Depression In Multiple Sclerosis Patients Research Articles

Predictive Model of Anxiety and Depression Perception in Multiple Sclerosis Patients: Possible Implications for Clinical Treatment.

To establish a predictive model for the presence of anxiety and depression in MS patients, based on variables such as psychological well-being, functional activity, and prefrontal symptoms. Additionally, this study aimed to propose non-pharmacological therapeutic alternatives based on this model. A descriptive, observational, and cross-sectional study was conducted with a sample of 64 diagnosed MS patients who underwent functional and cognitive assessments using the following questionnaires and scales: Functional Activities Questionnaire (FAQ), Acceptance and Action Questionnaire (AAQ-II), Experiences Questionnaire (EQ), Self-Compassion Scale Short Form (SCS-SF), Beck Depression Inventory II (BDI-II), State-Trait Anxiety Inventory (STAI), and Prefrontal Symptoms Inventory (PSI). The model showed an excellent fit to the data and indicated that psychological well-being was the most significant predictor of the criteria (β = -0.83), followed by functional activity (β = -0.18) and prefrontal symptoms (β = 0.15). The latter two are negatively related to psychological well-being (β = -0.16 and β = -0.75, respectively). Low psychological well-being is the variable that most significantly predicts the presence of anxiety and depression in MS patients, followed by functional activity and prefrontal alterations. Interventions based on mindfulness and acceptance are recommended, along with nutritional interventions such as antioxidant-enriched ketogenic diets and moderate group physical exercise.

IMPRESS: Impact of Baseline Depression in Multiple Sclerosis Patients Starting Treatment with Interferon β-1a

IMPRESS: Impact of Baseline Depression in Multiple Sclerosis Patients Starting Treatment with Interferon β-1a

The effects of Ellagic acid supplementation on neurotrophic, inflammation, and oxidative stress factors, and indoleamine 2, 3-dioxygenase gene expression in multiple sclerosis patients with mild to moderate depressive symptoms: A randomized, triple-blind, placebo-controlled trial

BackgroundDepression is one of the most common psychological disorders among multiple sclerosis (MS) patients that characterized as the first symptoms. Ellagic acid is a natural polyphenol that may have neuroprotective properties through antioxidant, anti-inflammatory, and immunomodulatory effects. PurposeThe aim of the present study was to investigate the effects of Ellagic acid on circulating levels of brain derived neurotrophic factor (BDNF), interferon-γ (IFN-ƴ), nitric oxide (NO), nuclear factor erythroid-2-related factor 2 (Nrf2), cortisol, serotonergic system, and indoleamine 2, 3-dioxygenase (IDO) gene expression in MS patients with mild to moderate depressive symptoms. Study designA randomized triple-blind clinical trial. MethodsThe eligible patients according to the inclusion criteria were randomly divided into two groups: either 180 mg Ellagic acid (Axenic company) (n = 25) or 180 mg maltodextrin (n = 25) group for 12 weeks. The Ellagic acid supplement were identical to placebo in shape, color and odor. Serum BDNF, NO, Nrf2, cortisol, serotonin, and IFN-ƴ were measured by ELISA kit in the baseline and end of the study. Also, demographic characteristics, anthropometric measurements, physical activity, food intake, Beck Depression Inventory-II (BDI-II) and expanding disability status scale (EDSS) questionnaires, as well as IDO gene expression were assessed. SPSS software version 24 was used for statistical analysis. ResultsFifty patients were evaluated, and a significant decrease in BDI-II (p = 0.001), IFN-ƴ (p = 0.001), NO (p = 0.004), cortisol (p = 0.015), IDO gene expression (p = 0.001) and as well as increased the level of BDNF (p = 0.006) and serotonin (p = 0.019) was observed among those who received 90 mg Ellagic acid twice a day for 12 weeks versus control group. However, there were no significant differences between groups for Nrf2 levels (p>0.05) at the end of study. ConclusionThe current study indicates that Ellagic acid intervention has a favorable effect on depression in MS patients. This is achieved by reducing BDI-II scores, as well as levels of NO, cortisol, IFN-ƴ, and IDO gene expression. Furthermore, we found a significant elevation in circulating levels of BDNF and serotonin.

Effects of Personality Style, Negative Stressful Events, and Social Support on Quality of Life and Depression in Multiple Sclerosis Patients

Background: Multiple sclerosis (MS) is a chronic disease that can negatively impact a person’s mental health, including depression and anxiety. The impact of social support on negative, stressful events can be analyzed in relation to different personality styles. Objectives: This study aimed to investigate the impact of personality style, negative, stressful events, and social support on depression and the quality of life of MS patients. Methods: This observational, descriptive study utilized a regression analysis method. The study population consisted of all MS patients, who were members of the Zahedan MS Society in Zahedan, Iran, during the 2019 internship. The study sample included 101 patients who were selected through convenience sampling. These patients completed various scales, including the Personal Style Inventory (PSI), Beck’s Depression Inventory (BDI), Short-Form Health Survey (SF-36), Interpersonal Support Evaluation List (ISEL), and Life Events Schedule (LES). Results: Negative, stressful events accounted for 22% of the variance in the quality of life of sociotropic patients (P = 0.036), while social support explained 33% of the variance in quality of life (P = 0.008). Moreover, adverse stressful events within this group accounted for 33% of the variance in depression (P = 0.007). In contrast, social support accounted for 60% of the variance in depression (P < 0.001). In the group with autonomous personalities, it was found that negative, stressful events accounted for 22% of the variance in the quality of life (P = 0.014), while social support did not account for any variance in the quality of life (P = 0.204). Conclusions: Social support can moderate and protect individuals from negative, stressful events, particularly for those who are sociotropic or autonomous. However, the moderating effect was more significant in the sociotropic group than in the autonomous group.

Impact of depression on the quality of life of patients with multiple sclerosis

Multiple sclerosis (MS) is a neurodegenerative disease that leads to multiple focal and diffuse lesions of the central nervous system, resulting in disability of patients. Currently the impact of depression on the quality of life (QoL) of MS patients has been little studied.Objective: to study the effect of depressive disorders on the QoL of patients with MS, to search for factors influencing the development of depression in patients with MS.Material and methods. The study involved 203 MS patients aged 15 to 60 years (mean age 39.7±10.91 years). Disability according to the EDSS scale was 2.51±1.45 points, the average duration of the disease was 8.07±7.22 years. The comparison group consisted of 52 healthy people aged 24 to 43 years (mean age 31.86±6.98 years).Results. Patients with MS in more than half of cases (55.7%) suffer from depressive disorders. In MS patients there was an association of depression with older age, a longer duration of the disease, as well as a higher level of disability and exacerbations (p<0.001). MS patients with depression significantly more often (p<0.01) complained of increased fatigue and had higher scores on the scales of asthenia, situational and personal anxiety, and were also exposed to stressful influences and tolerated them poorly; they were more likely than those of the control group to had depressive episodes earlier. MS patients with depression had lower scores (p<0.001) for all QoL criteria, which further accelerated their disability and social isolation.Conclusion. Depression in MS patients has a negative impact on all QoL indicators.

RTMS ameliorates depression/anxiety-like behaviors in experimental autoimmune encephalitis by inhibiting neurotoxic reactive astrocytes

One third of patients with multiple sclerosis (MS) suffered from depressive symptoms. The pathogenesis of depression in MS patients has been related to innate immune activation in certain regions of the brain such as hippocampus. However, pharmacotherapy lacks sufficient evidence for beneficial effects on depression in MS patients, urging for a novel treatment modality for this mental disorder. Treatment effects of rTMS on depression/anxiety-like behaviors in mice with experimental autoimmune encephalomyelitis (EAE) were assessed by behavioral tests. The role of innate immune response was examined by RNA sequencing, quantitative RT-PCR, and immunofluorescence techniques. Depressive symptom severity and astroglial activation in patients with MS were assessed by Beck Depression Inventory and serum glial fibrillary acidic protein (GFAP), respectively. EAE mice displayed depression/anxiety-like behaviors, which were ameliorated by rTMS. Transcriptome and gene-specific expression analysis of the hippocampus showed significant reduction in transcript levels associated with neurotoxic reactive astrocytes in EAE mice after rTMS treatment. This was confirmed by immunofluorescence studies. Complement component 3d, a marker of neurotoxic reactive astrocytes, was highly expressed in EAE hippocampus, but was reduced to a basal level after rTMS treatment. In patients with MS, astroglial activation, indicated by serum GFAP levels, was significantly elevated in those with moderate or major depressive symptoms. These findings support that the suppression of neurotoxic reactive astrocytes might be a potential target for treatment of depression in patients with MS, and suggest the potential of using rTMS as a potential therapeutic treatment for this disorder.

Impact of Multiple Sclerosis and Its Association with Depression: An Analytical Case-Control Investigation.

Multiple sclerosis (MS) is a neurological, chronic, inflammatory, and progressive disease with musculoskeletal problems and neurodegenerative disorders that causes worsening of the health status of patients. The aim of this study was to determine the level of depression in MS patients compared to a population of healthy subjects. The established sample size was 116 subjects matched with the same age, sex, and body mass index. The subjects were recruited from different multiple sclerosis associations and neurology clinics in different public health areas (case group n = 58) and healthy subjects from the same locality (control group n = 58). The scores and categories of the Beck Depression Inventory (BDI) in its Spanish version were collected. There was a clear statistically significant difference (p < 0.05) in the BDI scores between both groups. As a result, we found that the subjects with MS presented worse results with BDI = 9.52 ± 7.70 points compared to the healthy subjects with a BDI score = 5.03 ± 5.14. Within the BDI categories, there were statistically significant differences (p < 0.001), which were greater for the MS group. Depression is a dangerous factor for MS patients, being a trigger for a poorer quality of life.

Depression in Multiple Sclerosis

Background: Depression symptoms and major depression disorderare highly prevalent in multiple sclerosis(MS). Depression can worsen symptoms of MS and significantly reduced the patient's quality of life and increased the suicidal risk.The aim of our study was to assess depression in multiple sclerosis patients and to explore its associated factors.Material(s) and Method(s): We conducted a cross-sectional study, carried out on MS patients who consult in the neurology department of Gabes'shospital during a period of five months, from the 1st June 2021 to 25th October 2021.We used a pre-established sheet exploring the socio-demographic, clinical and therapeutic data of the patients.The Beck Depression Inventory (BDI) to measure characteristic attitudes and symptoms of depression The Expanded Disability Status Scale (EDSS) to quantify disability in MS patients.The Symbol Digit Modalities Test (SDMT) to detect cognitive impairment.Data were analyzed using the software SPSS (20th edition).Result(s): Nineteen patients were included. Eleven(57,9%) were females, mean age: 31,5 (SD=8,06) years. Fifty tow percent were married.Only two patients(10,5%)had a family history of MS.Four patients(21,1%) had a family psychiatric history.Five patients (26,3%) had a psychiatric history including depression in 10,5% anxiety disorder in 10,5% and psychotic disorder in 5,2% of cases.Two patients(10,5%) with moderate depression according to BDI had a history of suicidal attempt before MS onset. All patient had the remitting form of MS.The prevalence of depression was 89,4% according to BDI withmild depression in 26,3%, moderate depression in 26,3% and severe depression in 36,8%..MedianBDI score was 12,4 (3, 29).This represents moderate depression.Median SDMT score was 29 (18-41)..There was a significant association between depressioncerebellar lesion(p=0,038:Fisher test;OR=14[1,1-185]).Severe depression was more frequently observed in patients with higher EDSS(moderate to significant disability)(71,4% VS 41,7%) also in patient with cognitive impairment (100%VS 91,7%).No differences were observed regarding sex, marital and occupational status, education, family history of psychiatric disorders, disease course,disability according to the EDSS and cognitive impairment according to SDMT.Conclusion(s): The results of this study suggest that patients with MS are at risk to develop depression symptoms and that MS patients with severe depression may experience cognitive function impairment and present a high score of disability.Therefore depression should be assessed in MS patients to prevent motor and cognitive worsening. Background: Depression symptoms and major depression disorderare highly prevalent in multiple sclerosis(MS). Depression can worsen symptoms of MS and significantly reduced the patient's quality of life and increased the suicidal risk.The aim of our study was to assess depression in multiple sclerosis patients and to explore its associated factors. Material(s) and Method(s): We conducted a cross-sectional study, carried out on MS patients who consult in the neurology department of Gabes'shospital during a period of five months, from the 1st June 2021 to 25th October 2021.We used a pre-established sheet exploring the socio-demographic, clinical and therapeutic data of the patients.The Beck Depression Inventory (BDI) to measure characteristic attitudes and symptoms of depression The Expanded Disability Status Scale (EDSS) to quantify disability in MS patients.The Symbol Digit Modalities Test (SDMT) to detect cognitive impairment.Data were analyzed using the software SPSS (20th edition). Result(s): Nineteen patients were included. Eleven(57,9%) were females, mean age: 31,5 (SD=8,06) years. Fifty tow percent were married.Only two patients(10,5%)had a family history of MS.Four patients(21,1%) had a family psychiatric history.Five patients (26,3%) had a psychiatric history including depression in 10,5% anxiety disorder in 10,5% and psychotic disorder in 5,2% of cases.Two patients(10,5%) with moderate depression according to BDI had a history of suicidal attempt before MS onset. All patient had the remitting form of MS.The prevalence of depression was 89,4% according to BDI withmild depression in 26,3%, moderate depression in 26,3% and severe depression in 36,8%..MedianBDI score was 12,4 (3, 29).This represents moderate depression.Median SDMT score was 29 (18-41)..There was a significant association between depressioncerebellar lesion(p=0,038:Fisher test;OR=14[1,1-185]).Severe depression was more frequently observed in patients with higher EDSS(moderate to significant disability)(71,4% VS 41,7%) also in patient with cognitive impairment (100%VS 91,7%).No differences were observed regarding sex, marital and occupational status, education, family history of psychiatric disorders, disease course,disability according to the EDSS and cognitive impairment according to SDMT. Conclusion(s): The results of this study suggest that patients with MS are at risk to develop depression symptoms and that MS patients with severe depression may experience cognitive function impairment and present a high score of disability.Therefore depression should be assessed in MS patients to prevent motor and cognitive worsening.

Depression, Anxiety and Alexithymia in Tunisian Patients with Multiple Sclerosis

Depression, Anxiety and Alexithymia in Tunisian Patients with Multiple Sclerosis

Beyond the disability, what is the quality of life in Algerian patients with multiple sclerosis?

Multiple sclerosis (MS) is the most common chronic progressive and disabling neurological disease of the CNS. It has many impacts on social, family and professional life. These repercussions have often been discussed in terms of quality of life. The purpose of this study is to assess quality of life, fatigue, and depression in MS patients.

The Impact of Epigallocatechin Gallate and Coconut Oil Treatment on Cortisol Activity and Depression in Multiple Sclerosis Patients.

(1) Background: Multiple sclerosis (MS) is pathogenically characterized by high oxidative stress and symptomatically by progressive muscle loss and increased body fat associated with the presence of depression. Epigallocatechin gallate (EGCG) (particularly present in green tea) and ketone bodies (in particular beta-hydroxybutyrate (BHB)), whose main source is coconut oil, have shown emotional benefits and body fat loss. The aim of this study was to assess the impact of EGCG and coconut oil on cortisol activity related to fat loss and depression in MS patients. (2) Methods: The study involved 51 MS patients who were randomly divided into an intervention group or a control group. The intervention group received 800 mg of EGCG and 60 mL of coconut oil, which were included in their daily diet for four months. The control group received placebo and all patients followed an isocaloric diet. A blood sample was collected before and after the four-month period, and levels of cortisol, albumin and BHB were measured in serum. In addition, immediately before and after the intervention, anthropometric variables were measured: waist-to-hip ratio (WHR), body fat mass percentage, fat weight, total weight, and muscle mass percentage. Depression was assessed with the Beck Depression Inventory II (BDI-II). (3) Results: No significant changes were obtained in cortisol levels in any of the groups, and there was a significant increase in albumin in the blood of the intervention group only that could lead to a decrease in serum free cortisol. In addition, it was observed a significant decrease in levels of depression and abdominal fat. (4) Conclusions: EGCG combined with coconut oil increase the concentration of albumin in blood and produce less depression in MS patients.

The effect of pelvic floor exercise program on incontinence and sexual dysfunction in multiple sclerosis patients.

Multiple sclerosis (MS) is a chronic neuroinflammatory disease of the central nervous system that involves different neurological areas. In addition to lower urinary tract symptoms (LUTS), sexual dysfunction (SD), and psychopathological effects, MS sometimes seriously impairs the quality of life (QoL). We hypothesize that the pelvic floor exercise program (PFEP) could improve bladder, sexual function, depression, and QoL in MS patients. Patients diagnosed with MS completed the Incontinence Questionnaire Short Form (ICIQ-SF), the Beck Depression Inventory (BDI), the Multiple Sclerosis Quality of Life-54 (MSQoL-54) questionnaire, and either the Female Sexual Function Index (FSFI) or the Sexual Health Inventory for Men (SHIM). Maximum bladder volumes (MBV) and post-voiding residual (PVR) volumes were measured using ultrasonography. The patients who regularly completed the PFEP for 12weeks were asked to fill out the questionnaires again, and their MBV and PVR were remeasured. Seventy-two patients with relapsing-remitting multiple sclerosis (RRMS) were included in the study. Forty-two (58.3%) RRMS patients reached the end of the study. The patients' post-PFEP average MBV statistically increased (p = 0.01). In contrast, no statistically significant difference was found in the PVR (p = 0.2). After exercise, the FSFI values in women increased (p = 0.02), and ICIQ-SF and BDI values in all the RRMS patients statistically decreased (p = 0.004, p = 0.01, respectively), but there was no improvement in the MSQoL-54 score (p > 0.05). PFEP, which causes a reduction in LUTS by enhancing the MBV of RRMS patients, can be seen as an investment in the future in terms of reducing depression in MS patients and preventing or delaying SD in women.

Fear and anxiety in patients with multiple sclerosis during COVID-19 pandemic; report of an Iranian population

BackgroundThere are reports that stress-related disorders are increasing during coronavirus disease 2019 (COVID-19) pandemic. Patients with Multiple Sclerosis (MS) are at higher risk of developing psychiatric disorders, which result in worsening of their disability. There are concerns about the mental health of MS patients during this pandemic. ObjectiveWe aimed to evaluate the prevalence of anxiety, depression, and levels of fear about Corona in MS patients during the COVID-19 pandemic. Materials and methodsThis was a cross-sectional study on MS patients who were admitted to the MS clinics affiliated with Isfahan University of medical sciences from May to June 2020. Anxiety and depression were evaluated according to the Hospital Anxiety and Depression Scale (HADS). The Corona Fear Questionnaire developed by Ahorsu et al. was applied to evaluate the state of fear about COVID-19. Chi-square tests were used to compare depression and anxiety between different groups, Kruskal-Wallis was used for fear scores, Spearman correlation coefficient was also reported for correlations. Results410 MS patients with a mean age of 38.6 years (±10.35) were enrolled in the study. Among those patients who answered the HADS questionnaire completely (n=399, n=388, for anxiety and depression subscales respectively) the prevalence of anxiety and depression were 31.2% (n=128) and 39.3% (n=161), respectively. There was no significant relationship between anxiety and depression with any of the following variables: sex, marital status, history of drug abuse, smoking, duration of taking psychiatric medication, being tested for COVID-19, being quarantined. Regarding fear about COVID-19, patients with depression or anxiety showed higher scores on the fear questionnaire (p-value=0.03, p-value=0.008 respectively). ConclusionsThe prevalence of anxiety and depression in MS patients was higher than previously reported. Fear about COVID-19 was correlated with anxiety and depression. Multicenter studies are required to develop specific recommendations for screening mental health problems in MS patients during COVID pandemic.

Depression in multiple sclerosis patients associated with risk variant near NEGR1

BackgroundA substantial number of patients diagnosed with multiple sclerosis (MS) suffer from depression in addition to physical symptoms and disability. Recent evidence suggests a stronger relationship may exist between MS and depression than previously thought, in which a diagnosis of depression may be prodromic to the development of MS. MethodsA genome-wide association study (GWAS) was performed to identify genetic variants associated with the development of depression in a cohort of MS patients. The control group (n = 1180) was composed of MS patients with no diagnoses of depression as determined by ICD-9 and ICD-10 billing codes present in the electronic health record (EHR). Separate analyses were performed for three different case groups: 1) MS patients having a depression diagnosis at any time (n = 182), 2) MS patients having a depression diagnosis one year pre-MS diagnosis (n = 27), and 3) MS patients having a depression diagnosis one year post-MS diagnosis (n = 130). Logistic regression analyses were also performed to test for associations between the development of depression and an APOE tagging variant, as APOE was previously linked to depressive affect in MS. An additional logistic regression analysis tested for associations between depression in MS patients and SNPs associated with depression in the general population. Pathway enrichment analyses were also conducted to identify pathways that link the two diseases. ResultsGWAS identified no novel associations between variants and a diagnosis of depression relative to a diagnosis of MS. One variant, rs1432639, associated with depression in the general population, was significantly associated with the development of depression post-MS diagnosis. The APOE-related SNPs were not associated with depression in this study population. An IGF1 pathway approached statistical significance in patients diagnosed with depression prior to a diagnosis of MS. Conclusionrs1432639 and the IGF1 pathway provide evidence for a genetic link between MS and depression that warrants further research.

The impact of social media use on depression in multiple sclerosis patients.

Social media is a powerful tool in providing information and support for minority groups such as patients with chronic diseases. We aimed to assess the link between using online social media and depression in a sample population of Iranian Multiple Sclerosis (MS) patients. In this cross-sectional study, a number of MS patients between 18–55 years were recruited. The Persian-language version of the Beck Depression Inventory-II (BDI-II-Persian) was used to screen MS patients for depression. We selected a cut-off point of 16 to identify depressed MS patients, who answered the self-administered questionnaire designed by the authors (the validity and reliability was confirmed before). Patients, whose interaction with social networks and communication tools was limited to < 1 h/day for < 5 times/month, were allocated as controls. A two-sided p < 0.05 was considered statistically significant. We compared the depression score between patients who used internet and social media (16.38 ± 8.35) with those who did not (25 ± 13.98). We found out there was a significant difference (p = 0.046). However, there were no significant differences between the type (r = 0.098, p = 0.513) and duration (r = − 0.102, p = 0.564) of social media with depression score. Also, based on a cut-off of 3 number of social media there was no significant difference in the status of depression among patients (p = 0.921). Based on the experience of patients, it is helpful to implement a source using online social media to facilitate patients’ access to rehabilitation support and establish support groups with standard supervised information delivery.

Incident depression in patients diagnosed with multiple sclerosis: a multi-database study.

Data on rates of newly diagnosed depression after multiple sclerosis (MS) diagnosis are sparse. Here, incident, treated depression in MS patients after diagnosis compared with matched non-MS patients is described. A matched cohort study was conducted in two separate electronic medical databases: the US Department of Defense (US-DOD) military healthcare system and the UK's Clinical Practice Research Datalink GOLD (UK-CPRD). The study population included all patients with a first recorded diagnosis of MS and matched non-MS patients. Patients with a history of treated depression were excluded. Incidence rates and incidence rate ratios with 95% confidence intervals for treated depression after MS diagnosis/matched date were estimated. Incidence rate ratios of treated depression amongst MS patients compared with non-MS patients were 3.20 (95% confidence interval 3.05-3.35) in the US-DOD and 1.90 (95% confidence interval 1.74-2.06) in the UK-CPRD. Incidence rate ratios were elevated across age and sex. Rates were higher in females than males but, compared to non-MS patients, males with MS had a higher relative risk than females with MS. Multiple sclerosis patients in the UK and the USA have a two- to three-fold increased risk of new, treated depression compared to matched non-MS patients.

Effect of Donepezil on Cognitive Impairment, Quality of Life, and Depression in Multiple Sclerosis Patients: A Randomized Clinical Trial.

Background:Cognitive impairment is one of the debilitating consequences of multiple sclerosis (MS) with negative effects on daily life, individual and social activities, quality of life (QOL), and depression. No approved medication is introduced so far for affected individuals. We aimed to evaluate the efficacy of donepezil on cognitive performance, QOL, and depression in MS.Methods:This is a double-blinded randomized clinical trial conducted on 100 patients with MS during 2018. Patients were assessed prior to intervention abbreviated mental test (AMT), prospective and retrospective mental questionnaire (PRMQ), everyday memory questionnaire (EMQ), digit span test, Beck depression inventory (BDI), and MSQOL questionnaire. Then patients were randomly divided into two groups of treatment (daily regimen of 10 mg donepezil) and placebo for 3 months. Subjects were reassessed using the same instruments at the end of intervention.Results:Fifty patients remained in each group at the end of study. The mean age in donepezil and placebo groups was 31.9 ± 5.89 and 30.65 ± 5.43 years, respectively. EMQ, PRMQ, digit span test, MSQOL, and depression scores improved following donepezil therapy (P < 0.001) while no statistically significant difference was found in the placebo group (P > 0.05). Comparison of two groups also showed more favorable scores in donepezil group with respect to all assessment tools (P < 0.001).Conclusions:Donepezil could effectively improve cognitive impairment in MS patients. Also, its positive effect on QOL and depression could result in a smaller number of interventions in this group of patients.

Effect of Mindfulness-Based Therapy on Pain and Depression in Multiple Sclerosis Patients

Effect of Mindfulness-Based Therapy on Pain and Depression in Multiple Sclerosis Patients

The association between executive functioning, coping styles and depressive symptoms in patients with Multiple Sclerosis

ObjectivesTo investigate the direct, mediated and moderated relationships between executive functioning, coping and depressive symptoms in patients with multiple sclerosis (MS). MethodsCross-sectional cohort study of routine follow-up visits, including a standardized (neuro)psychological evaluation of 68 MS patients. Coping was measured with the Coping Inventory for Stressful Situations; Depressive symptoms with the subscale depression of the Hospital Anxiety and Depression Scale. Cognitive tests were reduced to a single ‘executive function’ factor by means of confirmatory factor analysis. Path analyses tested mediating and moderating effects of coping on the relation between executive functioning and depressive symptoms. ResultsConsistently, the executive functioning factor was not related to task-oriented and emotion-oriented coping. Better executive functioning, however, and less reliance on avoidance coping, was related to more depressive symptoms. Testing of the mediating path showed that executive dysfunctioning was indeed significantly related to more depressive symptoms by less reliance on avoidance coping. There was no additional direct effect of executive functioning on depressive symptoms and also no moderating effect of any coping style on the association between cognition and depressive symptoms. ConclusionOur findings suggest that task-oriented and emotion-oriented coping do not influence the relationship between executive functioning and depression in MS patients, but their mental health might benefit from more reliance on avoidance coping.

Symptoms of fatigue and depression is reflected in altered default mode network connectivity in multiple sclerosis.

BackgroundFatigue and depression are frequent and often co-occurring symptoms in multiple sclerosis (MS). Resting-state functional magnetic resonance imaging (rs-fMRI) represents a promising tool for disentangling differential associations between depression and fatigue and brain network function and connectivity. In this study we tested for associations between symptoms of fatigue and depression and DMN connectivity in patients with MS.Materials and methodsSeventy-four MS patients were included on average 14 months after diagnosis. They underwent MRI scanning of the brain including rs-fMRI, and symptoms of fatigue and depression were assessed with Fatigue Severity Scale (FSS) and Beck Depression Inventory II (BDI). A principal component analysis (PCA) on FSS and BDI scores was performed, and the component scores were analysed using linear regression models to test for associations with default mode network (DMN) connectivity.ResultsWe observed higher DMN connectivity with higher scores on the primary principal component reflecting common symptom burden for fatigue and depression (Cohen’s f2 = 0.075, t = 2.17, p = 0.03). The secondary principal component reflecting a pattern of low fatigue scores with high scores of depression was associated with lower DMN connectivity (Cohen’s f2 = 0.067, t = -2.1, p = 0.04). Using continuous mean scores of FSS we also observed higher DMN connectivity with higher symptom burden (t = 3.1, p = 0.003), but no significant associations between continuous sum scores of BDI and DMN connectivity (t = 0.8, p = 0.4).ConclusionMultivariate decomposition of FSS and BDI data supported both overlapping and unique manifestation of fatigue and depression in MS patients. Rs-fMRI analyses showed that symptoms of fatigue and depression were reflected in altered DMN connectivity, and that higher DMN activity was seen in MS patients with fatigue even with low depression scores.