Specifics of Relationship within a Complex of Neurological Deficit, Quality of Life and Depression in the Phenotypic Spectrum of Multiple Sclerosis.

Abstract

The mechanisms, leading to depression development in multiple sclerosis (MS) include progressive demyelination and axonal degeneration along with neurological deficit and a certain similarity of mechanisms leading to the development of immunological disorders and neuroinflammation involved in the pathogenesis of MS and depression. The objective of the study was to examine the specifics of relationships within a complex of neurological deficit, depression, and quality of life in MS. For purposes of integral quantification of neurologic disability in various functional systems, the "Expanded Disability Status Scale" (EDSS) is used. The severity of depression was measured using the Beck Depression Inventory (BDI). The level of quality of life was measured through the MS Quality of Life (MSQOL)-54 Instrument and Physical Health Composite Score MSQOL-54. The study was conducted among patients with relapsing-remitting (RRMS (n = 52) and secondary-progressive (SPMS, n = 51) phenotypes of MS. The study shows a positive correlation of depression with various indicators of the physical and mental components of the QOL of patients per course and progression of MS phenotypes. It was revealed that in SPMS patients' correlation is significant compared to patients with RRMS. It's proven that the risk of developing depression in patients with RRMS and SPMS depends on the level of neurological deficit. The infrastructure of the target parameters study evidenced that regardless of the type of MS course, depression was found to have a stable connection with neurological impairment (per EDSS scale), especially in the secondary-progressive course of MS (SPMS).