Managing Neuropsychiatric Effects of COVID-19 in Multiple Sclerosis

An increase in neuropsychiatric complications during the coronavirus 2019 (COVID-19) pandemic has encouraged specialists to reimagine treatment methods for patients with multiple sclerosis (MS), according to a study published in Multiple Sclerosis and Related Disorders.

The pandemic has affected the general population by increasing symptoms of depression, anxiety, and stress disorders. Already vulnerable to degrees of cognitive and neuropsychiatric complications, patients with MS are reportedly experiencing a “lower quality of life, increased fatigue and disability scores, and a more aggressive MS score” due to increasing neuropsychiatric complications, according to the study.

Researchers at Tehran University of Medical Sciences in Iran examined the impact of the pandemic on patients with MS. Cognitive dysfunction affects nearly 70% of MS patients and symptoms of anxiety and depression have been reported in around 57% and 40% of patients, respectively. The most prevalent effects of anxiety on cognitive function present in information processing and episodic memory, which may prevent effective verbal learning in patients with MS.

The use of immunosuppressive and immunomodulatory therapies for MS may elevate risk for viral infection, resulting in heightened health anxiety during the pandemic. Additionally, the pandemic has lessened the support received from social groups due to social distancing, which provided patients access to cognitive and physical rehabilitation.

The researchers noted that there has been a growing focus on treatments for cognitive dysfunction in MS. They advocated for providers to adapt preventive methods and monitor high risk patients for neuropsychiatric complications using strategies that align with social distancing measures, such as phone based anxiety scales.

According to the study, “therapeutic options including online support, at home yoga and exercise programs, and antianxiety medications when needed” are a few methods that may benefit patients. Despite the lack of direct treatment methods for symptoms of cognitive dysfunction, access to these preventive methods may alleviate stress during the COVID-19 pandemic. The researchers concluded that effective monitoring of psychiatric and cognitive comorbidities was essential for patients with MS and updated treatment options applicable to the conditions of the viral pandemic are a necessity.

Reference

Akhoundi, FH, Sahraian, MA, & Moghadasi, AN. Neuropsychiatric and cognitive effects of the COVID-19 outbreak on multiple sclerosis patients. [published online April 27, 2020]. Multiple Sclerosis and Related Disorders. doi:10.1016/j.msard.2020.102164