Related Experiment Videos
Psychological stress and the subsequent appearance of new brain MRI lesions in MS
D C Mohr1, D E Goodkin, P Bacchetti
1University of California at San Francisco, CA 94115-1642, USA.
Objective:
To examine the relationship between stressful life events and psychological distress, and the subsequent development of gadolinium-enhancing (Gd+) brain lesions.
Background:
It has long been speculated that stressful life events and psychological distress are associated with disease exacerbation in MS. This is the first prospective longitudinal study of the relationship between stressful life events, psychological distress, and disease activity as measured by Gd+ brain MRI.
Methods:
Thirty-six patients (mean age, 44.4 years; 22 women, 14 men) with relapsing forms of MS were assessed once every 4 weeks for 28 to 100 weeks. Assessments included Gd+ MRI, the Social Readjustment Rating Scale (SRRS), the Hassles Scale, and the Profile of Mood States. The SRRS was altered in the following manner: 1) three items that confounded with MS were eliminated, 2) endorsed items were rated for intensity, and 3) the scale was divided into three subscales: major negative events, conflict and disruption in routine, and positive life events. Data were analyzed using mixed-effects logistic regression to account for intrasubject correlations. Stress and distress measures were used to predict concurrent and future MRI activity.
Results:
For the total sample of patients, increased conflict and disruption in routine was followed by increased odds of developing new Gd+ brain lesions 8 weeks later (odds ratio, 1.64; p = 0.00083). There was no strong evidence of a relationship between psychological stress or distress and clinical exacerbation.
Conclusions:
These data provide support for the notion that conflict and disruption in routine are related to subsequent disease activity in MS. However, this relationship is not sufficiently robust to predict clinical exacerbations reliably in individual patients.
Insights
Stressful life events, particularly conflict and routine disruption, correlate with new gadolinium-enhancing (Gd+) brain lesions in multiple sclerosis (MS) patients. This association does not reliably predict clinical exacerbations in individuals.
Area of Science:
- Neuroimmunology
- Psychoneuroimmunology
- Radiology
Background:
- Stressful life events and psychological distress are speculated to worsen multiple sclerosis (MS) disease activity.
- This study is the first prospective longitudinal investigation into the relationship between stress, distress, and MS disease activity measured by MRI.
Purpose of the Study:
- To investigate the association between stressful life events and psychological distress.
- To determine the subsequent development of gadolinium-enhancing (Gd+) brain lesions in patients with relapsing-remitting MS.
Main Methods:
- Thirty-six patients with relapsing-remitting MS underwent assessments every 4 weeks for 28–100 weeks.
- Assessments included Gd+ MRI, Social Readjustment Rating Scale (SRRS), Hassles Scale, and Profile of Mood States.
- Mixed-effects logistic regression analyzed the relationship between stress/distress measures and concurrent/future MRI activity.
Main Results:
- Increased conflict and disruption in routine predicted a higher likelihood of new Gd+ brain lesions developing 8 weeks later (OR, 1.64; p = 0.00083).
- No significant relationship was found between psychological stress or distress and clinical exacerbation.
Conclusions:
- Conflict and disruption in routine are linked to subsequent MS disease activity, as evidenced by Gd+ brain lesions.
- This relationship is not robust enough for reliable prediction of clinical exacerbations in individual MS patients.