Modified-Mindfulness-Based Stress Reduction as a Treatment for Cognitive Recovery in Patients with Minor Stroke: a Randomized Controlled Pilot Study

BackgroundWell-developed rehabilitation paradigms exist for post-stroke language and motor impairments. However, no such recovery program has been identified for commonly disabling cognitive deficits in patients following minor stroke. Mindfulness Based Stress Reduction (MBSR) is thought to engage the frontal lobes, improving concentration and attention, and therefore may be an effective option. MethodsWe prospectively enrolled a cohort of patients with subacute minor stroke and randomized them to either an 8-week online modified-MBSR course or online traditional Stroke Support Group (SSG). All patients underwent a battery of cognitive tests and measures of patient reported outcomes (PROs) pre- and post-intervention. ANOVA was used to compare changes in scores over time across both groups, as well as a third group of control patients having received neither intervention (n=128). ResultsA total of 30 patients were randomized (n=16 for m-MBSR; n=14 for SSG). The average age of the cohort was 65.9 years. Both groups scored similarly on assessments one-month post-stroke and demonstrated increased T-scores on cognitive tasks at the 3-month visit. However, the m-MBSR group showed moderately elevated levels of improvement, specifically in processing speed, executive, and global cognitive function. Level of engagement was not associated with better clinical scores, though was unexpectedly low for both groups. Conclusionsm-MBSR appears to modestly improve frontal lobe activity and demonstrates some success in increasing cognitive performance. However, further studies are needed to determine if it is more efficacious in the chronic stage of recovery when more patients are able to fully engage and actively participate.