Diffusion tensor imaging abnormalities in depressed multiple sclerosis patients

Feinstein, Anthony; O’Connor, Paul; Akbar, Nadine; Moradzadeh, Linda; Scott, Christopher J.; Lobaugh, Nancy J.

doi:10.1177/1352458509355461

Cited by 96 publications

(86 citation statements)

References 33 publications

(33 reference statements)

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“…In MS patients, not only psychological, somatic or social implications of MS contribute to depression [1] and SD [23], but also MS-specific lesions, for example, in projection areas of the basal limbic system [37] give rise to depressive symptoms such as anhedonia or depressed affect [1,[37][38][39]. In 109 women with MS, Gold et al [38] found associations between depression and reduced thickness of the right hippocampus.…”

Section: Discussionmentioning

confidence: 99%

Sexual Dysfunction Seems to Trigger Depression in Female Multiple Sclerosis Patients

et al. 2018

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Background: In women with multiple sclerosis (MS), depression and sexual dysfunction (SD) are common. Whether SD promotes depression or vice versa remains unclear despite therapeutic relevance. Therefore, we aimed to assess whether SD more likely triggers depression or vice versa. Methods: In 83 female MS patients and 21 age-matched healthy women, we assessed depression, using the Beck Depression Inventory-V (BDI-V), and SD using the Female Sexual Function Index (FSFI). We diagnosed depression with BDI-V-scores >35 and SD with FSFI scores < 26.55. We divided patients into groups with and without SD, with and without depression. Between groups, we compared prevalence of SD and depression (Fisher’s-exact-test), age, MS-duration, MS-severity, BDI-V-, and FSFI scores (Mann-Whitney U-test; significance: p < 0.05). Results: A total of 37/83 MS patients and 1/21 controls had SD; 28/83 patients and 3/21 controls had depression; 51.4% patients with SD but only 19.6% without SD had depression (p = 0.003). SD was present in 67.9% depressed and 32.7% non-depressed patients. BDI-V-scores were higher in patients with SD than in patients without SD. FSFI scores were lower in depressed than non-depressed patients. Conclusion: In conclusion, SD was more common than depression. SD afflicted 67.9% depressed MS patients and was also more common in non-depressed MS patients than controls. SD may occur independently from depression while increased depressiveness seems linked to coexistent SD.

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Section: Discussionmentioning

confidence: 99%

Sexual Dysfunction Seems to Trigger Depression in Female Multiple Sclerosis Patients

et al. 2018

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“…31 Individual differences in depression in MS patients have been associated with altered regional activity and functional connectivity patterns within the limbic system.…”

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confidence: 99%

Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

Brenner

Piehl

2016

Acta Neurol Scand

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Multiple sclerosis (MS) is a neuroinflammatory condition with a prominent progressive neurodegenerative facet that typically affects young-or middle-aged adults. Although physical disabilities have been in the foreground by being easier to assess, there is an increasing interest in mental disabilities and psychiatric co-morbidities, which have a disproportionally high impact on important outcome measures such as quality of life and occupational disability. In particular, cognitive impairment, depression and mental fatigue, which mutually interact with each other, seem to be of importance in this context. In recent decades, major efforts have been invested in developing more effective disease modulatory treatments. This has resulted in novel therapeutic options and awareness of the importance of early intervention. In comparison, good quality and adequately powered studies on symptomatic treatments of fatigue and psychiatric co-morbidities in MS are rare, and awareness of treatment options is much lower. We here review the existing evidence base for symptomatic treatment of fatigue and depression in MS patients. With regard to fatigue, off-label prescription of alertness improving drugs is common, in spite of all but absent evidence of efficacy. In contrast, a number of smaller studies suggest that physical exercise and fatigue management courses may have some clinical benefit. Very few studies have addressed the efficacy of antidepressants and non-pharmaceutical interventions specifically in MS patients. Therefore, treatment guidelines largely rely on data from non-MS populations. In the future, there is a strong motive to direct additional resources to the study of these important aspects of MS. K E Y W O R D Scognitive symptoms, depression, fatigue, multiple sclerosis, treatment

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“…24,29,31,33 This is supported by the results of a comparative study in which depressed MS patients exhibited significantly more frontal lobe pathologies than nondepressed ones. 48 In fact, frontal lobe lesions could result in inappropriate behavior, lack of empathy, abnormal affect, and executive/cognitive dysfunction, which could be the presenting psychiatric symptoms of MS. 26,49 Temporal lobe pathologies, particularly on the left side, were found to be associated with the occurrence of psychosis in MS. 9,27 Notably, the role of temporal lobe lesions in psychiatric manifestations was further highlighted in studies comparing MS groups with or without psychiatric symptoms. 35,50 New cerebellar and brainstem lesions have been documented in one patient presenting with catatonia.…”

Section: Radiological Hints Toward the Diagnosis Of Psychiatric-onset Msmentioning

confidence: 99%

Psychiatric event in multiple sclerosis: could it be the tip of the iceberg?

Chalah

Ayache

2017

Rev. Bras. Psiquiatr.

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Multiple sclerosis (MS) is a chronic progressive inflammatory disease of the central nervous system. Psychiatric comorbidities are highly prevalent in patients with MS, and can have drastic impact on quality of life and interpersonal relationships. Despite this high prevalence, whether psychiatric manifestations may represent the first signs of MS is still debatable. This constitutes an important issue, since early diagnosis of ''psychiatric-onset MS'' would result in prompt management, which usually ameliorates long-term prognosis. Here, we discuss clinical and radiological hints that suggest a diagnosis of psychiatric-onset MS. Briefly, this entity should be considered in healthy patients presenting with late-onset psychiatric symptoms, with or without cognitive decline, and with negative family history of psychiatric diseases. A thorough neurological exam is crucial to detect any subtle neurological signs. Brain magnetic resonance imaging is recommended to rule out frontotemporal lesions that might explain the clinical picture. Poor response to standard psychiatric treatments provides additional evidence for the diagnosis of an organic disease (e.g., MS). Combining psychopharmaceuticals with intravenous corticosteroids would result in good outcomes, but patients should be monitored carefully for possible psychiatric exacerbation, a common side effect of steroids.

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Diffusion tensor imaging abnormalities in depressed multiple sclerosis patients

Cited by 96 publications

References 33 publications

Sexual Dysfunction Seems to Trigger Depression in Female Multiple Sclerosis Patients

Sexual Dysfunction Seems to Trigger Depression in Female Multiple Sclerosis Patients

Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

Psychiatric event in multiple sclerosis: could it be the tip of the iceberg?

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