Related Experiment Videos
[Effect of methylprednisolone on emotional functioning of patients with multiple sclerosis]
Alina Kułakowska1, Wiesław Drozdowski, Dorota Halicka
1Klinika Neurologii Akademii Medycznej w Białymstoku.
Unlabelled:
The effects were examined of high doses of intravenous methylprednisolone (MP; 1 g daily, administered for 5 days) on emotional functions in multiple sclerosis (MS) patients with clinical relapse. Thirty two patients with relapsing-remitting disease were included. The mean age was 39.4 (20-56) years, mean disease duration and mean Expanded Disability Status Scale scores were 6.6 (0.8-28) years and 4.1 (2-6.5), respectively. MS patients were subjected twice to psychological tests: immediately after MP treatment and 6 months later. Hamilton Rating Scale for Depression (HRSD) and Hopkins Symptom Check List (HSCL) were used. Thirty two control subjects (mean age 37.2 years) with ischialgia, not receiving steroids, underwent the same testing procedure. On the basis of their results in learning tests (Nonverbal Learning Test and Rey Auditory Verbal Learning Test) upon admission, MS subjects were allocated into 2 different subgroups: 20 patients were included into cognitively preserved group (cpMS) and 12 patient into the group with cognitive decline (cdMS). Immediately after MP treatment, MS patients (total group) achieved significantly higher scores than controls on the HRSD and two subclasses of the HSCL: depression with inhibition and phobic anxiety. There were no significant differences between cpMS and control subjects in HRSD and HSCL tests. CdMS patients, as compared with controls and cpMS subjects upon admission showed depressed mood, obsessive-compulsive disorder, increased anxiety and interpersonal hypersensitivity. Therapy with MP did not markedly change emotional functions in all MS patients (total group, cpMS, cdMS).
Conclusions:
1. Only cdMS patients show emotional disturbances. 2. Therapy with MP does not significantly change the emotional profile of MS patients.
Insights
High-dose methylprednisolone (MP) treatment did not significantly alter emotional functions in multiple sclerosis (MS) patients. Only patients with cognitive decline (cdMS) exhibited emotional disturbances, which were not improved by MP therapy.
Area of Science:
- Neurology
- Psychiatry
- Clinical Pharmacology
Context:
- Multiple sclerosis (MS) is a chronic neurological disease affecting young adults.
- Clinical relapses in MS are often treated with high-dose corticosteroids.
- Emotional dysfunction is a common but complex comorbidity in MS.
Purpose:
- To investigate the impact of high-dose intravenous methylprednisolone (MP) on emotional functions in relapsing-remitting MS patients.
- To differentiate the effects of MP on emotional well-being between MS patients with and without cognitive decline.
- To assess changes in depression and anxiety symptoms post-MP treatment.
Summary:
- Thirty-two relapsing-remitting MS patients received 1g MP daily for 5 days, with psychological testing before and 6 months after treatment.
- Patients were subgrouped into cognitively preserved (cpMS) and cognitive decline (cdMS) based on learning tests.
- Immediately post-MP, the total MS group showed higher depression and anxiety scores than controls; however, MP therapy did not significantly alter emotional profiles in any MS subgroup.
Impact:
- Cognitive decline in MS is associated with significant emotional disturbances, including depression, anxiety, and obsessive-compulsive symptoms.
- High-dose MP therapy does not appear to ameliorate emotional dysfunction in MS patients, irrespective of cognitive status.
- These findings highlight the need for targeted psychological interventions for MS patients with cognitive impairment.