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Anxiety and Depression Linked to Brain Inflammation in New Study of People with Relapsing-Remitting MS

October 2, 2017

SUMMARY
  • In a new study of 405 people with MS, those with inflammatory disease activity observed on MRI brain scans – whether or not they were experiencing symptoms or full-blown relapses – had higher levels of depression and anxiety.
  • When MRI scans showed that disease activity and inflammation had resolved, so did these mood changes. Participants who experienced a relapse within six months had higher levels of anxiety at the start of the study.
  • Further studies are necessary to clarify the association between mood and inflammation – for example, if these symptoms may be predictive of relapses. Right now, though, addressing emotional changes is an essential component of overall health and wellness. Recognizing and addressing issues related to mental and emotional health can greatly improve quality of life for people affected by MS. 
  • The team (Drs. Silvia Rossi, Valeria Studer, Jacopo Perugini and colleagues (Isitituto Neurologico Carlo Besta, Milan, and other institutions) report their findings in Neurology (Published online August 25, 2017).
 
DETAILS
Background: Depression and anxiety are increasingly recognized as common symptoms associated with MS. Research on psychiatric disorders in general indicates that inflammation may play a role in their development, so the current study investigates links between mood and the inflammatory disease activity that occurs in MS.
 
This Study: The investigators administered psychological tests measuring depression and anxiety to 405 people with relapsing-remitting MS. Inflammatory disease activity was assessed using MRI (magnetic resonance imaging) brain scans. In a subset of participants who had not yet received disease-modifying therapies, the team also measured levels of immune messenger proteins in the spinal fluid. Participants were reexamined three and six months later.
 
Results: Participants with signs of active inflammation observed on their MRI scans (78 people) had significantly higher levels of anxiety and depression, whether or not they were experiencing an actual relapse. After three months, inflammation had resolved in 74 people, and this reduction of disease activity was linked to a significant reduction in anxiety and depression. Of 29 participants who were experiencing an MS relapse at the start of the study, 20 underwent anti-inflammatory steroid treatment and depression and anxiety decreased for them as well. Participants who experienced a relapse within six months had higher levels of anxiety at the start of the study.
 
Upon examining immune messenger proteins in the spinal fluid, the team found that IL-2 and IL-8 were significantly higher in participants who showed increased levels of anxiety, and NF-alpha and IL-1beta were higher in those who showed increased depression.
 
The team (Drs. Silvia Rossi, Valeria Studer, Jacopo Perugini and colleagues (Isitituto Neurologico Carlo Besta, Milan, and other institutions) report their findings in Neurology (Published online August 25, 2017).
 
Next Steps: This study shows important connections between emotional changes and inflammatory disease activity in MS. Further studies are necessary to clarify the association between emotional symptoms and inflammation – for example, whether these symptoms may be able to predict relapses. Right now, though, addressing emotional changes is an essential component of overall health and wellness. Recognizing and addressing issues related to mental and emotional health can greatly improve quality of life for people affected by MS. 
 
Read more about emotional changes and MS
Learn how to enhance emotional well being
 

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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