Life In Multiple Sclerosis Research Articles

Effect of Home‐Based Aerobic Exercise Training on Quality of Life in Multiple Sclerosis

IntroductionMultiple sclerosis (MS) is an immune‐mediated autoimmune disease of the central nervous system that results in compromised quality of life (QOL) when compared with non‐disease adults and adults with other chronic, disease conditions. Depression and anxiety represent common determinants of QOL in MS. There is evidence that supervised, aerobic training can improve QOL and depression in MS, but there is little known about home‐based exercise training programs and these outcomes. The focus on home‐based exercise is important, as many individuals with MS perceive accessibility and acceptability of center‐based exercise programs as major barriers of participation.PurposeTo examine the effect of home‐based, aerobic exercise training compared with attention control on QOL in MS.MethodsParticipants with a definite diagnosis of MS were randomly assigned to two groups: exercise (N = 23, 48±12 yrs) and stretching (attention control N=21, 43±13 yrs). Both interventions included 3 days a week of training for 12 weeks with increasing duration and intensity. Both groups had one‐on‐one weekly video chat sessions with an experienced exercise coach designed for maximizing compliance with the prescription using behavioral change principles. Participants completed the Multiple Sclerosis Impact Scale (MSIS‐29) and Hospital Anxiety and Depression Scale (HADS) before and after the 12 week period. Aerobic capacity (VO2peak) was further measured on a cycle ergometer.ResultsThe overall MSIS‐29 score decreased for the exercisers, with no change in the controls; this change was driven by the mental component of the MSIS‐29. There was no difference in HADS score. The average anxiety scores from both groups, pre and post intervention, fell within clinical case range (score 11–21), and the average depression score for both groups are classified as normal (Score 0–7), while the post‐intervention exercisers scores are classified as borderline cases (score 8–10). VO2peak increased in the exercise group, with no change in the stretching group (Table 1).ConclusionOur home‐based exercise intervention yielded an impact on quality of life and VO2peak in our MS cohort. These findings can be applied to independence in MS patients; an increase in the quality of life with regular exercise will aid overall fitness and outlook, which may reinforce leading an active life style.Support or Funding InformationThis project was supported by the National Multiple Sclerosis Society RG 4702A1/2. Data presented: Mean ± SD. Stretchers (N= 21) Exercise (N=23) Pre‐Intervention Post‐Intervention Pre‐Intervention Post‐Intervention MSIS* 58.2±18.3 59.4±19.3 66.7±25.2 54.7±24.1 MSIS Physical Comp 37.6+3.2 37.5+2.9 42.9+2.9 37.8+2.7 MSIS Mental Coup* 20.6±1.9 21.9±1.8 22.9±1.7 19.0±1.6 HADS Anxiety 14.3±3.9 13.5±2.7 13.2±3.2 13.7±2.9 HADS Depression 5.3±3.8 6.9±2.7 6.7±3.1 7.7±32 VO2peak* (ml/kg/min) 22.58+4.79 21.94+4.86 19.40+4.33 20.95+5.25 Peak Power (Watts) 116±7.1 114.2±7.2 112.3±6.7 116±6.7 (p<0.05), Interaction‐‐‐‐‐‐‐‐‐‐‐‐‐_(Time*Group)

Social support network and quality of life in multiple sclerosis patients.

To analyse the relationship between the social support network (SSN) and health related quality of life (HRQOL) in multiple sclerosis (MS) patients. The sample comprised 150 consecutive MS patients attending our MS clinic. To assess the socio-demographic data, a specifically designed questionnaire was applied. The HRQOL dimensions were measured with the Short-Form Health Survey Questionnaire-SF36 and the SSN with the Medical Outcomes Study Social Support Survey. Spearman's correlation was used to compare the magnitude of the relationship between the SSN and HRQOL. The mean patient age was 41.7 years (± 10.4; range: 18-70 yr); the mean Expanded Disability Status Score was 2.5 (±2.4; range: 0-9). There was a statistically significant correlation between the structure of the SSN and the HRQOL. The composition of the SSN, social group membership and participation in voluntary work have an important role in the HRQOL of patients with MS.

The Effects of Interferon β-1b on Depression, Anxiety, and Quality of Life in Multiple Sclerosis

The Effects of Interferon β-1b on Depression, Anxiety, and Quality of Life in Multiple Sclerosis

Features Pyramidal and Sensory Disorders in Multiple Sclerosis Patients Under Comorbidity

Reduced muscle strength is one of the most important factors in violation of life in multiple sclerosis (MS). Muscle spasticity – another significant common symptom in patients with MS, which is one of the main reasons for the deepening of disability. The objective: to determine the prevalence of pyramidal disorders (PD), and sensory disorders (SD) in patients with MS and to find out the characteristics of their curs in the aspect of comorbidity. Patients and methods. Neurological examination 216 MS patients with different forms of process was held a points assessment of the disturbed functional systems of the FS-1 – FS-7 (scale FS1 Functional System for J. Kurtzke, 1983), determined the level of disability (the EDSS), revealed the presence or absence PD and SD in the survey, to determine the degree of severity and character. Results. At 88,4% PC patients had PD. Changes in muscle tone were found in 73.2% of patients with MS. In 65.3% of MS patients the total sample were clinical signs of superficial and deep sensitivity changes. In addition to medication for relief of PD and SD in patients with MS were effectively used methods of acupuncture, which allowed more quickly and efficiently to reduce the severity of spasticity and pain. Conclusions. 1. The average prevalence of PD in our study of MS patients is 88.4%, and the average prevalence of the SD – 65.3%. 2. In the group with the presence of comorbid pathology PD significantly more often manifested tetraparesis and high spastic tone. 3. In the group with the presence of comorbid pathology SD significantly more often manifested dysesthesia, termogiperestesia, palleanestesia.

Health-related quality of life in multiple sclerosis: Direct and indirect effects of comorbidity.

To evaluate the direct and indirect influences of physical comorbidity, symptoms of depression and anxiety, fatigue, and disability on health-related quality of life (HRQoL) in persons with multiple sclerosis (MS). A large (n = 949) sample of adults with MS was recruited from 4 Canadian MS clinics. HRQoL was assessed using the patient-reported Health Utilities Index Mark 3. Expanded Disability Status Scale scores, physical comorbidity, depression, anxiety, and fatigue were evaluated as predictors of HRQoL in a cross-sectional path analysis. All predictors were significantly associated with HRQoL and together accounted for a large proportion of variance (63%). Overall, disability status most strongly affected HRQoL (β = -0.52) but it was closely followed by depressive symptoms (β = -0.50). The direct associations of physical comorbidity and anxiety with HRQoL were small (β = -0.08 and -0.10, respectively), but these associations were stronger when indirect effects through other variables (depression, fatigue) were also considered (physical comorbidity: β = -0.20; anxiety: β = -0.34). Increased disability, depression and anxiety symptoms, fatigue, and physical comorbidity are associated with decreased HRQoL in MS. Disability most strongly diminishes HRQoL and, thus, interventions that reduce disability are expected to yield the most substantial improvement in HRQoL. Yet, interventions targeting other factors amenable to change, particularly depression but also anxiety, fatigue, and physical comorbidities, may all result in meaningful improvements in HRQoL, as well. Our findings point to the importance of further research confirming the efficacy of such interventions.

Health-related quality of life in multiple sclerosis: role of cognitive appraisals of self, illness and treatment.

Health-related quality of life (HRQoL) is considered an important measure of treatment and rehabilitation outcomes in multiple sclerosis (MS) patients. In this study, we used multivariate regression analysis to examine the role of cognitive appraisals, adjusted for clinical, socioeconomic and demographic variables, as correlates of HRQoL in MS. The cross-sectional study included 257 MS patients, who completed Multiple Sclerosis Impact Scale, Generalized Self-Efficacy Scale, Rosenberg Self-Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale (a part of Berlin Social Support Scale) and Socioeconomic Resources Scale. Demographic and clinical characteristics of the participants were collected with a self-report survey. Correlation and regression analyses were conducted to determine associations between the variables. Five variables, illness identity (β=0.29, p≤0.001), self-esteem (β=-0.22, p≤0.001), general self-efficacy (β=-0.21, p≤0.001), disability subgroup "EDSS" (β=0.14, p=0.006) and age (β=0.12, p=0.012), were significant correlates of HRQoL in MS. These variables explained 46% of variance in the dependent variable. Moreover, we identified correlates of physical and psychological dimensions of HRQoL. Cognitive appraisals, such as general self-efficacy, self-esteem and illness perception, are more salient correlates of HRQoL than social support, socioeconomic resources and clinical characteristics, such as type and duration of MS. Therefore, interventions aimed at cognitive appraisals may also improve HRQoL of MS patients.

Do Flexible Goal Adjustment and Acceptance Help Preserve Quality of Life in Patients with Multiple Sclerosis?

Goal regulation strategies such as flexible goal adjustment and acceptance are believed to be protective factors in persons with chronic illness, but research on their relative contributions to quality of life in multiple sclerosis (MS) is lacking. We aimed to test the idea that acceptance and flexible goal adjustment (in contrast to tenacious goal pursuit) may help preserve the quality of life in persons with MS. A sample of 117 patients with MS was recruited. They completed questionnaires measuring quality of life (physical functioning, psychological distress), acceptance, flexible goal adjustment, and tenacious goal pursuit. Acceptance significantly accounted for variance in all three indexes of quality of life, beyond the effects of demographic and illness characteristics. The role of goal regulation style was less clear. Flexible goal adjustment significantly accounted for psychological well-being only. Surprisingly, tenacious goal pursuit predicted better psychological functioning and less psychological distress. No support was found for the hypothesis that acceptance and flexible goal adjustment would moderate the relation between illness severity and quality of life. The findings suggest the potential importance of acceptance in understanding MS patients' quality of life, although its hypothesized protective function could not be confirmed. Further conceptual work on acceptance and goal regulation style is needed, as well as prospective work investigating their causal status.

Fatigue, Sleep Quality, and Disability in Relation to Quality of Life in Multiple Sclerosis.

Quality of life (QOL) is impaired in multiple sclerosis (MS) in part due to physical disability. MS-associated fatigue and poor sleep are common and treatable features of MS that affect QOL. We assessed the association between fatigue, sleep quality, and QOL in people with MS. Cross-sectional data were collected from 217 patients with MS. Health-related QOL (MS Quality of Life-54), fatigue (Fatigue Severity Scale [FSS]), and sleep quality (Pittsburgh Sleep Quality Inventory [PSQI]) were assessed. Expanded Disability Status Scale scores were also provided by a qualified neurologist. The mean ± SD age of the 217 patients was 32.6 ± 8.6 years, and 79% were female. One hundred fifty-two patients (70.0%) were classified as poor sleepers based on PSQI scores; 122 (56.2%) had significant fatigue based on FSS results. The mean ± SE physical (PCS) and mental (MCS) health composite scores of the MSQOL-54 were 40.12 ± 1.27 and 43.81 ± 1.61, respectively. There was a strong statistically significant positive correlation between PCS scores and MCS (r = 0.58), FSS (r = 0.49), and PSQI (r = 0.52) scores. MCS scores were strongly correlated with FSS (r = 0.53) and PSQI (r = 0.35) scores. Age exhibited statistically significant negative correlations with PCS (r = -0.21) and MCS (r = -0.58) scores, and was statistically significantly correlated with FSS (r = 0.23) and PSQI (r = 0.21) scores. Expanded Disability Status Scale scores were strongly correlated with FSS scores. These findings support screening of fatigue severity and sleep quality and their effects on QOL.

Use of botulinum toxin for genitourinary conditions: What is the evidence?

Botulinum toxin A is licensed for the treatment of urinary incontinence due to neurogenic detrusor overactivity (NDO) and overactive bladder (OAB). Only onabotulinumtoxinA has at this moment such approval, in NDO at a dose of 200 U and in OAB at a dose of 100 U. Regulatory phase 3 trials have been carried out in both conditions. In NDO it was shown to decrease urinary incontinence, to improve urodynamic parameters and to increase quality of life in multiple sclerosis and spinal cord injured patients. Adverse events included urinary tract infections and necessity of de novo clean intermittent catheterization, which occurred mainly in patients with multiple sclerosis. In OAB patients with urge incontinence, onabotulinumtoxinA decreased urinary incontinence and micturition frequency while improving quality of life. Again, main adverse events were urinary tract infections and transient urinary retentions. Long-term studies in both NDO and OAB demonstrate the efficacy and safety of the treatment. Available phase 3 trials of onabotulinumtoxinA in benign prostatic hyperplasia did not show any relevant efficacy in improving lower urinary tract symptoms.

Impact of peginterferon beta-1a and disease factors on quality of life in multiple sclerosis

BackgroundThe Phase III ADVANCE study has shown clinical benefits for peginterferon beta-1a 125µg dosed every 2 weeks versus placebo at 1 year in patients with relapsing-remitting multiple sclerosis (MS). This study assessed the impact of peginterferon beta-1a and disease factors on health-related quality of life (HRQoL) using data from ADVANCE. MethodsHRQoL was assessed at baseline and 12, 24, and 48 weeks using the 29-item Multiple Sclerosis Impact Scale (MSIS-29) and other generic HRQoL measures. Changes in scores from baseline within each group and differences in mean change from baseline between groups were evaluated. Post-hoc mixed-effects repeated measures analyses were performed to assess the impact of confirmed disability progression and relapses, and the interactions of treatment and these MS events on HRQoL. Predictors with p≥0.1 were excluded from the final models, unless they were clinically meaningful. ResultsRelapses and confirmed disability progression were major drivers of HRQoL. When comparing week 48 to baseline, in placebo-treated patients (n=500), confirmed disability progression was associated with a 6.0-point worsening (p<0.0001) of MSIS-29 physical scores, relative to a 1.9-point worsening (p=0.044) with peginterferon beta-1a every 2 weeks (n=512). Such findings were observed consistently with other generic HRQoL measures. Additionally, having a recent relapse (≤29 days before the HRQoL assessment) was associated with a 10.0-point worsening (p<0.0001) of MSIS-29 psychological scores in placebo-treated patients, compared with a 3.5-point (p=0.031) worsening with peginterferon beta-1a every 2 weeks. ConclusionTreatment with peginterferon beta-1a could help to improve or maintain HRQoL in addition to clinical outcomes.Trial registration: ClinicalTrials.gov: NCT00906399.

Therapeutic effect of Avonex, Rebif and Betaferon on quality of life in multiple sclerosis.

The aim of this study was to evaluate the effect of various disease-modifying therapies (DMT) on quality of life in multiple sclerosis (MS). This was a three-arm parallel study with balanced randomization in which 90 newly diagnosed, definite MS subjects referred to Ghaem Medical Center, Mashhad, Iran were enrolled between 2006 and 2009. Patients were randomly allocated into three DMT groups: Avonex, Rebif and Betaferon. Health-related quality of life was assessed in MS patients at baseline and 12 months after treatment with DMT using the MS Quality of Life-54 questionnaire. Both mental and physical health scores improved within all three treatment groups after 12 months of treatment; however, this increase was only significant in the mental health composite in the Betaferon group (P = 0.024). Betaferon had the highest mental health score change (14.04) while this change was 7.26 for Avonex (P = 0.031) and 5.08 for Rebif (P = 0.017). A physical health composite score comparison among the three treatment groups revealed no significant results. With a positive impact of DMT on mental and physical dimensions of QOL in MS patients, initiation of treatment soon after diagnosis is recommended. In MS patients with more mental issues and fewer physical disabilities, Betaferon might be considered as a better choice of treatment.

The effect of executive function on stress, depression, anxiety, and quality of life in multiple sclerosis

The experience of cognitive deficits and emotional dysfunction are prevalent in people with multiple sclerosis (PwMS), although research examining their interaction has provided inconsistent findings. The current study examined the ability of executive function to predict psychosocial adjustment in PwMS. One hundred and seven PwMS underwent cognitive assessment and completed measures of stress, depression, anxiety, and quality of life (QoL). There was limited support for a relationship. There was no relationship between objective cognitive tasks and state or trait anxiety, mental health QoL, overall QoL, or stress frequency. The only relationship with depression was found when the Beck Depression Inventory Fast-Screen was used, with a task of planning when the timing element was removed. A measure of error rates on a task of cognitive flexibility predicted physical health QoL, and severity, but not frequency, of stress was predicted by a task of working memory. The results of this study highlight the need for further research into the relationship between cognitive deficits and psychosocial adjustment because of the conflicting findings between studies and call for a common measurement framework for future investigation.

Neuroenhancement through cognitive training and anodal tDCS in multiple sclerosis

Background: Cognitive training has been shown to improve cognitive function and quality of life in multiple sclerosis (MS) patients and is correlated with increased activity in the left dorsolateral prefrontal cortex (DLPFC). Objective: This study aims to test whether combining attention training with anodal transcranial direct current stimulation (a-tDCS) over the left DLPFC can improve training efficacy. Methods: Twenty patients impaired in attention/speed of information processing were randomly assigned to cognitive training during a-tDCS over the left DLPFC or cognitive training during sham tDCS for 10 daily sessions. Neuropsychological evaluations were conducted at baseline, after treatment and six months later. Results: When a-tDCS, rather than sham, was applied during the cognitive training, patients showed a significantly greater improvement in the Symbol Digit Modality Test (SDMT) and Wisconsin Card Sorting Test (WCST) after treatment (p < 0.05) and in the Paced Auditory Serial Addition Test (PASAT) 2” and WCST six months later (p < 0.05). They also had significantly shorter time to reach the most difficult exercise level, compared to sham treatment (6.3 vs. 7.4 sessions; p < 0.05). Conclusions: These results indicate that a-tDCS on the DLPFC during cognitive training fosters improvements in attention and executive function in MS patients and shortens treatment duration.

Barriers and Facilitators Related to Rehabilitation Stays in Multiple Sclerosis: A Qualitative Study.

Studies have shown the positive effects of multidisciplinary rehabilitation on disability and health-related quality of life in multiple sclerosis (MS). However, many patients do not seek such treatment, even if it is available free of charge. The aim of this study was to identify facilitators and barriers related to use of such treatment options. Five focus group interviews with 27 MS patients were conducted. Three groups included patients who had been admitted to a multidisciplinary MS rehabilitation institution, and two groups included outpatients of a university hospital who had not applied for specialized rehabilitation. Interviews were audiotaped and transcribed, and were analyzed qualitatively by means of a modified form of systematic text condensation. Important factors influencing the use of an MS rehabilitation service were 1) the availability and suitability of initial information about the disease and the service, 2) assumptions and expectations about such a service, and 3) practical barriers in the patient's life. The prospect of having a retreat from work and family was described as a motivational factor. Lack of reorientation after diagnosis, fears and perceptions of being labeled as an MS patient, or having information overload and being confronted with disabled individuals were identified as barriers. Communication skills, including information-giving skills, of neurologists in relation to newly diagnosed MS patients need improvement. Rehabilitation programs for MS patients should include stays of different durations and purposes to fit patients' needs. Health-care authorities should take measures to secure equal access to information about rehabilitation options across institutions and practicing physicians.

Examining trait mindfulness, emotion dysregulation, and quality of life in multiple sclerosis.

Dispositional mindfulness exhibits a positive association with quality of life (QoL). One potential mechanism for this association is enhanced emotion regulation abilities. Individuals with multiple sclerosis (MS) experience a range of physical, cognitive, and affective impairments, thus reducing overall QoL. The current cross-sectional study examines the relation between trait mindfulness and QoL, mediated by emotion dysregulation in individuals with MS. Ninety-five participants with self-reported MS completed an online survey that incorporated self-report measures of trait mindfulness, emotion dysregulation, and QoL. Although clinically significant depression was exclusionary, we observed a wide range of depressive symptoms in our sample. These scores were thus entered as a moderator in the mediation analysis. Dispositional mindfulness correlated positively with QoL, with lower emotion dysregulation partially mediating the correlation. Depression scores moderated the observed mediation, such that the effect was stronger in those with higher symptoms of depression. Trait mindfulness is positively associated with QoL in individuals with MS. Reduced emotion dysregulation may be a critical pathway linking mindfulness and QoL in MS, especially in those with higher symptoms of depression.

Cerebrospinal Venous Outflow in Multiple Sclerosis Patients versus Fatigue and/or Depression

Background: Endovascular treatment of impaired cerebrospinal venous outflow has been suggested to improve the overall quality of life in multiple sclerosis (MS) patients. Fatigue and depression are key factors in measuring the quality of life in MS patients. Objective: In the present study, we investigated the correlation between anomalous venous outflow and the seriousness of fatigue and depression in MS patients and healthy controls. Methods: Five cerebrospinal venous outflow parameters were measured in 20 MS patients and age- and sex-matched controls using extra- and transcranial Colour Doppler sonography. All patients and volunteers filled out the Fatigue Severity Scale (FSS) and Hospital Anxiety Depression Subscale (HADS). Results: Nine abnormal parameters were found in 8 MS patients, whereas five abnormal parameters were found in 3 healthy controls (no significant difference). Only 1 MS patient met the criteria for chronic cerebrospinal venous insufficiency compared to 2 healthy controls. No significant differences were found in the FSS and HADS scores between patients with and without abnormal cerebrospinal venous outflow parameters. Conclusions: We found no significantly impaired cerebrospinal venous outflow in patients with MS versus sex- and age-matched controls. Furthermore, we did not find any correlation between anxiety or depression and impaired venous outflow in MS patients.

Effects of fampridine on walking parameters, upper limb function, fatigue and quality of life in multiple sclerosis

Effects of fampridine on walking parameters, upper limb function, fatigue and quality of life in multiple sclerosis

Thalamic atrophy and cognitive impairment in clinically isolated syndrome and multiple sclerosis

BackgroundCognitive deficits worsen the quality of life in multiple sclerosis and may be predicted by deep gray matter atrophy, especially thalamic atrophy. This relationship has not been studied in the clinically isolated syndrome (CIS). The aims of this study were to assess cognitive deficits in patients with CIS and relapsing-remitting multiple sclerosis (RRMS) using neuropsychological testing, to search for thalamic atrophy on brain MRI, and to test for their correlations. MethodsForty-three patients (19 with CIS and 24 with RRMS) underwent brain MRI and neuropsychological testing involving multiple cognitive domains and the severity of depression. Thalamic volumes automatically segmented from MRI data were compared to 19 healthy controls. Correlations were sought between cognitive performance and thalamic volume. ResultsCognitive impairment was detected in the majority of both CIS and MS patients, most affected in executive functions, auditory memory, lexical verbal fluency, distribution of attention and psychomotor speed. Cognitive impairment and depression were not significantly correlated to disease duration. Both CIS and MS patients demonstrated thalamic atrophy compared to controls, while many cognitive deficits correlated with thalamic volume in both patient groups. ConclusionCognitive deficits in CIS resemble those found in the later stages of MS and may be directly related to the amount of thalamic damage.

Multiple sclerosis is associated with high trait anger: A case–control study

IntroductionIn recent years there has been a focus on health-related quality of life in multiple sclerosis (MS) and in particular the importance of non-motor problems such as fatigue, pain, depression, anxiety, and cognitive disorders. However, little attention has been focused on other negative emotions, such as anger. Our purpose was to evaluate whether trait anger (a predisposition to experience frequent and intense episodes of anger over time) is different between persons with and without MS after controlling for depression, anxiety, and other socio-demographic variables. Methods157 consecutive MS patients were enrolled in the study and compared to eighty age, gender, and education-matched healthy controls. Participants were administered affective trait measures (Beck Depression Inventory, Beck Anxiety Inventory) and the trait anger measure (the Spanish adapted version of the State–Trait Anger Expression Inventory-2 [STAXI-2]). ResultsMS patients had significantly higher scores on anger intensity (state anger) and trait anger than did controls. They also had a trend to experience direct anger toward other persons or objects in the environment (higher anger expression-out score) and to hold in or suppress angry feelings (higher anger expression-in score). However, in a regression analysis that adjusted for different demographic and clinical variables, we found that diagnosis category (MS patient vs. control) was associated with none of the highest quartiles of STAXI-2 scores, except for the Trait Anger scale (odds ratios between 2.35 and 3.50). ConclusionsThe present study provides further evidence that MS is independently associated with high trait anger.

Perceived Stress in Multiple Sclerosis

Stressful life events are associated with worsening neurological symptoms and decreased quality of life in multiple sclerosis (MS). Mindful consciousness can alter the impact of stressful events and has potential to improve health outcomes in MS. This study evaluated the relationship between trait mindfulness and perceived stress, coping, and resilience in people with MS. Quality of life was assessed as a secondary outcome. One hundred nineteen people with confirmed MS completed the Five-Facet Mindfulness Questionnaire, Perceived Stress Scale, Brief Coping Orientation for Problem Experiences, Connor-Davidson Resilience Scale, and Medical Outcome Study Short Form-36. Greater trait mindfulness was significantly associated with decreased psychological stress, better coping skills, increased resilience, and higher quality of life. After investigators controlled for confounders, mindfulness accounted for 25% of the variation in perceived stress scores and 44% of the variation in resilience scores. Results support further investigation of mindfulness training to enhance psychological resilience and improve well-being for those living with MS.