Stress in Multiple Sclerosis: Review of New Developments and Future Directions

Abstract

In the experimental autoimmune encephalitis model of multiple sclerosis, the effects of stress on disease severity depend on multiple factors, including the animal's genetics and the type of stressor. The studies in humans relating stress to the risk of developing multiple sclerosis have found discordant results. The studies looking at the association of stress with relapses show a fairly consistent association, where higher stress is associated with a higher risk of relapse. Higher stress levels also appear to increase the risk of development of gadolinium-enhancing lesions. A recent randomized trial shows that reducing stress using stress management therapy (SMT), a cognitive-behavioral therapy approach, results in a statistically significant reduction in new magnetic resonance imaging lesions. The magnitude of this effect is large and comparable to the effects of existent disease-modifying therapies, but no data exist yet proving that SMT reduces relapses or clinical progression; the effect of SMT appears to be short-lived. Additional work is needed to improve the duration of this effect and make this therapy more widely accessible.

The Role of Biogenic Amines in the Regulation of Interaction between the Immune and Nervous Systems in Multiple Sclerosis

“…For example, psycho-emotional stress can enhance the production of proinflammatory cytokines in MS patients [8] and promote exacerbations [9][10][11] . At the same time, the mechanisms connecting stress and inflammation in MS are not clear [12][13][14][15][16][17] .…”

Validation of the Social Provisions Scale in people with multiple sclerosis.

“…In particular, stress is associated with MS recurrence and progression (Lovera & Reza, 2013), and social support plays a significant role in buffering the impact of stress (Thoits, 1982). In addition, social support increases self-esteem and self-efficacy, which are critical components for living a positive, healthy, and productive life with MS (Bandura, 1982; Cobb, 1976; Cutrona & Russell, 1987; Dlugonski & Motl, 2010).…”

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“…In this way, the hypothalamus, the chiasm, optic nerves, internal capsules and the left temporal lobe are revascularized, and through these omental neovessels, the ischemic parenchyma receives an increase in blood flow, oxygen, neurotransmitters, neurotrophic factors, adipocytokines and omental stem cells [8,18,24]. Therefore, our surgical technique improved the short-term memory, and the visual and motora function; as well as caused a reduction in the hyperactivity of the hypothalamo-pituitary-adrenal (HPA) axis observed in patients with MS [25][26][27][28][29][30]. Because substantial evidences indicates that stress can precipitate or worsen symptoms of inflammmation in general and more specifically in MS.…”