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Depression in the early phase of MS: influence of functional disability, cognitive impairment and brain abnormalities
E Millefiorini1, A Padovani, C Pozzilli
1Department of Neurological Science, University of Rome La Sapienza, Italy.
Abstract:
This study investigated the relationship between depression, physical disability, cognitive deficit and brain abnormalities on magnetic resonance imaging (MRI) in patients with early MS. Eighteen relapsing-remitting MS patients were evaluated: depression was diagnosed according to DSM-III R and measured by the MMPI depression subscale, physical disability was assessed by using the Kurtzke Expanded Disability Status Scale (EDSS) and cognitive functions by means of an extensive neuropsychological test battery. A neuroradiologist blinded to clinical findings quantified cerebral lesion on MRI. Weighted brain area lesion score were developed according to number and size of cerebral lesions. On the basis of DSM-III criteria, six patients were classified as having major depression, seven patients had minor depression and five patients were without depressive symptoms. No significant differences were found among the three groups on both neuropsychological performances and weighted MRI lesion scores. However patients with major depression exhibit greater physical disability than the other MS subgroups. A significant correlation was found between MMPI depression subscale and physical disability. This study suggests that at least in the early phase of MS, depression appears more related to the physical disability than to the severity of pathological brain involvement.
Insights
In early multiple sclerosis (MS), depression is linked more to physical disability than to brain lesions. This finding highlights the impact of physical limitations on mood in MS patients.
Area of Science:
- Neurology
- Psychiatry
- Radiology
Background:
- Depression is a common comorbidity in multiple sclerosis (MS).
- The relationship between depression, cognitive function, physical disability, and brain pathology in early MS requires further investigation.
- Understanding these associations is crucial for comprehensive patient management.
Purpose of the Study:
- To investigate the relationship between depression, cognitive deficits, physical disability, and brain abnormalities on MRI in patients with early relapsing-remitting MS.
Main Methods:
- Eighteen relapsing-remitting MS patients were assessed.
- Depression was diagnosed using DSM-III R criteria and measured with the MMPI depression subscale.
- Physical disability was evaluated using the Kurtzke Expanded Disability Status Scale (EDSS).
- Cognitive functions were assessed via a comprehensive neuropsychological test battery.
- Cerebral lesions on MRI were quantified by a neuroradiologist, and weighted lesion scores were calculated.
Main Results:
- No significant differences in neuropsychological performance or MRI lesion scores were observed among patients with major depression, minor depression, and no depressive symptoms.
- Patients with major depression exhibited greater physical disability compared to other MS subgroups.
- A significant correlation was found between the MMPI depression subscale scores and physical disability.
Conclusions:
- In the early stages of MS, depression is more strongly associated with physical disability than with the extent of brain pathology as measured by MRI.
- These findings suggest that managing physical disability may be a key factor in addressing depression in early MS.
- Further research should explore the mechanisms linking physical disability and depression in MS.