Improved quality of life and psychological symptoms following mindfulness and cognitive rehabilitation in multiple sclerosis and their mediating role for cognition: a randomized controlled trial.
Ilse M Nauta, Maureen Van Dam, Dirk Bertens, Roy P C Kessels, Luciano Fasotti, Bernard M J Uitdehaag, Anne E. M. Speckens, Brigit A De Jong
Journal of Neurology July 1, 2024 DOI: 10.1007/s00415-024-12327-y (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 99 |
| Population | Multiple sclerosis patients with cognitive complaints |
| Interventions | Mindfulness-based cognitive therapy Cognitive rehabilitation therapy |
| Duration | 8-week intervention, 6-month follow-up |
| Topics | Meditation |
| Keywords | Cognitive rehabilitation Multiple sclerosis Quality of life |
| Citations | 20 |
| Key findings | MBCT and CRT reduced depressive symptoms and improved mental quality of life in MS patients with cognitive complaints, with MBCT showing additional benefits on fatigue and brooding and some effects lasting six months. |
Abstract
Multiple sclerosis (MS) frequently gives rise to depressive and anxiety symptoms, but these are often undertreated. This study investigated the effect of mindfulness-based cognitive therapy (MBCT) and cognitive rehabilitation therapy (CRT) on psychological outcomes and quality of life (QoL), and whether they mediate treatment effects on MS-related cognitive problems. This randomized controlled trial included MS patients with cognitive complaints (n = 99) and compared MBCT (n = 32) and CRT (n = 32) to enhanced treatment as usual (n = 35). Baseline, post-treatment and 6-months follow-up assessments included patient-reported outcome measures (PROMS) and cognitive outcomes (self-reported and neuropsychological assessment). PROMS concerned psychological symptoms, well-being, QoL, and daily life function. Linear mixed models indicated intervention effects on PROMS and mediation effects of PROMS on cognitive outcomes. MBCT positively affected depressive symptoms (Cohen's d (d) = -0.46), fatigue (d = -0.39), brooding (d = -0.34), mindfulness skills (d = 0.49), and mental QoL (d = -0.73) at post-treatment. Effects on mindfulness skills remained significant 6 months later (d = 0.42). CRT positively affected depressive symptoms (d = -0.46), mindfulness skills (d = 0.37), and mental QoL (d = -0.45) at post-treatment, but not at 6-month follow-up. No effects on anxiety, well-being, self-compassion, physical QoL, and daily life function were found. Treatment effects on self-reported, but not objective, cognition were mediated by psychological symptoms and mindfulness skills. MBCT and CRT reduced a wide array of psychological symptoms and improved mental QoL. These improvements seemed to impact self-reported cognitive problems after both treatments, whereas objective cognitive improvements after MBCT seemed independent of improvement in psychological symptoms. Future studies should investigate long-term sustainability of these beneficial effects. The trial was prospectively registered in the Dutch Trial registry on 31 May 2017 (NL6285; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6459 ).
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 4
- Study protocol for the MIND-PD study: a randomized controlled trial to investigate clinical and biological effects of mindfulness-based cognitive therapy in people with Parkinson's disease. BMC Neurology June 25, 2024
- Hypnosis and mindfulness audio recordings for reducing fatigue in individuals with multiple sclerosis: A randomized controlled study. Multiple Sclerosis Journal June 1, 2025
- Effects of Tailored Mindful Exercise on Back Pain, Balance, Kinesiophobia, Anxiety and Depression in Older Patients with Primary Osteoporosis: A Randomized Controlled Trial Mindfulness August 28, 2025
- The effectiveness of mindfulness-based cognitive therapy on rumination and related psychological indicators: a systematic review and meta-analysis. BMC Psychology August 26, 2025
Cites 7
- Mindfulness-based cognitive therapy for depression August 21, 2006
- Competence in Teaching Mindfulness-Based Courses: Concepts, Development and Assessment Mindfulness September 21, 2011
- Mindfulness-based interventions for people with multiple sclerosis: a systematic review and meta-aggregation of qualitative research studies Disability and Rehabilitation September 9, 2021
- A systematic review and meta-analysis exploring the efficacy of mindfulness-based interventions on quality of life in people with multiple sclerosis. Journal of Neurology November 9, 2022
- Mindfulness-based cognitive therapy for severely fatigued multiple sclerosis patients: A waiting list controlled study. Journal of rehabilitation medicine June 28, 2017
and 2 more in the library