Brain Inflammation Associated With Depression, Anxiety in Multiple Sclerosis

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Researchers investigate the relationship between neuroinflammation and MS-related mood symptoms.
Researchers investigate the relationship between neuroinflammation and MS-related mood symptoms.

Neuroinflammation is associated with anxiety and depression in patients with relapsing-remitting multiple sclerosis (MS), according to results of an exploratory study published in Neurology.

Patients with relapsing-remitting MS (N=405) underwent a brain magnetic resonance imaging (MRI) scan with gadolinium 5 days before the study. Inflammatory markers and associative incidences of depression and anxiety were then evaluated in this patient group. The State/Trait Anxiety Inventory-state and Beck Depression Inventory II (BDI-II) were used to score depression and anxiety among patients. Active patients were deemed to have experienced clinical relapses or signs of activity at MRI.

There were greater State-Trait Anxiety Inventory (STAI-state) and Beck Depression Inventory-II (BDI-II) scores among relapsing patients compared with remitting patients. With the reduction of neuroinflammation, researchers observed a significant decrease in STAI-state and BDI-II scores. In addition, investigators observed a stepwise increase in BDI-II with increasing duration of disease (P <.01). 

Levels of interleukin-2 cerebrospinal correlated with STAI-state, whereas BDI-II was associated with tumor necrosis factor alpha and interleukin 1 beta. Higher Interaction Anxiousness Scale and STAI-state scores were observed at baseline among patients with clinical/radiologic reactivation of disease at 6 months (P <.05). Disease reactivation occurred more frequently in patients with clinically significant state anxiety (P <.01), and high STAI-state scores at baseline were found to predict disease reactivation risk after logistic regression analyses.

At baseline, active patients featured greater BDI-II values and higher frequency of depression compared with nonactive patients (34% vs 20%; P <.03). Also, a higher rate of concurrent depression and anxiety was observed in active patients (14.1% vs 7.0%; P =.06).

The researchers observed that steroid therapy was effective in reducing mood disturbances during relapses, suggesting "central inflammation may trigger psychiatric symptoms in MS."

Reference

Rossi S, Studer V, Motta C, et al. Neuroinflammation drives anxiety and depression in relapsing-remitting multiple sclerosis. Neurology. 2017;89(13):1338-1347.

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