine.disease Surgery Brain Disorders Clinical trial Brain Injuries Neurology (clinical) business Chi-squared distribution Follow-Up Studies |
| Zdroj: | Neurology, vol 79, iss 5 |
| Popis: | 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. Trial registration: ClinicalTrials.gov, number NCT00147446. Neurology ® 2012;79:412–419 |
| Databáze: | OpenAIRE |
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