Researchers at St. Joseph's Care Group, Toronto Rehab and the Ottawa Hospital Rehabilitation Centre are conducting a multi-site study to identify the benefits of mindfulness and meditation for traumatic brain injury patients suffering from depression. The two-year study is being funded by the Ontario Neurotrauma Foundation.
The principal investigator is Dr. Michel Bedard, scientific director at St. Joseph's Care Group in Thunder Bay. According to Bedard, more than 300 new traumatic brain injury cases are reported each year in Thunder Bay alone. The majority of these are the result of car and other motorized vehicle crashes, bad falls or sport injuries.
Depending upon what areas of the brain are injured, motor and intellectual functions can be affected. This can alter the individual's ability to concentrate, stay focussed and remember recent events or instructions. As a result, the person may not be able to return to work fully, or at all, and simple pleasures like reading a book can be compromised.
Depression
These changes affect self-image and quality of life, which in turn trigger changes in emotions and behaviour while the individual learns to deal with this new reality.
Statistics indicate that 30 to 40 per cent of people with brain injuries will experience depression.
"Meditation and breathing exercises help people move beyond the limitations they may have in some aspect of their life," said Bedard. "It helps them recognize that they can still live in the present and enjoy life. Meditation is becoming more prevalent as an intervention for all sorts of medical conditions."
In order to assess this intervention's potential benefits, the study - a multi-site, randomized, controlled trial of a mindfulness-based cognitive therapy intervention for treating depression in a traumatic brain injury population - will build on data collected during three earlier, smaller studies.
"These studies showed improvement in quality of life and participant health status with a significant reduction in depression symptoms. Sixty per cent were no longer clinically depressed," said Bedard. "These are very encouraging results."
In the fall of 2010, controlled trials will begin to monitor 40 participants at each of the three sites. The participants will be randomly divided into intervention and control groups. Facilitators will meet with the intervention groups for 90 to120-minute weekly sessions to teach a series of breathing and meditation exercises to be practiced at home.
All participants will be assessed at the beginning and end of the 10-week period. Measures will include depression symptoms, quality of life, anxiety levels, concentration and attention. The control groups will be taught the various techniques after the final assessment - as part of the second wave of the study.
Additional assessments will take place three months after each group finishes its facilitated training to monitor any gains that may have occurred during that time period.
The study data from all three sites is being collated by the St. Joseph's Care Group team for analysis and will form the basis of final reports and articles.
It is hoped that this data will point toward effective strategies for reducing symptoms of depression.
"We continue hoping that people can live good, happy, productive lives and we want to help them achieve that. Right now this is not very well-studied, so it isn't meant to replace other forms of rehabilitation, but it could be used in earlier treatment to maximize the benefit of other interventions," said Bedard. "We are all researchers so we have to continue looking at new, economically feasible approaches. This is an intervention that is not overly costly.
That's why we need to do these trials - to get the evidence. If this works, we want to make sure it can be provided in different areas and not just with specialized people in Thunder Bay.
"We always look to do research that can be applied, as opposed to research for research sake," said Tracy Buckler, President & CEO of St. Joseph's Care Group. "To help the people we serve here and be involved in research that might impact the broader community and across the province is important. We have a small research department but they are doing big things and we're really proud of them."
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