Article

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: 7.01). 04/1992; 49(3):238-44. DOI: 10.1001/archneur.1992.00530270052018
Source: PubMed

ABSTRACT 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.

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    • "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). "
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    • "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. "
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    • "Inflammation, demyelination, axonal dysfunction and grey matter (GM) damage are all highly associated with the clinical manifestations of multiple sclerosis, including affective disorders (Foley et al., 1992; Bakshi et al., 2000; Mohr et al., 2001; Feinstein, 2007). Hence, identifying brain markers of emotional dysfunctions in multiple sclerosis represents a fundamental step for increasing our knowledge about the disease's mechanisms and for improving treatments that specifically target these symptoms. "
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