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

Sophia Girgenti¹Isabella Dallasta¹Erin Lawrence¹Dawn Merbach¹Jonathan Z Simon²Rafael H Llinas¹Neda F Gould¹Elisabeth Breese Marsh^1*

• ¹Johns Hopkins Medicine, Johns Hopkins University, Baltimore, Maryland, United States
• ²University of Maryland, College Park, College Park, Maryland, United States

Background: Well-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.We 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, along with a third group of control patients having received neither intervention (n=128).Results: A 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. Post-intervention, both groups demonstrated significantly improved T-scores on cognitive tasks, regardless of intervention. Compared to SSG, the m-MBSR group showed a larger degree of improvement in processing speed, executive, and global cognitive function; however, the difference between groups was not statistically significant. Engagement level was not associated with better clinical scores, though was unexpectedly low for both groups.Conclusions: m-MBSR may 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.