Emotional outcomes in clinically isolated syndrome and early phase multiple sclerosis: a systematic review and meta-analysis

Rintala, Aki; Matcham, Faith; Radaelli, Marta; Locafaro, G.; Simblett, Sara; Pietro, Chiara Barattieri di San; Bulgari, Viola; Burke, Peter; Devonshire, J.; Weyer, Jürgen; Wykes, Til; Comı, Gıancarlo; Hotopf, Matthew; Myin-Germeys, Inez

doi:10.1016/j.jpsychores.2019.109761

Cited by 20 publications

(6 citation statements)

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“…Patients with CIS are already afflicted by fatigue and depression, typically of milder severity than in relapsing–remitting MS (RR-MS) patients [ 20 , 21 ]. Although several studies demonstrated a relationship between fatigue and depression symptomatology and brain function alterations in RR-MS patients [ 15 , 18 , 19 , 22 ], there is no direct evidence for such a relation in CIS patients.…”

Section: Introductionmentioning

confidence: 99%

Distinct hemodynamic and functional connectivity features of fatigue in clinically isolated syndrome and multiple sclerosis: accounting for the confounding effect of concurrent depression symptoms

et al. 2023

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Purpose This study aims to identify common and distinct hemodynamic and functional connectivity (FC) features for self-rated fatigue and depression symptoms in patients with clinically isolated syndrome (CIS) and relapsing–remitting multiple sclerosis (RR-MS). Methods Twenty-four CIS, 29 RR-MS patients, and 39 healthy volunteers were examined using resting-state fMRI (rs-fMRI) to obtain whole-brain maps of (i) hemodynamic response patterns (through time shift analysis), (ii) FC (via intrinsic connectivity contrast maps), and (iii) coupling between hemodynamic response patterns and FC. Each regional map was correlated with fatigue scores, controlling for depression, and with depression scores, controlling for fatigue. Results In CIS patients, the severity of fatigue was associated with accelerated hemodynamic response in the insula, hyperconnectivity of the superior frontal gyrus, and evidence of reduced hemodynamics–FC coupling in the left amygdala. In contrast, depression severity was associated with accelerated hemodynamic response in the right limbic temporal pole, hypoconnectivity of the anterior cingulate gyrus, and increased hemodynamics–FC coupling in the left amygdala. In RR-MS patients, fatigue was associated with accelerated hemodynamic response in the insula and medial superior frontal cortex, increased functional role of the left amygdala, and hypoconnectivity of the dorsal orbitofrontal cortex, while depression symptom severity was linked to delayed hemodynamic response in the medial superior frontal gyrus; hypoconnectivity of the insula, ventromedial thalamus, dorsolateral prefrontal cortex, and posterior cingulate; and decreased hemodynamics–FC coupling of the medial orbitofrontal cortex. Conclusion There are distinct FC and hemodynamic responses, as well as different magnitude and topography of hemodynamic connectivity coupling, associated with fatigue and depression in early and later stages of MS.

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Section: Introductionmentioning

confidence: 99%

Distinct hemodynamic and functional connectivity features of fatigue in clinically isolated syndrome and multiple sclerosis: accounting for the confounding effect of concurrent depression symptoms

et al. 2023

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“…Of note, the risk to develop depression is two or five-times higher for MS patients than general population, with a lifetime prevalence of 50%, a rate of 44,5% during relapses but with no differences in terms of gender (Feinstein, 2011). In a recent meta-analysis, depressive symptoms have been reported in 35% of CIS and in the early phase of MS (Rintala et al, 2019). They may occur even in the absence of physical disability, sometimes anticipating the onset of clinical deficits (Haussleiter et al, 2009;Lo Fermo et al, 2010), suggesting that mood disturbances are not a reactive phenomenon to the pathology, but a considerable part of it (Feinstein et al, 2014).…”

Section: Depressive Symptoms In Msmentioning

confidence: 99%

Inflammation-Associated Synaptic Alterations as Shared Threads in Depression and Multiple Sclerosis

Bruno

Dolcetti

Rizzo

et al. 2020

Front. Cell. Neurosci.

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In the past years, several theories have been advanced to explain the pathogenesis of Major Depressive Disorder (MDD), a neuropsychiatric disease that causes disability in general population. Several theories have been proposed to define the MDD pathophysiology such as the classic “monoamine-theory” or the “glutamate hypothesis.” All these theories have been recently integrated by evidence highlighting inflammation as a pivotal player in developing depressive symptoms. Proinflammatory cytokines have been indeed claimed to contribute to stress-induced mood disturbances and to major depression, indicating a widespread role of classical mediators of inflammation in emotional control. Moreover, during systemic inflammatory diseases, peripherally released cytokines circulate in the blood, reach the brain and cause anxiety, anhedonia, social withdrawal, fatigue, and sleep disturbances. Accordingly, chronic inflammatory disorders, such as the inflammatory autoimmune disease multiple sclerosis (MS), have been associated to higher risk of MDD, in comparison with overall population. Importantly, in both MS patients and in its experimental mouse model, Experimental Autoimmune Encephalomyelitis (EAE), the notion that depressive symptoms are reactive epiphenomenon to the MS pathology has been recently challenged by the evidence of their early manifestation, even before the onset of the disease. Furthermore, in association to such mood disturbance, inflammatory-dependent synaptic dysfunctions in several areas of MS/EAE brain have been observed independently of brain lesions and demyelination. This evidence suggests that a fine interplay between the immune and nervous systems can have a huge impact on several neurological functions, including depressive symptoms, in different pathological conditions. The aim of the present review is to shed light on common traits between MDD and MS, by looking at inflammatory-dependent synaptic alterations associated with depression in both diseases.

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“…We found elevated scores of depression and anxiety in MS patients consistent with the previous research 4,7 also in line with a study in early phase MS. Symptoms of anxiety are comparable or even marginally higher in early stages relative to later stages of MS 37 . Our findings suggest that, in the early phase of cognitively preserved MS patients, higher anxiety and lower purposefulness (SD2) significantly impacted depression symptoms.…”

Section: Discussionmentioning

confidence: 90%

Temperament and character in relapsing-remitting multiple sclerosis: the association with clinical factors and psychiatric disorders

Kılıç

ÇELİK²,

Emül³

et al. 2022

Cukurova Medical Journal

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ÖzPurpose: Despite its implications for quality of life, temperament, and character in multiple sclerosis are underexplored. We aimed to explore temperament and character traits, their association with clinical characteristics, and explore the factors that impact depression in patients with relapsing-remitting multiple sclerosis (RRMS). Materials and Methods: This cross-sectional study enrolled 67 patients (male/female=12/55) (median age=30 (18-53)) and 50 age-and gender-matched healthy controls (HCs) (male/female=16/34) (median age= 26.5 (18-60)) using a convenience sampling method. Temperament and Character Inventory, Beck Depression and Beck Anxiety Inventories, and Structured Clinical Interview for DSM-Axis I Disorders-SCID-I were applied. Results: In the patient group there were 45 MS patients with no psychiatric comorbidity (MSN) and 22 MS patients with psychiatric comorbidity (MSP). Higher selfforgetfulness was observed in the MSP group compared with MSN and HC groups. MSP and MSN demonstrated higher total harm avoidance than HCs. MSP group showed lower total self-directedness compared with HCs. While EDSS, duration of disease, or the number of relapses did not impact depression scores; higher anxiety (Β=0.416) and lower purposefulness (Β=-1.565) significantly impacted them (R2=.50, F=32.459). Conclusion: Temperament and character differences were observed in patients with and without psychiatric Amaç: Yaşam kalitesi üzerindeki etkilerine rağmen, multipl sklerozda mizaç ve karakter yeterince araştırılmamıştır. Mizaç ve karakter boyutlarını, i, bunların klinik özelliklerle ilişkisini ve depresyon şiddetini etkileyen faktörleri tekrarlayan ve düzelen multiple skleroz (TDMS) hastalarında incelemeyi amaçladık. Gereç veYöntem: Bu kesitsel çalışmaya, elverişli örnekleme yöntemiyle 67 hasta (erkek/kadın=12/55) (medyan yaş=30 (18-53)) ve yaş ve cinsiyet açısından eşleştirilmiş 50 sağlıklı kontrol (SK) (erkek/kadın=16/34) (medyan yaş= 26.5 (18-60)) alındı. Mizaç ve Karakter Envanteri, Beck Depresyon ve Beck Anksiyete Envanterleri, DSM-Eksen I Bozuklukları için Yapılandırılmış Klinik Görüşme uygulandı. Bulgular: Hasta grubu içinde, psikiyatrik komorbiditesi olan 45 (MSP), psikiyatrik komorbiditesi olmayan (MSO) 22 hasta bulunuyordu. MSP grubu, MSO grubuna ve SK'lere göre daha yüksek kendilik kaybı gösterdi. MSP grubu ve MSO grubu toplam zarardan kaçınma puanları SK'lere kıyasla yüksekti. Toplam kendini yönetme puanları MSP grubunda SK'lerden düşüktü. EDSS, hastalık süresi, toplam nüks sayısı depresyon şiddetini etkilemezken; yüksek anksiyete (Β=0,416) ve düşük amaçlılık düzeyleri (Β=-1,565) depresyon düzeyini anlamlı derecede etkilemekteydi (R2=0.50, F=32.459). Sonuç: Komorbid psikiyatrik bozukluğu olan ve olmayan hastalar arasında mizaç ve karakter özellikleri açısından farklılıklar gözlendi. Artmış anksiyete düzeyleri; anlamlı Kılıc et al. Cukurova Medical Journal 1340 comorbidity. Higher anxiety levels and the difficulty to establish and attain meaningful goals may relate to higher depression levels. Future studi...

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Emotional outcomes in clinically isolated syndrome and early phase multiple sclerosis: a systematic review and meta-analysis

Cited by 20 publications

References 83 publications

Distinct hemodynamic and functional connectivity features of fatigue in clinically isolated syndrome and multiple sclerosis: accounting for the confounding effect of concurrent depression symptoms

Distinct hemodynamic and functional connectivity features of fatigue in clinically isolated syndrome and multiple sclerosis: accounting for the confounding effect of concurrent depression symptoms

Inflammation-Associated Synaptic Alterations as Shared Threads in Depression and Multiple Sclerosis

Temperament and character in relapsing-remitting multiple sclerosis: the association with clinical factors and psychiatric disorders

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