Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-02T20:13:30.223Z Has data issue: false hasContentIssue false
  • English
  • Français

Do positive or negative stressful events predict the development of new brain lesions in people with multiple sclerosis?

Published online by Cambridge University Press:  17 May 2013

M. N. Burns ,
E. Nawacki ,
M. J. Kwasny ,
D. Pelletier  and
D. C. Mohr
M. N. Burns
Affiliation:
Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
E. Nawacki
Affiliation:
Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
M. J. Kwasny
Affiliation:
Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
D. Pelletier
Affiliation:
Department of Neurology, Yale School of Medicine, New Haven, CT, USA
D. C. Mohr*
Affiliation:
Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
*
* Address for correspondence: D. C. Mohr, Ph.D., Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Stressful life events have long been suspected to contribute to multiple sclerosis (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 patients with MS followed for 48 weeks during a randomized controlled trial comparing stress management therapy for MS (SMT-MS) to a waitlist control (WLC). Patients underwent magnetic resonance imaging (MRI) scans every 8 weeks. Every month, patients 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 patient's 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.

Keywords

AnxietydepressionlesionsMRImultiple sclerosisneuroimagingstress
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 2 , January 2014 , pp. 349 - 359
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Artemiadis, AK, Anagnostouli, MC, Alexopoulos, EC (2011). Stress as a risk factor for multiple sclerosis onset or relapse: a systematic review. Neuroepidemiology 36, 109–120.Google Scholar
Brown, RF, Tennant, CC, Sharrock, M, Hodgkinson, S, Dunn, SM, Pollard, JD (2006). Relationship between stress and relapse in multiple sclerosis: Part I. Important features. Multiple Sclerosis 12, 453–464.Google Scholar
Chen, L, Lui, S, Wu, QZ, Zhang, W, Zhou, D, Chen, HF, Huang, XQ, Kuang, WH, Chan, RC, Mechelli, A, Gong, QY (2013). Impact of acute stress on human brain microstructure: an MR diffusion study of earthquake survivors. Human Brain Mapping 34, 367–373.Google Scholar
Cohen, S, Janicki-Deverts, D, Doyle, WJ, Miller, GE, Frank, E, Rabin, BS, Turner, RB (2012). Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proceedings of the National Academy of Sciences USA. Published online: 2 04 2012 . doi:10.1073/pnas.1118355109.Google Scholar
Cohen, S, Kessler, RC, Gordon, UL (1995). Strategies for measuring stress in studies of psychiatric and physical disorder. In Measuring Stress: A Guide for Health and Social Scientists (ed. Cohen, S., Kessler, R. C. and Gordon, U. L.), pp. 3–26. Oxford University Press: New York.Google Scholar
Cohen, S, Tyrrell, DAJ, Smith, AP (1991). Psychological stress and susceptibility to the common cold. New England Journal of Medicine 325, 606–612.CrossRefGoogle ScholarPubMed
Cohen, S, Tyrrell, DAJ, Smith, AP (1993). Negative life events, perceived stress, negative affect, and susceptibility to the common cold. Journal of Personality and Social Psychology 64, 131–140.Google Scholar
Cotton, F, Weiner, HL, Jolesz, FA, Guttmann, CRG (2003). MRI contrast uptake in new lesions in relapsing-remitting MS followed at weekly intervals. Neurology 60, 640–646.Google Scholar
Dantzer, R, O'Connor, JC, Castanon, N, Lestage, J, Kelley, KW (2009). Cytokines and depression: experimental evidence and intermediate mechanisms. In Understanding Depression: A Translational Approach (ed. Pariante, C. M., Nesse, R. M., Nutt, D. and Wolpert, L.), pp. 123–138. Oxford University Press: New York.Google Scholar
Dantzer, R, O'Connor, JC, Freund, GG, Johnson, RW, Kelley, KW (2008). From inflammation to sickness and depression: when the immune system subjugates the brain. Nature Reviews Neuroscience 9, 46–56.Google Scholar
Filippi, M, Rocca, MA, Martino, G, Horsfield, MA, Comi, G (1998). Magnetization transfer changes in the normal appearing white matter precede the appearance of enhancing lesions in patients with multiple sclerosis. Annals of Neurology 43, 809–814.Google Scholar
Goodin, DS, Ebers, GC, Johnson, KP, Rodriguez, M, Sibley, WA, Wolinsky, JS (1999). The relationship of MS to physical trauma and psychological stress: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 52, 1737–1745.CrossRefGoogle Scholar
Goodkin, DE, Rooney, WD, Sloan, R, Bacchetti, P, Gee, L, Vermathen, M, Waubant, E, Abundo, M, Majumdar, S, Nelson, S, Weiner, MW (1998). A serial study of new MS lesions and the white matter from which they arise. Neurology 51, 1689–1697.CrossRefGoogle ScholarPubMed
Grossman, RI (1996). Magnetic resonance imaging: current status and strategies of improving multiple sclerosis clinical trial design. In Multiple Sclerosis: Advances in Clinical Trial Design, Treatment and Future Perspectives (ed. Goodkin, D. E. and Rudick, R. A.), pp. 161–186. Springer: London.Google Scholar
Herrmann, C (1997). International experiences with the Hospital Anxiety and Depression Scale – a review of validation data and clinical results. Journal of Psychosomatic Research 42, 17–41.Google Scholar
Honarmand, K, Feinstein, A (2009). Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients. Multiple Sclerosis 15, 1518–1524.CrossRefGoogle ScholarPubMed
Kurtzke, JF (1983). Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33, 1444–1452.Google Scholar
Lazarus, RS, Folkman, S (1984). Stress, Appraisal, and Coping. Springer: New York.Google Scholar
Lehman, KA, Burns, MN, Gagen, EC, Mohr, DC (2012). Development of the Brief Inventory of Perceived Stress. Journal of Clinical Psychology 68, 631–644.Google Scholar
McEwen, BS, Gianaros, PJ (2010). Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease. Annals of the New York Academy of Sciences 1186, 190–222.Google Scholar
Mohr, DC (2010 a). The Stress and Mood Management Program for Individuals with Multiple Sclerosis: Therapist Guide. Oxford University Press: New York.Google Scholar
Mohr, DC (2010 b). The Stress and Mood Management Program for Individuals with Multiple Sclerosis: Workbook. Oxford University Press: New York.Google Scholar
Mohr, DC, Goodkin, DE, Bacchetti, P, Boudewyn, AC, Huang, L, Marrietta, P, Cheuk, W, Dee, B (2000). Psychological stress and the subsequent appearance of new brain MRI lesions in MS. Neurology 55, 55–61.Google Scholar
Mohr, DC, Goodkin, DE, Nelson, S, Cox, D, Weiner, M (2002). Moderating effects of coping on the relationship between stress and the development of new brain lesions in multiple sclerosis. Psychosomatic Medicine 64, 803–809.Google Scholar
Mohr, DC, Lovera, J, Brown, T, Cohen, B, Neylan, T, Henry, R, Siddique, J, Jin, L, Daikh, D, Pelletier, D (2012). A randomized trial of stress management for the prevention of new brain lesions in MS. Neurology 79, 412–419.Google Scholar
Mohr, DC, Pelletier, D (2006). A temporal framework for understanding the effects of stressful life events on inflammation in patients with multiple sclerosis. Brain, Behavior, and Immunity 20, 27–36.CrossRefGoogle ScholarPubMed
Pluess, M, Wurmser, H, Buske-Kirschbaum, A, Papousek, M, Pirke, K-M, Hellhammer, D, Bolten, M (2012). Positive life events predict salivary cortisol in pregnant women. Psychoneuroendocrinology 37, 1336–1340.Google Scholar
Polman, CH, Reingold, SC, Edan, G, Filippi, M, Hartung, HP, Kappos, L, Lublin, FD, Metz, LM, McFarland, HF, O'Connor, PW, Sandberg-Wollheim, M, Thompson, AJ, Weinshenker, BG, Wolinsky, JS (2005). Diagnostic criteria for multiple sclerosis: 2005 revisions to the ‘McDonald Criteria’. Annals of Neurology 58, 840–846.Google Scholar
Radloff, LS (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385–401.CrossRefGoogle Scholar
Rudick, RA, Lee, JC, Simon, J, Fisher, E (2006). Significance of T2 lesions in multiple sclerosis: a 13-year longitudinal study. Annals of Neurology 60, 236–242.Google Scholar
Shafer, AB (2006). Meta-analysis of the factor structures of four depression questionnaires: Beck, CES-D, Hamilton, and Zung. Journal of Clinical Psychology 62, 123–146.Google Scholar
Shimizu, M, Pelham, BW (2004). The unconscious cost of good fortune: implicit and explicit self-esteem, positive life events, and health. Health Psychology 23, 101–105.CrossRefGoogle ScholarPubMed
Yamout, B, Itani, S, Hourany, R, Sibaii, AM, Yaghi, S (2010). The effect of war stress on multiple sclerosis exacerbations and radiological disease activity. Journal of the Neurological Sciences 288, 42–44.Google Scholar
Zigmond, AS, Snaith, RP (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 67, 361–370.CrossRefGoogle ScholarPubMed