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Area of Science:

  • Neurology
  • Psychiatry
  • Neuroimmunology

Background:

  • Multiple sclerosis (MS) is associated with a higher prevalence of psychiatric disturbances compared to other chronic conditions.
  • This study investigates the co-occurrence of MS and bipolar disorder, examining potential etiological factors and therapeutic strategies.

Observation:

  • Three cases of MS and bipolar disorder are presented, with patients exhibiting manic or depressive symptoms before or after MS diagnosis.
  • Clinical and radiological features included a manic episode triggered by high-dose corticosteroids and an orbitofrontal MRI lesion coinciding with psychiatric symptom onset.

Findings:

  • Brain magnetic resonance imaging (MRI) lesions in MS patients may contribute to the development of isolated psychiatric episodes.
  • Interferon beta treatments were generally well-tolerated, whereas high-dose corticosteroids were observed to potentially induce manic episodes.

Implications:

  • Local MS-related brain damage is a potential factor in the manifestation of psychiatric symptoms in MS patients.
  • Genetic susceptibility is also considered a possible etiological hypothesis for the association between MS and bipolar disorder.