Stressful life events are associated with the risk of multiple sclerosis

Abstract

Background and purpose Unexpected stressful life events may alter immune function and affect susceptibility to autoimmune diseases including multiple sclerosis (MS). Current results from epidemiological investigations examining the role of stress in MS remain inconsistent. The aim was to conduct the hitherto largest population‐based case–control study on this topic. Methods Extensive questionnaire information collected on lifestyle environmental factors available for 2930 incident MS cases and 6170 controls were used to assess the association of 10 major life events that had occurred before disease onset with the risk of MS by unconditional logistic regressions, adjusting for potential confounders. Stratified analyses were also performed by sex and time. Results Compelling evidence was found for a link between major life events and risk of MS – most events significantly increased disease risk by 17%–30%. It was further observed that women were affected to a greater extent than men under certain stressful scenarios, and that most events that happened recently (≤5 years prior to MS onset) had significant effects on MS, indicating a critical window in disease development. Conclusion Stressful life events may have an adverse effect on the risk of MS. Research into the mechanisms of this observation may give important clues to triggering pathogenetic events in MS.

Genetic, Environmental and Lifestyle Determinants of Accelerated Telomere Attrition as Contributors to Risk and Severity of Multiple Sclerosis

“…Stressful life circumstances might explain the timing of symptom exacerbation for some patients with MS, perhaps by perturbing an already unstable neuroimmunological system [237]. Sickness, accidents or death of a family member and major changes to a romantic or working relationship posed a 14% to 26% increased risk of MS [238]. No elevated risk was seen for individuals who reported physical or sexual abuse during childhood or adolescence in the study by Riise et al [239].…”

Association of adverse childhood experiences with the development of multiple sclerosis

“…Previous studies on adverse events have mainly focused on adulthood and have found that most events happened during the last 1–5 years before MS onset. 3 32 33 …”

“…This is the first fully prospective study that has assessed the association between childhood adverse events and subsequent MS. Previous studies on adverse events have mainly focused on adulthood and have found that most events happened during the last 1–5 years before MS onset 3 32 33…”

“…Trauma and stressful life events have been associated with an increased risk of autoimmune disorders 1. Any impact of stress on multiple sclerosis (MS) is debated,2 but a recent population-based study from Sweden with 2930 MS cases indicated a link between major stressors in adult life, such as loss of a loved one, divorce or personal conflict and subsequent MS disease 3. Adverse childhood experiences such as abuse, neglect and household dysfunction are extreme types of stress, and increase the risk of psychiatric and physical disorders in adulthood,4 including cardiovascular disease, cancer and autoimmune disease 5…”

Abuse and revictimization in adulthood in multiple sclerosis: a cross-sectional study during pregnancy

“…The aim was to explore the direction of the associations. As women with future MS did not have the vulnerability of having a chronic condition [ 6 , 8 ], higher rates of abuse in this group could signify that adult abuse predating the diagnosis could be risk or trigger factor for MS [ 24 , 25 ], or associated with unknown confounders, rather than being a consequence of MS. In this analysis, we excluded women who had their first symptom of MS within 5 years after MoBa inclusion and could have been in a prodromal phase of MS [ 26 ].…”