Self-management of Stage 2 Parkinson’s disease

Vandenberg, Brooke, E., et al. Mindfulness-based lifestyle programs for the self-management of Parkinson’s disease in Australia, Health Promotion Internationalhttps://doi.org/10.1093/heapro/day021.

Abstract. Despite emerging evidence suggesting positive outcomes of mindfulness training for the self-management of other neuro-degenerative diseases, limited research has explored its effect on the self-management of Parkinson’s disease (PD).

We aimed to characterize the experiences of individuals participating in a facilitated, group mindfulness-based lifestyle program for community living adults with Stage 2 PD and explore how the program influenced beliefs about self-management of their disease.

Our longitudinal qualitative study was embedded within a randomized controlled trial exploring the impact of a 6-week mindfulness-based lifestyle program on patient-reported function. The study was set in Melbourne, Australia in 2012–2013. We conducted semi-structured interviews with participants before, immediately after, and 6 months following participation in the program. Sixteen participants were interviewed prior to commencing the program. Of these, 12 were interviewed shortly after its conclusion, and 9 interviewed at 6 months.

Prior to the program, participants felt a lack of control over their illness. A desire for control and a need for alternative tools for managing the progression of PD motivated many to engage with the program. Following the program, where participants experienced an increase in mindfulness, many became more accepting of disease progression and reported improved social relationships and self-confidence in managing their disease.

Mindfulness-based lifestyle programs have the potential for increasing both participants’ sense of control over their reactions to disease symptoms as well as social connectedness. Community-based mindfulness training may provide participants with tools for self-managing a number of the consequences of Stage 2 PD.

Neurobehavioral effects in patients with Parkinson’s Disease

Pickut, B., et al. (2015). Mindfulness Training among Individuals with Parkinson’s Disease: Neurobehavioral Effects. Parkinson’s Disease, in press. To find full text, go to hindawi.com and search for Article ID 816404.

From the Abstract. Objective. To investigate possible neurobehavioral changes secondary to a mindfulness based intervention (MBI) training for individuals living with Parkinson’s disease (PD).

Background. In the context of complementary medicine, MBIs are increasingly being used for stress reduction and in patient populations coping with chronic illness. The use of alternative and complementary medicine may be higher in patients with chronic conditions such as PD. However, behavioral effects of mindfulness training in PD have not yet been reported in the literature and this points to an unmet need and warrants further examination.

Methods. A total of 27 out of 30 PD patients completed a randomized controlled longitudinal trial. Results. Significant changes after the MBI were found …. To the best of our knowledge, this is the first quantitative analysis of neurobehavioral effects of MBI in PD.

Evidence from neuroimaging studies (lit review)

Marchand, W. R. (2014). Neural mechanisms of mindfulness and meditation: Evidence from neuroimaging studies. World Journal of Radiology, 6(7), 471-479. Full text.

mindimagesAbstract. Mindfulness is the dispassionate, moment-by-moment awareness of sensations, emotions and thoughts. Mindfulness-based interventions are being increasingly used for stress, psychological well being, coping with chronic illness as well as adjunctive treatments for psychiatric disorders. However, the neural mechanisms associated with mindfulness have not been well characterized. Recent functional and structural neuroimaging studies are beginning to provide insights into neural processes associated with the practice of mindfulness.

A review of this literature revealed compelling evidence that mindfulness impacts the function of the medial cortex and associated default mode network as well as insula and amygdala. Additionally, mindfulness practice appears to effect lateral frontal regions and basal ganglia, at least in some cases. Structural imaging studies are consistent with these findings and also indicate changes in the hippocampus. While many questions remain unanswered, the current literature provides evidence of brain regions and networks relevant for understanding neural processes associated with mindfulness.

Mindfulness and chronic illness

Dobkin PL, Zhao Q. (2011). Increased mindfulness–the active component of the mindfulness-based stress reduction program? [Abstract]. Complementary Therapies in Clinical Practice, 17(1):22-7.

While there is growing consensus that Mindfulness-Based Stress Reduction (MBSR) is an effective program for patients with a wide range of health problems, little is known with regard to the processes underlying benefits seen following the program. Herein we examined the relationship between increases in mindfulness and improvements in patient outcomes.

We sought to determine if there was a relationship between the practice of various types of meditation taught during the program and post-MBSR results. Eighty-three chronic ill patients provided pre- and post-MBSR data. An increase in mindfulness was significantly related to reductions in depressive symptoms, stress, medical symptoms and an increase in overall sense of coherence. However, the relationship between practice and outcomes was less evident. Future research is needed to identify which factors lead to an increase in mindfulness.