A Prospective Study of Depression and Immune Dysregulation in Multiple Sclerosis

Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461.
JAMA Neurology (Impact Factor: 7.42). 04/1992; 49(3):238-44. DOI: 10.1001/archneur.1992.00530270052018
Source: PubMed


This study examined psychologic distress and immune function in patients with chronic-progressive multiple sclerosis participating in a placebo-control trial of cyclosporine. Immune measures included percentages and absolute numbers of CD2+, CD4+, CD8+, Leu-11-b+, HLA-DR (IA+), and transferrin-receptor-positive cells, which were evaluated by immunofluorescence using monoclonal antibodies. Distress was measured with self-report scales. The Expanded Disability Status Scale assessed neurologic disability. Subjects were followed up for 2 years, and their high-depressed and low-depressed times were compared. Times of greater depression were associated with lower CD8+ cell numbers and CD8+%, and a higher CD4/CD8 ratio. CD4+ cell numbers and percent were also higher when subjects were depressed, but only in the placebo group. There were no differences in Expanded Disability Status Scale when subjects were more depressed. Evaluation of a single subject revealed that Ia+ and transferrin-receptor-positive lymphocytes increased 3 months before distress increased. It was concluded that distress is associated with immune dysregulation in multiple sclerosis, although the mechanisms of this association have yet to be delineated.

7 Reads
  • Source
    • "The BDI is a self-evaluation method for recording the severity of symptoms of depression [11]. MS patients show a higher depression level [12]. Disease-related symptoms, e.g. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Olfactory dysfunction in MS patients is reported in the literature. MRI of the olfactory bulb (OB) is discussed as a promising new testing method for measuring olfactory function (OF). Aim of this study was to explore reasons for and optimize the detection of olfactory dysfunction in MS patients with MRI. OB and olfactory brain volume was assessed within 34 MS patients by manual segmentation. Olfactory function was tested using the Threshold-Discrimination-Identification-Test (TDI), gustatory function was tested using Taste Strips (TST). 41% of the MS patients displayed olfactory dysfunction (8% of the control group), 16% displayed gustatory dysfunction (5% of the control group). There was a correlation between the OB volume and the number and volume of MS lesions in the olfactory brain. Olfactory brain volume correlated with the volume of lesions in the olfactory brain and the EDSS score. The TST score correlated with the number and volume of lesions in the olfactory brain. The correlation between a higher number and volume of MS lesions with a decreased OB and olfactory brain volume could help to explain olfactory dysfunction.
    PLoS ONE 05/2011; 6(5):e19702. DOI:10.1371/journal.pone.0019702 · 3.23 Impact Factor
  • Source
    • "Depression may also exact a greater toll on the health of people with MS. Depression may affect MS indirectly by decreasing adherence to MS disease modifying medications (Mohr et al., 1997) and more directly by aggravating MS-related immune dysregulation (Foley et al., 1992; Mohr, Goodkin, Islar, Hauser, & Genain, 2001). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Anxiety is highly comorbid with depression, but little is known about the impact of anxiety disorders on the effectiveness of empirically supported psychotherapies for depression. We examined such outcomes for people with Multiple Sclerosis (MS) and depression, with versus without comorbid anxiety disorders. Participants with MS (N = 102) received 16 weeks of telephone-administered psychotherapy for depression and were followed for one year post-treatment. Participants with comorbid anxiety disorders improved to a similar degree during treatment as those without anxiety disorders. Outcomes during follow-up were mixed, and thus we divided the anxiety diagnoses into distress and fear disorders. The distress disorder (GAD) was associated with elevated anxiety symptoms during and after treatment. In contrast, fear disorders (i.e., panic disorder, agoraphobia, social phobia, specific phobia) were linked to depression, specifically during follow-up, across 3 different measures. People with GAD receiving treatment for depression may benefit from additional services targeting anxiety more specifically, while those with comorbid fear disorders may benefit from services targeting maintenance of gains after treatment.
    Rehabilitation Psychology 08/2010; 55(3):255-62. DOI:10.1037/a0020492 · 1.91 Impact Factor
  • Source
    • "A study that compared psychotherapy with placebo found lower levels of depression but no reduction in anxiety scores in the group that received psychotherapy [20]. Other studies have compared cognitivebehavioral therapy with psychotherapy [21], and have reported lower depression levels with cognitive-behavioral therapy versus placebo [22], without significant differences between groups. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the efficacy of a computer-based intensive training program of attention, information processing and executive functions in patients with clinically-stable relapsing-remitting (RR) multiple sclerosis (MS) and low levels of disability. DESIGN, PATIENTS AND INTERVENTIONS: A total of 150 patients with RR MS and an Expanded Disability Status Scale (EDSS) score of < or =4 were examined. Information processing, working memory and attention were assessed by the Paced Auditory Serial Addition Test (PASAT) and executive functions by the Wisconsin Card Sorting Test (WCST). Twenty patients who scored below certain cut-off measures in both tests were included in this double-blind controlled study. Patients were casually assigned to a study group (SG) or a control group (CG) and underwent neuropsychological evaluation at baseline and after 3 months. Patients in the SG received intensive computer-assisted cognitive rehabilitation of attention, information processing and executive functions for 3 months; the CG did not receive any rehabilitation. Ambulatory patients were sent by the MS referral center. Improvement in neuropsychological test and scale scores. After rehabilitation, only the SG significantly improved in tests of attention, information processing and executive functions (PASAT 3'' p=0.023, PASAT 2'' p=0.004, WCSTte p=0.037), as well as in depression scores (MADRS p=0.01). Neuropsychological improvement was unrelated to depression improvement in regression analysis. Intensive neuropsychological rehabilitation of attention, information processing and executive functions is effective in patients with RR MS and low levels of disability, and also leads to improvement in depression.
    Journal of the neurological sciences 10/2009; 288(1-2):101-5. DOI:10.1016/j.jns.2009.09.024 · 2.47 Impact Factor
Show more