other health professionals use biomarkers as tools to obtain
information about a person=E2=80=99s health status or response to
interventions. Defined as characteristics that indicate biological
processes, biomarkers are essential for monitoring the health of
individuals and a key way of determining the effectiveness of
therapeutic interventions. One of the drawbacks to behavioral
interventions in many diseases is that their effectiveness is often
based on self-report. Unfortunately, "Gosh I do or do not feel better"
doesn't inform in quite the same manner as using objective measures to
evaluate the effectiveness of the intervention regardless of the
disease. The recently published PACE protocol for example, did not use
biomarkers to measure the effectiveness of exercise as an intervention
in the group of people they monitored.
Therapeutic Advances in Neurological Disorders July 2011 vol. 4 no. 4 217-2=
29
Biological outcome measurements for behavioral interventions in
multiple sclerosis
Anja Fischer, Christoph Heesen, Stefan M. Gold=E2=87=93
Institute for Neuroimmunology und Clinical Multiple Sclerosis Research
(inims), Falkenried 94, D-20251 Hamburg, Germany
stefan.gold@zmnh.uni-hamburg.deorgold@uke.de
Abstract
Behavioral interventions including exercise, stress management,
patient education, psychotherapy and multidisciplinary
neurorehabilitation in general are receiving increasing recognition in
multiple sclerosis (MS) clinical practice and research.
Most scientific evaluations of these approaches have focused on
psychosocial outcome measures such as quality of life, fatigue or
depression.
However, it is becoming increasingly clear that neuropsychiatric
symptoms of MS are at least partially mediated by biological processes
such as inflammation, neuroendocrine dysfunction or regional brain
damage. Thus, successful treatment of these symptoms with behavioral
approaches could potentially also affect the underlying biology.
Rigidly designed scientific studies are needed to explore the
potential of such interventions to affect MS pathology and biological
pathways linked to psychological and neuropsychiatric symptoms of MS.
Such studies need to carefully select outcome measures on the
behavioral level that are likely to be influenced by the specific
intervention strategy and should include biomarkers with evidence for
an association with the outcome parameter in question.
In this overview, we illustrate how biological and psychological
outcome parameters can be combined to evaluate behavioral
interventions. We focus on two areas of interest as potential targets
for behavioral interventions: depression and fatigue.
Additional information regarding biomarkers in chronic disease in
general can be found here:
http://www.iom.edu/Reports/2010/Evaluation-of-Biomarkers-and-Surrogate-Endp=
oints-in-Chronic-Disease.aspx
---------------------------------------------
Send posts to CO-CURE@listserv.nodak.edu
Unsubscribe at http://www.co-cure.org/unsub.htm
Too much mail? Try a digest version. See http://www.co-cure.org/digest.htm
---------------------------------------------
Co-Cure's purpose is to provide information from across the spectrum of
opinion concerning medical, research and political aspects of ME/CFS and/or
FMS. We take no position on the validity of any specific scientific or
political opinion expressed in Co-Cure posts, and we urge readers to
research the various opinions available before assuming any one
interpretation is definitive. The Co-Cure website <www.co-cure.org> has a
link to our complete archive of posts as well as articles of central
importance to the issues of our community.
---------------------------------------------
