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Stress relief may slow multiple sclerosis lesions

NEW YORK (Reuters Health) – Stress management therapy may help curb some of the brain inflammation seen in multiple sclerosis (MS) — at least for a time, researchers reported Wednesday.

Stress management counseling designed specifically for MS has been shown to help people feel better. But the new study is the first to show that there may be detectable effects on the brain.

In a study of 121 MS patients, researchers found that those given six months of stress management sessions were less likely to develop new brain lesions.

It’s too early to recommend stress management for slowing the progression of MS, the study’s lead researcher said. For one, the brain benefits disappeared once people stopped going to therapy. Plus, it’s not clear what the effects might be on people’s actual MS symptoms.

“This is really the first time a behavioral intervention has been shown to have an effect on MS disease activity,” said lead researcher Dr. David C. Mohr, a professor at Northwestern University School of Medicine in Chicago.

That’s “good news,” according to an editorial published online July 11 with the study in the journal Neurology.

But the “bad news” was that the effects on brain lesions vanished in the six months after patients stopped stress management therapy, write Drs. Christoph Heesen and Stefan M. Gold of the University Medical Center Eppendorf in Hamburg, Germany.

For the new study, Dr. Mohr’s team tested a stress management therapy designed specifically for people with MS. Research had already shown that this particular therapy can help patients’ mood, fatigue and quality of life.

But no one had known whether it affects brain lesions.

So Dr. Mohr’s team randomly assigned patients to either have 16 one-on-one sessions with a psychologist over 24 weeks or go on a wait-list.

Using MRI scans, the researchers found that more of the stress management patients remained free of new lesions. After 24 weeks, 77% had no new gadolinium-enhancing lesions in their brains. That compared with 55% of the wait-listed patients.

But the advantage disappeared in the 24 weeks after therapy ended. During that period, 69% of therapy patients and 61% of wait-list patients had no new lesions.

Dr. Mohr said that longer-term help might be needed. But, he said, “with one-on-one counseling, that’s difficult. It’s hard for people to keep up, and it gets costly.”

That cost varies place to place, but a typical one-on-one session would run about $100 an hour.

A potential answer, according to Dr. Mohr, might be to offer therapy over the phone or online. Other research, he said, has suggested that telephone stress management counseling can be as effective as face-to-face.

And why would the therapy have an effect on MS brain lesions? It’s not fully clear, Dr. Mohr said. The theory is essentially that stress can exacerbate inflammation, and reducing stress may, therefore, lessen inflammation.

But there are many questions left.

“It’s premature to recommend this therapy for managing MS progression,” Dr. Mohr said.

Nor does he see it as a potential alternative to the disease-modifying drugs used to treat MS. In this study, patients stuck with any medications they were already using.

Still, the program used in the study may help with problems like depressed mood and fatigue. And it’s available in manual form for therapists to use, according to Dr. Mohr.

SOURCE: http://bit.ly/N2DcLw

Neurology 2012.