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Coping style as a protective factor for emotional consequences of structural neuropathology in multiple sclerosis. J Clin Exp Neuropsychol 2019; 41:390-398. [DOI: 10.1080/13803395.2019.1566443] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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van Geest Q, Boeschoten RE, Keijzer MJ, Steenwijk MD, Pouwels PJ, Twisk JW, Smit JH, Uitdehaag BM, Geurts JJ, van Oppen P, Hulst HE. Fronto-limbic disconnection in patients with multiple sclerosis and depression. Mult Scler 2018; 25:715-726. [PMID: 29587565 PMCID: PMC6439942 DOI: 10.1177/1352458518767051] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: The biological mechanism of depression in multiple sclerosis (MS) is not well understood. Based on work in major depressive disorder, fronto-limbic disconnection might be important. Objective: To investigate structural and functional fronto-limbic changes in depressed MS (DMS) and non-depressed MS (nDMS) patients. Methods: In this retrospective study, 22 moderate-to-severe DMS patients (disease duration 8.2 ± 7.7 years), 21 nDMS patients (disease duration 15.3 ± 8.3 years), and 12 healthy controls underwent neuropsychological testing and magnetic resonance imaging (MRI; 1.5 T). Brain volumes (white matter (WM), gray matter, amygdala, hippocampus, thalamus), lesion load, fractional anisotropy (FA) of fronto-limbic tracts, and resting-state functional connectivity (FC) between limbic and frontal areas were measured and compared between groups. Regression analysis was performed to relate MRI measures to the severity of depression. Results: Compared to nDMS patients, DMS patients (shorter disease duration) had lower WM volume (p < 0.01), decreased FA of the uncinate fasciculus (p < 0.05), and lower FC between the amygdala and frontal regions (p < 0.05). Disease duration, FA of the uncinate fasciculus, and FC of the amygdala could explain 48% of variance in the severity of depression. No differences in cognition were found. Conclusion: DMS patients showed more pronounced (MS) damage, that is, structural and functional changes in temporo-frontal regions, compared to nDMS patients, suggestive of fronto-limbic disconnection.
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Affiliation(s)
- Quinten van Geest
- Department of Anatomy & Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Rosa E Boeschoten
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - Matthijs J Keijzer
- Department of Anatomy & Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn D Steenwijk
- Department of Anatomy & Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Petra Jw Pouwels
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Jos Wr Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Johannes H Smit
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - Bernard Mj Uitdehaag
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.,Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Jeroen Jg Geurts
- Department of Anatomy & Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - Hanneke E Hulst
- Department of Anatomy & Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
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Prevalence of depression and anxiety in Multiple Sclerosis: A systematic review and meta-analysis. J Neurol Sci 2017; 372:331-341. [DOI: 10.1016/j.jns.2016.11.067] [Citation(s) in RCA: 303] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 11/25/2016] [Accepted: 11/28/2016] [Indexed: 11/23/2022]
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Towards a better understanding of MS pain: a systematic review of potentially modifiable psychosocial factors. J Psychosom Res 2015; 78:12-24. [PMID: 25438982 DOI: 10.1016/j.jpsychores.2014.07.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/06/2014] [Accepted: 07/08/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Pain is a common symptom of Multiple Sclerosis (MS). Biomedical treatments achieve only modest reductions in pain severity suggesting that this approach may be too narrow. The aim of this systematic review was to assess evidence for associations between modifiable psychosocial factors and MS pain severity and pain interference and use this evidence to develop a preliminary biopsychosocial model of MS pain. METHODS Empirical studies of pain in MS utilising standardised pain severity and pain interference measures were included. Online databases (Cochrane, PsychInfo, EMBASE, CINAHL, Medline, Web of Science and World Cat) and reference sections of included articles were searched, and corresponding authors contacted to identify unpublished studies. Information about design, sample size, MS type, time since diagnosis, psychosocial and pain measures and key findings were extracted. Thirty-one studies were assessed for quality and a narrative synthesis was conducted. RESULTS Similar to primary chronic pain, most studies reported small to medium associations between several psychosocial factors and pain severity and interference. Pain catastrophizing showed consistently strong associations with pain interference. Preliminary findings revealed a strong correlation between pain acceptance and pain interference. However, fear-avoidance appeared less important in MS, and other forms of behavioural avoidance were not explored. CONCLUSIONS A preliminary model of MS pain outlining specific psychosocial factors is presented with a conceptual formulation from both traditional, and contextual, cognitive-behavioural perspectives. Pain catastrophizing, acceptance, and endurance, as opposed to fear avoidance, responses are highlighted as potentially important treatment targets in MS, and directions for future research are outlined.
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Taylor KL, Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis. BMC Psychiatry 2014; 14:327. [PMID: 25467385 PMCID: PMC4263016 DOI: 10.1186/s12888-014-0327-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 11/10/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Depression is the most common co-morbidity for people with Multiple Sclerosis (MS); irrespective of disease severity, depression has the greatest impact on quality of life. An emerging paradigm in the treatment of depression is lifestyle medicine. There is significant potential to prevent and treat depression through modification of lifestyle risk factors for people with MS. This study sought to understand the association between lifestyle risk factors, medication and depression risk through the analysis of self-reported data from a large international sample of people with MS. METHODS This cross-sectional analysis recruited a total of 2459 participants via Web 2.0 platforms. Survey data included socio-demographics; a range of lifestyle risk factors; medication; disease variables and depression risk using the Patient Health Questionnaire-2 (PHQ-2). RESULTS In total approximately one fifth (19.3%) of our sample screened positive for depression (PHQ-2 score ≥3). Several demographic factors were significantly associated with this depression risk in bivariate analysis. Regression analyses showed that poor diet, low levels of exercise, obesity, smoking, marked social isolation and taking interferon were associated with greater depression risk. Participants who supplemented with omega 3s, particularly flaxseed oil, had frequent fish consumption, supplemented with vitamin D, meditated, and had moderate alcohol consumption had significantly reduced depression risk. CONCLUSIONS This study demonstrates a significant association between modifiable lifestyle factors and depression risk. Planned longitudinal follow up may clarify causality. Clinicians and people with MS should be aware of the wide range of modifiable lifestyle factors that may reduce depression risk as part of a comprehensive secondary and tertiary preventive medical approach to managing MS.
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Affiliation(s)
- Keryn L Taylor
- Department of Psychiatry, St Vincent's Hospital Melbourne, Victoria, VIC, 3065, Australia. .,Department of Medicine, The University of Melbourne St Vincent's Hospital, Melbourne, Victoria, Australia.
| | - Emily J Hadgkiss
- Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.
| | - George A Jelinek
- Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Tracey J Weiland
- Department of Medicine, The University of Melbourne St Vincent's Hospital, Melbourne, Victoria, Australia. .,Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.
| | - Naresh G Pereira
- Faculty of Medicine, Notre Dame University, Fremantle, Western Australia, Australia.
| | - Claudia H Marck
- Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.
| | - Dania M van der Meer
- Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.
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Patten SB, Williams JVA, Lavorato DH, Koch M, Metz LM. Depression as a predictor of occupational transition in a multiple sclerosis cohort. FUNCTIONAL NEUROLOGY 2014; 28:275-80. [PMID: 24598395 DOI: 10.11138/fneur/2013.28.4.275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In MS, transitions between working and not-working status may occur in association with depression. This can complicate patients' ability to promptly obtain disability support due to an expectation that their functioning will improve after the depression resolves, a viewpoint that sees depression assuming a role as a causal determinant of disability. In this study, prospective data were used to model the relationship between depressive symptoms and the transition out of employment. In unadjusted analyses, depression increased the risk of transition to non-working status, HR = 1.7 (95%CI 1.3-2.3). Adjustments for ambulation status, physical and mental quality of life composite scores and fatigue impact attenuated or eliminated the association. While depression commonly occurs around the time of occupational transitions in MS, it does not appear to be an independent or direct cause of such transitions.
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Arnett PA, Ukueberuwa DM. Ask the Experts: Managing depression in multiple sclerosis: prevalence, pathology and progress. Neurodegener Dis Manag 2013. [DOI: 10.2217/nmt.13.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Dr Arnett received his PhD in Psychology (Clinical) from the University of Wisconsin – Madison (WI, USA), and completed a postdoctoral fellowship in Clinical Neuropsychology at the Medical College of Wisconsin. He is currently a psychology professor and Director of Clinical Training at Penn State University (PA, USA). Dr Arnett’s research focuses on clinical neuropsychology, with an emphasis on secondary influences on cognitive functioning in persons with multiple sclerosis and mild traumatic brain injury. He is the director of the Neuropsychology of Sports-Related Concussion and Multiple Sclerosis programs at Penn State University, a fellow of the National Academy of Neuropsychology (NAN), past winner of NAN’s Nelson Butters Award for Research Contributions to Clinical Neuropsychology, and was Program Co-Chair for the 2010 Mid-Year Meeting of the International Neuropsychological Society (INS). He has authored over 90 research articles and book chapters, as well as over 160 conference presentations. He is an editorial board member of several journals, including Neuropsychology, Journal of the International Neuropsychological Society and Archives of Clinical Neuropsychology. Dede Ukueberuwa received her bachelor’s degree from Princeton University (NJ, USA) and earned a master’s degree in Psychology at Penn State University (PA, USA), where she is currently a PhD student in Clinical Psychology. She is also the coordinator of the Penn State University Multiple Sclerosis Project. Her work uses neuropsychological testing and neuroimaging to understand cognitive and biological factors relating to emotional difficulties in multiple sclerosis. She is the author of several publications pertaining to multiple sclerosis and has also presented her work at numerous conferences.
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Affiliation(s)
- Peter A Arnett
- Psychology Department, Penn State University, 352 Bruce V Moore Building, University Park, PA 16802-3105, USA
| | - Dede M Ukueberuwa
- Psychology Department, Penn State University, 352 Bruce V Moore Building, University Park, PA 16802-3105, USA
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Thielscher C, Thielscher S, Kostev K. The risk of developing depression when suffering from neurological diseases. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2013; 11:Doc02. [PMID: 23326249 PMCID: PMC3546419 DOI: 10.3205/000170] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Indexed: 11/30/2022]
Abstract
Aim of the study: To investigate the comorbidity of Alzheimer’s/dementia, epilepsy, multiple sclerosis and Parkinson’s with depression. Methods: 42,914 patients who were newly diagnosed with the four comorbid diseases were included in the study. We analyzed how many of these patients developed depression within five years. Results: Between 21% (males with epilepsy) and 39% (women with Parkinson’s)/44% (Alzheimer’s patients under 60 years) developed depression within five years. Conclusion: We recommend routine checks for depression in patients diagnosed with one of these diseases, especially in the most comorbid ones.
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Affiliation(s)
- C Thielscher
- FOM University of Applied Sciences, Essen, Germany.
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Boeschoten RE, Dekker J, Uitdehaag BMJ, Polman CH, Collette EH, Cuijpers P, Beekman ATF, van Oppen P. Internet-based self-help treatment for depression in multiple sclerosis: study protocol of a randomized controlled trial. BMC Psychiatry 2012; 12:137. [PMID: 22967202 PMCID: PMC3493307 DOI: 10.1186/1471-244x-12-137] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 08/31/2012] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Depression in MS patients is frequent but often not treated adequately. An important underlying factor may be physical limitations that preclude face-to-face contact. Internet-based treatment showed to be effective for depressive symptoms in general and could thus be a promising tool for treatment in MS. METHODS/DESIGN Here, we present a study protocol to investigate the effectiveness of a 5 week Internet-based self-help problem solving treatment (PST) for depressive symptoms in MS patients in a randomized controlled trial. We aim to include 166 MS patients with moderate to severe depressive symptoms who will be randomly assigned to an Internet-based intervention (with or without supportive text-messages) or waiting list control group. The primary outcome is the change in depressive symptoms defined by a change in the sum score on the Beck Depression Inventory (BDI-II). Secondary outcomes will include measures of anxiety, fatigue, cognitive functioning, physical and psychological impact of MS, quality of life, problem solving skills, social support, mastery, satisfaction and compliance rate. Assessments will take place at baseline (T0), within a week after the intervention (T1), at four months (T2) and at ten months follow-up (T3: only the intervention group). The control group will be measured at the same moments in time. Analysis will be based on the intention-to-treat principle. DISCUSSION If shown to be effective, Internet-based PST will offer new possibilities to reach and treat MS patients with depressive symptoms and to improve the quality of care. TRIAL REGISTRATION The Dutch Cochrane Center, NTR2772.
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Affiliation(s)
- Rosa E Boeschoten
- Department of Psychiatry, VU University Medical Center Academic Anxiety Outpatient Clinic and GGZinGeest, A. J. Ernststraat 1187, Amsterdam, HL 1081, The Netherlands.
| | - Joost Dekker
- Department of Psychiatry, VU University Medical Center Academic Anxiety Outpatient Clinic and GGZinGeest, A. J. Ernststraat 1187, Amsterdam, HL, 1081, The Netherlands,EMGO Institute for Mental Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Bernard MJ Uitdehaag
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Chris H Polman
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Emma H Collette
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Pim Cuijpers
- EMGO Institute for Mental Health and Care Research, VU University, Amsterdam, The Netherlands,Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
| | - Aartjan TF Beekman
- Department of Psychiatry, VU University Medical Center Academic Anxiety Outpatient Clinic and GGZinGeest, A. J. Ernststraat 1187, Amsterdam, HL, 1081, The Netherlands,EMGO Institute for Mental Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, VU University Medical Center Academic Anxiety Outpatient Clinic and GGZinGeest, A. J. Ernststraat 1187, Amsterdam, HL, 1081, The Netherlands,EMGO Institute for Mental Health and Care Research, VU University, Amsterdam, The Netherlands
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Jensen MP, Molton IR, Gertz KJ, Bombardier CH, Rosenberg DE. Physical activity and depression in middle and older-aged adults with multiple sclerosis. Disabil Health J 2012; 5:269-76. [PMID: 23021738 DOI: 10.1016/j.dhjo.2012.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 05/07/2012] [Accepted: 05/29/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Depression is common among people with multiple sclerosis (MS), and research shows that individuals, including individuals with MS, who are more physically active report lower rates of depression. However, little is known about the relative importance of level of physical activity (e.g., moderate versus vigorous) in relationship to depression, or the role that age might play in this relationship among people with MS. The current study sought to (1) clarify the associations between moderate and vigorous physical activity and depression in a sample of individuals with MS, (2) determine the associations between age and physical activity, and (3) test for the potential moderating influence of age on the associations between physical activity and depression. OBJECTIVE/HYPOTHESIS Cross-sectional survey. METHODS 112 individuals with MS completed a survey assessing demographic variables, amount of moderate and vigorous physical activity, and depression. RESULTS There was a gradual decrease in the amount of moderate and vigorous physical activity as age increased, but this decrease was not statistically significant. Moderate physical activity was significantly (negatively) associated with depression across all age cohorts. Time spent in vigorous physical activity was significantly (negatively) associated with depression among the middle-aged but not younger or older participants who are physically active. CONCLUSIONS The findings support a link between moderate physical activity and depression and, for middle-aged individuals, vigorous physical activity and depression in persons with MS. The findings indicate that research examining the impact of activity enhancing treatments on depression in individuals with MS is warranted.
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Affiliation(s)
- Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA.
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