Institute for Neuroimmunology and Clinical Multiple Sclerosis Research (inims), University Hospital Hamburg, Eppendorf, Germany.
Ther Adv Neurol Disord. 2011 Jul;4(4):217-29. doi: 10.1177/1756285611405252.
Behavioral interventions including exercise, stress management, patient education, psychotherapy and multidisciplinary neurorehabilitation in general are receiving increasing recognition in multiple sclerosis (MS) clinical practice and research. Most scientific evaluations of these approaches have focused on psychosocial outcome measures such as quality of life, fatigue or depression. However, it is becoming increasingly clear that neuropsychiatric symptoms of MS are at least partially mediated by biological processes such as inflammation, neuroendocrine dysfunction or regional brain damage. Thus, successful treatment of these symptoms with behavioral approaches could potentially also affect the underlying biology. Rigidly designed scientific studies are needed to explore the potential of such interventions to affect MS pathology and biological pathways linked to psychological and neuropsychiatric symptoms of MS. Such studies need to carefully select outcome measures on the behavioral level that are likely to be influenced by the specific intervention strategy and should include biomarkers with evidence for an association with the outcome parameter in question. In this overview, we illustrate how biological and psychological outcome parameters can be combined to evaluate behavioral interventions. We focus on two areas of interest as potential targets for behavioral interventions: depression and fatigue.
行为干预措施，包括运动、压力管理、患者教育、心理治疗和一般的多学科神经康复，在多发性硬化症（MS）的临床实践和研究中越来越受到重视。这些方法的大多数科学评估都集中在心理社会结果测量上，如生活质量、疲劳或抑郁。然而，越来越明显的是，MS 的神经精神症状至少部分是由炎症、神经内分泌功能障碍或区域性脑损伤等生物学过程介导的。因此，通过行为方法成功治疗这些症状，也有可能影响潜在的生物学机制。需要严格设计的科学研究来探索这些干预措施对 MS 病理学和与 MS 的心理和神经精神症状相关的生物学途径的潜在影响。这些研究需要仔细选择行为层面的结果测量指标，这些指标很可能受到特定干预策略的影响，并且应该包括与所研究的结果参数具有关联证据的生物标志物。在本综述中，我们说明了如何将生物学和心理学结果参数结合起来评估行为干预措施。我们重点关注两个可能作为行为干预目标的感兴趣领域：抑郁和疲劳。
