A Multimodal, Nonpharmacologic Intervention Improves Mood and Cognitive Function in People with Multiple Sclerosis.
Study Goal
The researchers aimed to determine whether a multimodal intervention including neuromuscular electrical stimulation (EStim) could improve mood and cognitive function in adults with progressive multiple sclerosis (MS).
Results Summary
Greater participation in the intervention, including EStim, was associated with improvements in anxiety, depression, cognitive function, and executive function over 12 months. Mood and cognitive improvements were more strongly linked to dietary changes than to exercise or stress management.
Population
Adults with progressive multiple sclerosis (MS).
Effective Dosage
Not specified
Duration
12 months
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
12-month multimodal intervention | increase | mood | adults with progressive multiple sclerosis (MS) | - | improve | #1 |
12-month multimodal intervention | increase | cognitive function | adults with progressive multiple sclerosis (MS) | - | improve | #2 |
multimodal intervention activities | decrease | anxiety (Beck Anxiety Inventory [BAI]) | individuals | - | greater improvements | #3 |
multimodal intervention activities | decrease | depression (Beck Depression Inventory [BDI]) | individuals | - | greater improvements | #4 |
multimodal intervention activities | increase | cognitive function (Cognitive Stability Index [CSI/T], Delis-Kaplan Executive Function System [DKEFS]) | individuals | - | greater improvements | #5 |
multimodal intervention activities | increase | executive function (Wechsler Adult Intelligence Scale [WAIS]) | individuals | - | greater improvements | #6 |
modified Paleolithic diet | increase | mood improvements | - | - | more closely related to | #7 |
modified Paleolithic diet | increase | cognitive improvements | - | - | more closely related to | #8 |
multimodal intervention | decrease | anxiety | - | - | changes were evident | #9 |
multimodal intervention | decrease | depression | - | - | changes were evident | #10 |
multimodal intervention | increase | cognitive function | - | - | changes were generally not observed until later | #11 |
multimodal intervention | increase | fatigue improvements | - | - | significantly associated with | #12 |
modified Paleolithic diet, exercise, EStim, and stress management intervention | increase | mood symptoms | people with MS | - | has the potential to improve | #13 |
modified Paleolithic diet, exercise, EStim, and stress management intervention | increase | cognitive symptoms | people with MS | - | has the potential to improve | #14 |
OBJECTIVE: The objective of this study was to examine whether participation in a 12-month multimodal intervention would improve mood and cognitive function in adults with progressive multiple sclerosis (MS). METHODS: In this one-arm, open-label feasibility trial, participants were prescribed a home-based multimodal intervention, including (1) a modified Paleolithic diet; (2) an exercise program (stretching and strengthening of the trunk and lower limb muscles); (3) neuromuscular electrical stimulation (EStim) of trunk and lower limb muscles; and (4) stress management (meditation and self-massage). Individuals completed measures of mood (Beck Anxiety and Depression Inventories) and cognitive (Cognitive Stability Index, Cognitive Screening Test, Delis-Kaplan Executive Function System) and executive function (Wechsler Adult Intelligence Scale) at baseline and 3, 6, 9, and 12 months after the start of the intervention. Dosage of the multimodal intervention was assessed at 3, 6, 9, and 12 months. RESULTS: The more individuals participated in the intervention activities, the greater improvements they had from baseline to 12 months on self-report measures of anxiety (Beck Anxiety Inventory [BAI]; ps = 0.001 to 0.02), depression (Beck Depression Inventory [BDI]; ps = <0.0001 to 0.09), cognitive function (Cognitive Stability Index [CSI/T], Delis-Kaplan Executive Function System [DKEFS]; ps = 0.001 to 0.06), and executive function (Wechsler Adult Intelligence Scale [WAIS]; ps = <0.0001 to 0.09). Mood and cognitive improvements were more closely related to a higher intake of the modified Paleolithic diet than to exercise and stress management dosage. Anxiety and depression changes were evident after just a few months, whereas changes in cognitive function were generally not observed until later in the intervention period. Mood and cognitive function changes from baseline to 12 months were significantly associated with fatigue improvements (ps = <0.0001 to 0.03). CONCLUSIONS: A modified Paleolithic diet, exercise, EStim, and stress management intervention like this one has the potential to improve the mood and cognitive symptoms that can lead to considerable suffering in people with MS, potentially improving quality of life and function for people with progressive MS.