PDF(Pubmed)
Abstract：
Multiple sclerosis (MS) is a chronic neurological disease frequently associated with significant fatigue, anxiety, depression, and stress. These symptoms are difficult to treat, and prominently contribute to the decreases in quality of life observed with MS. The underlying mechanisms of these \"silent\" symptoms are not well understood and include not just the psychological responses to a chronic disease, but also biological contributions from bidirectional psycho-neuro-immune (dys)regulation of systemic inflammatory biology. To address these issues, we conducted a prospective, observational pilot study to investigate the psychological, biological, and neuroarchitecture changes associated with a mindfulness-based stress reduction (MBSR) program in MS. The overarching hypothesis was that MBSR modulates systemic and central nervous system inflammation via top-down neurocognitive control over forebrain limbic areas responsible for the neurobiological stress response. 23 patients were enrolled in MBSR and assessed pre/post-program with structural 3 T MRI, behavioral measures, hair cortisol, and blood measures of peripheral inflammation, as indexed by the Conserved Transcriptional Response to Adversity (CTRA) profile. MBSR was associated with improvements across a variety of behavioral outcomes, as well as on-study enlargement of the head of the right hippocampus. The CTRA analyses revealed that greater inflammatory gene expression was related to worse patient-reported anxiety, depression, stress, and loneliness, in addition to lower eudaimonic well-being. Hair cortisol did not significantly change from pre- to post-MBSR. These results support the use of MBSR in MS and elucidate inflammatory mechanisms related to key patient-reported outcomes in this population.
摘要：
多发性硬化症（MS）是一种慢性神经系统疾病，通常与严重的疲劳有关。焦虑,抑郁症,和压力。这些症状很难治疗，并显著导致MS观察到的生活质量下降。这些“沉默”症状的潜在机制还没有得到很好的理解，不仅包括对慢性病的心理反应，但也从系统炎症生物学的双向心理-神经免疫（dys）调节的生物学贡献。为了解决这些问题,我们进行了一个前瞻性的，观察性试点研究，以调查心理，生物，以及与MS中基于正念的减压（MBSR）计划相关的神经结构变化。总体假设是MBSR通过对负责神经生物学应激反应的前脑边缘区域的自上而下的神经认知控制来调节全身和中枢神经系统炎症。23例患者被纳入MBSR，并在程序前/后进行结构3TMRI评估，行为措施，头发皮质醇,和周围炎症的血液测量，由保守的逆境转录反应(CTRA)概况索引。MBSR与各种行为结果的改善有关，以及右侧海马头部的研究扩大。CTRA分析显示，更高的炎症基因表达与更严重的患者报告的焦虑有关，抑郁症,压力，和孤独，除了较低的Eudaimonic幸福感。从MBSR前后，头发皮质醇没有显着变化。这些结果支持在MS中使用MBSR，并阐明了与该人群中关键患者报告结果相关的炎症机制。
