Tailored psychotherapy could improve the lives of patients with MND – study

Tailored psychological support could enhance the quality of life of patients with motor neurone disease (MND), a study has found.

Treatments aimed at improving the psychological wellbeing of those with the condition are “crucial” in the absence of a cure, researchers said.

MND affects the brain and nerves, with patients eventually losing the ability to move, speak, swallow and breathe.

Current treatments include physiotherapy to maintain muscle strength and a drug called riluzole, which can slow the progression of the disease.

The Commend study, led by a team from the University of Sheffield and University College London (UCL), explored whether acceptance and commitment therapy (ACT) could boost the psychological health of people with MND.

ACT is a type of psychotherapy that combines behavioural therapy with strategies like mindfulness, encouraging patients to accept difficult thoughts and feelings rather than trying to control or avoid them.

Chris McDermott, a professor of translational neurology at the University of Sheffield, honorary consultant neurologist and joint lead of the trial, said: “We desperately need treatments to slow down and stop MND.

“In a year when several large drug trials have already reported negative results we are reminded what a huge and difficult challenge that is.

“While we work hard for a cure, it is essential we support those living with MND now.”

Commend began in 2019 and involved 191 people across 16 MND centres in the UK.

Patients were randomly assigned to have either their usual care or their usual care plus ACT.

The results, published in The Lancet, showed ACT, when combined with usual care, was “clinically effective for maintaining or improving quality of life” in patients with MND.

Researchers said: “As further evidence emerges confirming these findings, healthcare providers should consider how access to ACT, adapted for the specific needs of people with motor neurone disease, could be provided within motor neurone disease clinical services.”

Prof McDermott added: “The Commend study shows that tailored psychological support can have a major impact on the quality of life of those people living with MND.”

Rebecca Gould, a professor of psychological therapies at UCL, honorary clinical psychologist, chief investigator of the study and joint lead of the trial, said: “In the absence of a cure for this devastating disease, interventions aimed at helping to improve the psychological wellbeing and quality of life of people living with MND are crucial.

“Poor quality of life and psychological distress are associated with numerous negative outcomes, including shorter survival and increased risk of suicide.

“Therefore, it is vital that we provide evidence-based interventions to help manage this.

“This study provides strong evidence that acceptance and commitment therapy can be a valuable tool for improving quality of life for the 5,000 people who are currently living with MND in the UK.”

The study was funded by the NIHR Health Technology Assessment and the MND Association.

According to the MND Association, the condition can affect up to 5,000 adults in the UK at any one time.

Chris Bennett, head of regional services and partnerships at the charity, added: “We know many people with MND seek help to cope with the psychological impact of the disease but often this isn’t available or, if it is, not in a timely way.

“The Commend study shows psychological support can be effective in improving quality of life and that there is clear clinical benefit in acceptance commitment therapy specifically.

“It is therefore important these findings are taken forward and consideration is given to offering psychological support, such as ACT, within the standard care package to all those who may benefit from it.”