Stress predicting active lesions on MRI

Stress is associated with the appearance of active MS lesions on MRI. #MSBlog #MSResearch

Epub: Burns et al. Do positive or negative stressful events predict the development of new brain lesions in people withmultiple sclerosis? Psychol Med. 2013:1-11.

BACKGROUND: Stressful life events have long been suspected to contribute to MS disease activity. The few studies examining the relationship between stressful events and neuroimaging markers have been small and inconsistent. This study examined whether different types of stressful events and perceived stress could predict the development of brain lesions. 

METHOD: This was a secondary analysis of 121 MSers followed for 48 weeks during a randomized controlled trial comparing stress management therapy for MS (SMT-MS) to a wait list control (WLC). MSers underwent MRI scans every 8 weeks. Every month, MSers completed an interview measure assessing stressful life events and self-report measures of perceived stress, anxiety and depressive symptoms, which were used to predict the presence of gadolinium-enhancing (Gd+) and T2 lesions on MRI scans 29-62 days later. Participants classified stressful events as positive or negative. Negative events were considered ‘major’ if they involved physical threat or threat to the MSers’ family structure, and ‘moderate’ otherwise.

RESULTS: Positive stressful events predicted decreased risk for subsequent Gd+ lesions in the control group [odds ratio (OR) 0.53 for each additional positive stressful event, 95% confidence interval (CI) 0.30-0.91] and less risk for new or enlarging T2 lesions regardless of group assignment (OR 0.74, 95% CI 0.55-0.99). Across groups, major negative stressful events predicted Gd+ lesions (OR 1.77, 95% CI 1.18-2.64) and new or enlarging T2 lesions (OR 1.57, 95% CI 1.11-2.23) whereas moderate negative stressful events, perceived stress, anxiety and depressive symptoms did not.

CONCLUSIONS: Major negative stressful events predict increased risk for Gd+ and T2 lesions whereas positive stressful events predict decreased risk.

“Do you believe this study? It needs to be confirmed. Most MSers under my care tell me that stress makes their MS worse; either it triggers relapses or it makes intermittent symptoms worse. It is well know in normal subjects that stress affects cognition and memory. Therefore I am not surprised with the results of this study.”

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.


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