Willekens Barbara, Perrotta Gaetano, Cras Patrick, Cools Nathalie
Department of Neurology, Antwerp University Hospital, Antwerp, Belgium.
Laboratory of Experimental Hematology, Faculty of Medicine and Health Sciences, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
Front Behav Neurosci. 2018 May 22;12:103. doi: 10.3389/fnbeh.2018.00103. eCollection 2018.
Mindfulness was introduced in the Western world by Jon Kabat-Zinn in 1979. He defined it as "awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally." Since then, research on mindfulness-based interventions (MBIs) has increased exponentially both in health and disease, including in patients with neurodegenerative diseases such as dementia and Parkinson's disease. Research on the effect of mindfulness and multiple sclerosis (MS) only recently gained interest. Several studies completed since 2010 provided evidence that mindfulness improves quality of life (QoL), depression and fatigue in MS patients. In addition to patient-reported outcome measures, potential effects on cognitive function have been investigated only to a very limited extent. However, research on laboratory biomarkers and neuroimaging, capable to deliver proof-of-concept of this behavioral treatment in MS, is mainly lacking. In this perspective, we illustrate possible neurobiological mechanisms, including the tripartite interaction between the brain, the immune system and neuroendocrine regulation, through which this treatment might affect multiple sclerosis symptoms. We propose to (1) include immunological and/or neuroimaging biomarkers as standard outcome measures in future research dedicated to mindfulness and MS to help explain the clinical improvements seen in fatigue and depression; (2) to investigate effects on enhancing cognitive reserve and cognitive function; and (3) to investigate the effects of mindfulness on the disease course in MS.
正念于1979年由乔恩·卡巴金引入西方世界。他将其定义为“通过有目的地、当下地、不加评判地关注而产生的觉察”。从那时起，基于正念的干预措施（MBIs）在健康和疾病领域的研究呈指数级增长，包括在患有痴呆症和帕金森病等神经退行性疾病的患者中。关于正念与多发性硬化症（MS）的影响的研究直到最近才受到关注。自2010年以来完成的几项研究提供了证据，表明正念可改善MS患者的生活质量（QoL）、抑郁和疲劳。除了患者报告的结局指标外，对认知功能的潜在影响仅在非常有限的程度上进行了研究。然而，主要缺乏对实验室生物标志物和神经影像学的研究，这些研究能够为MS中这种行为治疗提供概念验证。从这个角度来看，我们阐述了可能的神经生物学机制，包括大脑、免疫系统和神经内分泌调节之间的三方相互作用，通过这些机制这种治疗可能会影响多发性硬化症的症状。我们建议：（1）在未来致力于正念与MS的研究中，将免疫和/或神经影像学生物标志物作为标准结局指标，以帮助解释在疲劳和抑郁中观察到的临床改善；（2）研究对增强认知储备和认知功能的影响；（3）研究正念对MS疾病进程的影响。
