Stress and Multiple Sclerosis – Systematic review and meta-analysis of the association with disease onset, relapse risk and disability progression

von Drathen, Sönke; Gold, Stefan Michael; Peper, Julia; Rahn, Anne Christin; Ramien, Caren; Magyari, Melinda; Hansen, Hans-Christian; Friede, Tim; Heesen, Christoph

doi:10.1016/j.bbi.2024.06.004

Brain, Behavior, and Immunity

2024

DOI: 10.1016/j.bbi.2024.06.004

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Stress and Multiple Sclerosis – Systematic review and meta-analysis of the association with disease onset, relapse risk and disability progression

Sönke von Drathen,

Stefan Michael Gold,

Julia Peper

et al.

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2024

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Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress

Zveik,

Friedman‐Korn,

Rechtman

et al. 2024

Ann Clin Transl Neurol

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ObjectivesPsychological stress has been suggested as a contributory factor in the onset and progression of multiple sclerosis (MS). The 7 October 2023 terrorist attacks in Israel caused significant psychological stress, providing a unique context to study its impact on MS activity. This study aims to assess the impact of war‐related psychological stress on MS activity using magnetic resonance imaging (MRI) scans and clinical follow‐up.MethodsThis observational retrospective case–control study includes 93 patients with MS (pwMS) who had routine annual MRI scans from three periods (7 October 2021 to 7 January 2022; 7 October 2022 to 7 January 2023; and 7 October 2023 to 7 January 2024). Data were collected from medical records and MRI scans at Hadassah Medical Center. MRI scans were classified as active if new or enlarging T2 lesions and/or enhancing T1 lesions were present.ResultsMRI activity significantly increased among pwMS during the first 3 months of the war compared to the corresponding period in the preceding year (11/93 vs. 23/93, P = 0.0139), with an OR of 4.0 (95% confidence interval: 1.29–16.442). pwMS with an EDSS score ≥4 showed a significant increase in MRI activity (P = 0.045), whereas no significant increase was observed in patients with an EDSS score ≤3.5 (P = 0.23). Additionally, MRI activity increased later during the war compared to the previous year (P < 0.0001).InterpretationThis study provides evidence of increased MRI‐detected disease activity in pwMS during periods of war‐related psychological stress. Our findings highlight the importance of considering psychological stress in MS management. Healthcare providers should be aware of the potential for increased disease activity in pwMS during extreme stress and may consider more frequent monitoring, including MRI scans, or treatment adjustments during such periods.

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Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress

Zveik,

Friedman‐Korn,

Rechtman

et al. 2024

Ann Clin Transl Neurol

View full text Add to dashboard Cite

show abstract

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Stress and Multiple Sclerosis – Systematic review and meta-analysis of the association with disease onset, relapse risk and disability progression

Cited by 1 publication

References 56 publications

Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress

Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress

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