Behavioral Interventions in Multiple Sclerosis

A Biopsychosocial Perspective

C Heesen; S Köpke; J Kasper; J Poettgen; A Tallner; DC Mohr; SM Gold

Disclosures

Expert Rev Neurother. 2012;12(9):1089-1100. 

In This Article

Five-year View

Ideally, researchers from different backgrounds will engage in integrated approaches using complex interventions and combine a clinical view with molecular and imaging techniques. Exercise should be paradigmatically studied, focusing on the putative neuroprotective effects. Combining cognitive behavior and molecular work will expand our understanding of the hidden symptoms in MS, moving from cross-sectional correlational work to longitudinal intervention studies. This might not only enhance our understanding of treatment benefits but could provide prognostic and treatment response markers. Further comparative work is needed to clarify the differential effects and indications of group, face-to-face, online and computer-based interventions. Mindfulness and acceptance-oriented approaches will be the first applications of cognitive behavior in advanced MS stages. Palliative care and MS in the elderly will become increasingly important given the demographic changes.

Implementation of BI into routine care is a major obstacle in this area. With more healthcare-oriented work addressing utilization of resources, cognitive-behavioral interventions might be transferred into everyday care. Expanding work on evidence-based patient information will lead to structured decision coaching strategies. Risk–knowledge assessment tools as well as communication quality ratings might help to benchmark MS center quality from a patient perspective.

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