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Stress as a risk factor for multiple sclerosis onset or relapse: a systematic review
Artemios K Artemiadis1, Maria C Anagnostouli, Evangelos C Alexopoulos
1Immunogenetic Laboratory, Department of Neurology, Aeginition Hospital, National and Kapodistrian University Medical School, Athens, Greece. artemiad @ med.uoa.gr
Neuroepidemiology
|February 22, 2011
Summary
Psychological stress may influence multiple sclerosis (MS) onset and relapse, but current studies lack consistent methods for measuring stress, hindering definitive conclusions. Future research needs standardized approaches for reliable insights into the stress-MS connection.
Area of Science:
- Neuroscience
- Epidemiology
- Psychology
Background:
- The link between psychological stress and multiple sclerosis (MS) has been hypothesized since the disease's initial description.
- Numerous studies suggest psychological stress may predispose individuals to MS onset and relapses.
Purpose of the Study:
- To synthesize existing knowledge on the relationship between psychological stress and MS onset and relapse.
- To critically evaluate the quality of observational studies investigating this association.
Main Methods:
- A comprehensive literature search was conducted on MEDLINE for observational longitudinal studies published between January 1980 and November 2010.
- The Newcastle-Ottawa scale was employed to assess the quality of the included studies.
- Seventeen publications were analyzed, focusing on MS onset (5 studies) and MS relapse (12 studies).
Main Results:
- A significant heterogeneity was observed in how stress was measured, predominantly focusing on environmental stressors.
- Quality issues were identified, particularly concerning comparability, with inadequate control for confounding psychosocial factors.
- Despite most studies favoring a stress-MS relationship, methodological heterogeneity prevents drawing secure conclusions.
Conclusions:
- Future research should adopt a multidisciplinary approach for stress measurement and incorporate radiological criteria for MS relapse assessment.
- Investigating the impact of early life stress and stress management techniques on the clinical course of MS is recommended.
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