A supplementary training program integrating cold exposure, breathing exercises and mindfulness as a complementary treatment for neuropsychological aspects of multiple sclerosis - a pilot interventional study.

BACKGROUND: Most of the patients with multiple sclerosis (MS) suffer from cognitive impairment, fatigue and/or mood disturbances. These symptoms are usually resistant to both disease-modifying and symptomatic treatment. Since there is a trend to a holistic approach to MS patients, we aimed to confirm the effect of combined cold exposure, controlled breathing and mindfulness - Wim Hof Method (WHM) - on neuropsychiatric symptoms of MS. METHODS: In this randomized interventional study we examined the change in the score of specific neuropsychiatric scales/questionnaires before and after the 12-week WHM-based training program. We compared the change with a control group with no intervention. RESULTS: We obtained complete data from 12 patients in the WHM group and 13 patients in the control group. After 12 weeks, the WHM group had significantly higher improvement in cognition - SDMT (p = 0.045), TMT-A (p = 0.041), TMT-B (p < 0.001); fatigue - FSMCC (p = 0.039); anxiety - GAD (p = 0.015), and depression - PHQ-9 (p = 0.033). CONCLUSION: Our results indicate that the Wim Hof method appears to be a suitable complementary non-pharmacological treatment for neuropsychiatric symptoms of MS.