Comparison of the Efficacy and Mechanisms for MBCT and CT for Multiple Sclerosis (MS) Chronic Pain
Condition: Multiple Sclerosis
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      Chronic pain is a pervasive, serious problem for many individuals with multiple sclerosis
      (MS) that is typically inadequately treated by medications alone. There is a critical need to
      develop and evaluate innovative psychosocial interventions that have the capacity to
      effectively target the multidimensional nature of MS pain. Cognitive Therapy (CT) is one
      psychosocial treatment that has been found to be a potentially beneficial treatment for
      chronic MS pain. This approach teaches patients to identify and replace unhelpful thoughts
      about pain with helpful, more adaptive thoughts. In addition, over the past decade there has
      been a steady upsurge of research examining mindfulness meditation-based therapies for the
      treatment of medical conditions, including symptoms associated with MS. Mindfulness mediation
      involves training the mind to disengage from automatic thinking patterns to mindfully
      perceive, in a non-judgmental manner, one's moment-to-moment experiences. This meditation
      technique teaches patients to become aware of thoughts, emotions, and physical sensations and
      to recognize that these are transient experiences that can be mindfully perceived, accepted
      and let go. A promising, more recent trend in treatment development research is the
      integration of tradition CT with mindfulness-based meditation, an approach referred to as
      Mindfulness-Based Cognitive Therapy (MBCT). To date, we are the only research group that has
      adapted and tested a manualized MBCT approach for the treatment of painful medical
      conditions. Thus, the proposed pilot randomized controlled trial aims to utilize
      state-of-the-art research methodology to evaluate traditional Cognitive Therapy (CT) compared
      to an innovative, newly developed Mindfulness-Based Cognitive Therapy (MBCT) protocol for the
      treatment of chronic pain in individuals with multiple sclerosis. This study will answer
      three primary questions: (1) Do these treatments work to improve chronic pain for individuals
      with MS and do these treatment also improve associated symptoms such as depression, fatigue,
      and engagement in daily activities?; (2) How do these treatments work in individuals with MS,
      i.e., what factors underlie improvement in outcomes during treatment?; and (3) What are the
      individual person characteristics that best predict outcome? This will be the first study to
      examine MBCT within an MS population. The results will lead to the emergence of a novel, much
      needed additional psychosocial treatment option for patients with chronic MS pain.
    


Intervention name(s): Mindfulness Based Cognitive Therapy; Cognitive Therapy
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: multiple sclerosis; chronic pain; treatment; nonpharmacological; mindfulness; cognitive therapy