Mindfulness May Improve Depression, Quality of Life in ALS Patients

Mindfulness-based programs may help improve anxiety and depression in patients with amyotrophic lateral sclerosis (ALS), according to results of a study published recently in the European Journal of Neurology.

The study is titled “Meditation training for people with amyotrophic lateral sclerosis: a randomized clinical trial.”

The journal also published an editorial written by Jaushin Lou, MD, a neurologist at the University of North Dakota School of Medicine and Health Science, reviewing the study’s results. The editorial is titled “Mindfulness, depression and quality of life in amyotrophic lateral sclerosis.”

ALS is a progressive and irreversible disease, and patients may experience increasing levels of depression over time, which greatly decreases their quality of life. Previous studies had suggested that one of the approaches that may improve anxiety and depression associated with ALS is mindfulness.

“Mindfulness is a meditation technique that trains a person to bring his attention to the internal and external experiences of the present moment,” Lou wrote. “It encourages non-judgmental openness, curiosity and acceptance. The basis of mindfulness practices is that experiencing the present moment non-judgmentally and openly can counteract the effects of stressors of the past or future that can cause depression and anxiety.”

The open-label, randomized clinical trial was conducted to assess whether mindfulness practice improved depression and anxiety in 100 ALS patients, 18 months after their diagnosis. Patients were assigned to receive usual care or an eight-week mindfulness-based stress reduction (MBSR) program.

The trial’s primary goal was the quality of life, measured by the ALS-Specific Quality of Life Revised scale. Researchers also analyzed other parameters, including anxiety and depression, using the Hospital Anxiety and Depression Scale.

Patients were evaluated at baseline and after two, six and 12 months. Due to the rapid progression and short survival of ALS patients, the study had increased dropout over the one-year period. As such, from the 100 enrolled patients, only 75, 43 and 29 patients remained in the study at two, six and 12 months, respectively.

“This study provides crucial implications in the care of patients with ALS,” Lou wrote. “The study showed that the intervention group using ALS-specific MBSR reported better [quality of life] and lower levels of depression compared to the patients receiving usual care.”

He concluded that ALS-specific MBSR gives clinicians one more tool to treat depression in patients with ALS.

“Being aware of how we are in a certain moment…dramatically increases well-being,” Francesco Pagnini, PhD, study’s author, said in a press release. “Meditation practice, for those who are interested, can be a very helpful resource against stress and depressive thoughts. Furthermore, meditation teaches how to talk to the self, which can be used to improve acceptance of the lack of movements in advanced ALS stages.”