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The impact of early life stress on patient-reported outcomes in multiple sclerosis
Myla Goldman1, Shanshan Chen2, Rylan Pearsall1
1Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Background:
Early life stress (ELS) has been implicated in the risk of developing autoimmune disorders including multiple sclerosis (MS), but less is known about its relationship to the clinical course of MS.
Objective:
Investigate the relationship between ELS and MS patient-reported outcomes (PRO).
Methods:
In a single-center, cross-sectional study, persons with MS completed a composite of surveys assessing ELS and PRO including the adverse childhood experiences (ACE) survey, the Childhood Trauma Questionnaire, MS Performance Scales, MS Impact Scale (MSIS-29) and MS Quality of Life (MSQOL-54). Multiple linear regression models were used to assess the associations between ELS and outcomes while adjusting for potential confounding variables.
Results:
A total of 133 persons with MS completed the study. ELS was significantly associated with worse outcomes on the MSQOL-54. Persons with MS with ACE score ≥ 4 were 25.6 points lower (95% CI -15.7 to -35.6) on the Mental Health Composite and 24.6 points lower (95% CI -14.4 to -34.8) on the Physical Health Composite scores of the MSQOL-54. ELS was also associated with worse outcomes on the MS Performance Scale and the MSIS-29.
Conclusion:
In persons with MS, a history of ELS is associated with significantly worse MS symptom burden and quality of life.
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