Symptoms In Multiple Sclerosis Patients Research Articles

The presence of attentional and interpretation biases in patients with severe MS-related fatigue.

Severe fatigue is a prevalent and disabling symptom in multiple sclerosis (MS). This study tested if a fatigue- andphysical activity-related attentional bias (AB) and a somatic interpretation bias (IB) are present in severely fatigued patients with MS. Biases were compared to healthy controls and patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Severely fatigued patients with MS or ME/CFS and healthy controls completed a Visual Probe Task (VPT) assessing fatigue- and physical activity-related AB and an IB task that assesses the tendency to interpret ambiguous information in either a somatically threatening way or in a more neutral manner. The VPT was completed by 38 MS patients, 44 ME/CFS patients, and 46 healthy controls; the IB task was completed by 156, 40 and 46 participants respectively. ANOVA showed no statistically significant group differences in a fatigue-related AB or physical activity-related AB (omnibus test of interaction between topic × condition: F2,125 = 1.87; p = .159). Both patient groups showed a tendency to interpret ambiguous information in a somatically threatening way compared to healthy controls (F1,2 = 27.61, p < .001). This IB was significantly stronger in MS patients compared to ME/CFS patients. IB was significantly correlated with cognitive responses to symptoms in MS patients. MS patients tend to interpret ambiguous information in a somatically threatening way. This may feed into unhelpful ways of dealing with symptoms, possibly contributing to the perpetuation of severe fatigue in MS.

Eye movement desensitization and reprocessing for depressed individuals with multiple sclerosis: A pilot study

Background: Multiple studies have highlighted elevated rates of depression among individuals with Multiple Sclerosis (MS), with its associated symptoms posing a significant threat to overall well-being. Moreover, existing literature suggests a potential interconnection between depressive manifestations and the decline of physical functionalities in the context of MS. Objective: to examine the viability of the Eye Movement Desensitization Reprocessing (EMDR) therapy protocol for the treatment of depressive disorders (DeprEND) for alleviating depression in individuals with MS. Methods: We conducted a process–outcome study to examine the feasibilty and effectiveness DeprEND enrolling 13 individuals with MS and depressive symtpoms. Psychological and physical assessment pre-, post-intervention and 3-month follow-up were included. Pre- and post-magnetic resonance imaging (MRI) scans were conducted to analyze potential alterations in brain function. Results: The EMDR DeprEND treatment showed a high level of adherence and feasibility. Significant reductions in depressive symptoms were found at post-intervention and at 3 months follow-up. No significant differences were observed in terms of physical symptoms. A significant modulation observed in parietal and premotor areas when examining negative valence stimuli post-treatment was found. Conclusion: for The EMDR DeprEND protocol may represent a feasible and cost-effective treatment for reducing depressive symptoms in MS patients and improving their mental well-being.

A Self-Reported Study on Explanatory Variables of Stress in Multiple Sclerosis Patients: Exploring the Effect of Physical Conditions and Emotion Regulation Processes.

Multiple sclerosis (MS)-linked stress is frequent, multidetermined and facilitates the onset/exacerbation of MS. However, few explanatory models of stress analysed the joint explanatory effect of emotion regulation and clinical outcomes of MS in those patients. This study explored whether self-reported MS-related conditions (number of relapses, fatigue and global disability) and specific emotion regulation processes (experiential avoidance and self-compassion) explain stress symptoms in MS patients. The MS sample comprised 101 patients with MS diagnosis receiving treatment in hospitals and recruited through the Portuguese MS Society. The no-MS sample included 134 age-, sex- and years of education-matched adults without MS recruited from the general Portuguese population. Both samples did not report other neurological disorders. Data were collected using self-response measures. All potential explanatory variables differed significantly between samples, with higher scores found in MS patients. In MS clinical sample, those variables and years of education correlated with stress symptoms and predicted stress symptoms in simple linear regression models. These results allowed their selection as covariates in a multiple linear regression model. Years of education, the number of relapses, fatigue and experiential avoidance significantly predicted 51% of stress symptoms' total variance. This study provides preliminary evidence on the importance of clinicians and researchers considering the simultaneous contribution of years of education, the number of perceived relapses, fatigue and experiential avoidance as factors that can increase vulnerability to stress in MS patients. Psychological intervention programmes that tackle these factors and associated stress symptomatology should be implemented.

Investigating the association between spiritual well-being and psychological symptoms in multiple sclerosis patients: A cross-sectional analytical study

Investigating the association between spiritual well-being and psychological symptoms in multiple sclerosis patients: A cross-sectional analytical study

Monoaminergic network dysfunction and development of depression in multiple sclerosis: a longitudinal investigation.

Monoaminergic network dysfunction is thought to underpin depression in multiple sclerosis (MS) patients. However, longitudinal studies are lacking. Here, we investigated the association between development of depressive symptoms in MS and changes of resting-state functional connectivity (RS FC) within monoaminergic networks. Forty-nine MS patients without depression [Montgomery-Asberg Depression Scale (MADRS) ≤ 9] and 27 healthy controls underwent clinical and 3.0T RS FC assessment at baseline and after a median follow-up of 1.6years (interquartile range 1.0-2.1years). Monoamine-related RS FC was derived by independent component analysis, constrained to PET atlases for dopamine, noradrenaline and serotonin transporters. Longitudinal changes of RS FC within monoaminergic networks and their correlations with MADRS scores were assessed. At baseline, MS patients showed decreased RS FC vs healthy controls in all PET-guided monoaminergic networks in frontal, cingulate and cerebellar cortices, and increased RS FC in parieto-occipital regions. Fourteen (29%) MS patients developed depressive symptoms (MADRS > 9) at follow-up (D-MS) and exhibited widespread RS FC decrease over time in the PET-guided dopamine network, mainly in orbitofrontal, occipital, anterior cingulate and precuneal cortices compared to patients who did not develop depressive symptoms. In D-MS, decreased RS FC over time was also observed in parahippocampal and occipital regions of the PET-guided noradrenaline network. Decreased RS FC over time in dopamine and noradrenaline PET-guided networks correlated with concomitant increased MADRS scores (r = range - 0.65/- 0.61, p < 0.001). The development of depressive symptoms in MS patients was associated with specific RS FC changes within the dopamine and noradrenaline networks.

The Potential Role of Fecal Microbiota Transplant in the Reversal or Stabilization of Multiple Sclerosis Symptoms: A Literature Review on Efficacy and Safety.

Multiple sclerosis (MS) affects millions of people worldwide, and recent data have identified the potential role of the gut microbiome in inducing autoimmunity in MS patients. To investigate the potential of fecal microbiota transplant (FMT) as a treatment option for MS, we conducted a comprehensive literature search (PubMed/Medline, Embase, Web of Science, Scopus, and Cochrane) and identified five studies that involved 15 adult MS patients who received FMT for gastrointestinal symptoms. The primary outcome of this review was to assess the effect of FMT in reversing and improving motor symptoms in MS patients, while the secondary outcome was to evaluate the safety of FMT in this patient population. Our findings suggest that all 15 patients who received FMT experienced improved and reversed neurological symptoms secondary to MS. This improvement was sustained even in follow-up years, with no adverse effects observed. These results indicate that FMT may hold promise as a treatment option for MS, although further research is necessary to confirm these findings.

Unveiling sex-based impact of TYK2 rs2304256 polymorphism on interferon beta-1alpha responsiveness in COVID-19 patients

Interferon beta-1a was one of the medications suggested by the World Health Organization in the COVID-19 therapy protocol in early 2020. IFNb-1a has previously been used to treat symptoms in multiple sclerosis patients. Previous studies have revealed that TYK2 and HLA genes play crucial roles in immune responses. The current study examined the relationship between TYK2 rs2304256, HLA-DQA1 rs9272105, and rs1448673 and the therapeutic response to IFNb-1a in COVID-19 patients from Kurdish ethnicity. A total of 124 patients with mild COVID-19 were included in this study. These patients received three injections of IFNb-1a every other day. The severity of COVID-19 symptoms and treatment response was determined using the World Health Organization (WHO) scoring method. Changes in WHO scores were assessed after five days, and patients with a difference of <0 were classified as responders (n = 74), whereas those with a difference of 0 or >0 were considered non-responders (n = 50). PCR techniques were used to genotype polymorphisms. The AG rs9272105 genotype reduced the treatment response (codominant model, OR = 0.37, P = 0.027; overdominant model, OR = 0.33, P = 0.011). Stratification by sex revealed that the AC and CC genotypes of rs2304256 reduced response to treatment in female and male patients, (p < 0.05), respectively. The rs2304256 and rs9272105 polymorphisms may play a role in the response to IFNb-1a treatment in COVID-19 patients.

Non-invasive brain stimulation on clinical symptoms in multiple sclerosis patients: A systematic review and meta-analysis.

Non-invasive brain stimulation (NIBS) has demonstrated mixed effects on the clinical symptoms of multiple sclerosis. This systematic review and meta-analysis aimed to evaluate the effects of NIBS techniques on the most common symptoms of MS. A literature search was performed until October 2022 which included randomized controlled trials and quasi-experimental studies that used sham-controlled NIBS in patients with MS. We calculated the Hedge's effect sizes of each domain of interest and their 95% confidence intervals (95% CIs) and performed random effects meta-analyses. A total of 49 studies were included in the systematic review (944 participants). Forty-four eligible studies were included for quantitative analysis, of which 33 applied transcranial direct current stimulation (tDCS), 9 transcranial magnetic stimulation (TMS), and 2 transcranial random noise stimulation (tRNS). We found a significant decrease in fatigue (ES: -0.86, 95% CI: -1.22 to-0.51, p<0.0001), pain (ES:-1.91, 95% CI,-3.64 to-0.19, p=0.03) and psychiatric symptoms (ES:-1.44, 95% CI-2.56 to-0.32, p=0.01) in favor of tDCS compared with the sham. On the other hand, there was no strong evidence showing tDCS effectiveness on motor performance and cognition (ES:-0.03, 95% CI-0.35 to 0.28, p=0.83 and ES: 0.71, 95% CI,-0.09 to 1.52, p=0.08, respectively). Regarding TMS, we found a significant decrease in fatigue (ES:-0.45, 95% CI:-0.84 to -0.07, p=0.02) and spasticity levels (ES:-1.11, 95% CI:-1.48 to-0.75, p<0.00001) compared to the sham. However, there was no strong evidence of the effectiveness of TMS on motor performance (ES:-0.39, 95% CI-0.95 to 0.16, p=0.16). Finally, there was no significant evidence showing the effectiveness of tRNS on fatigue levels (ES:-0.28, 95% CI:-1.02 to 0.47, p=0.46) and cognitive improvement (ES:-0.04, 95% CI:-0.6, 0.52, p=0.88) compared with the sham. Overall, most studies have investigated the effects of tDCS on MS symptoms, particularly fatigue. The symptom that most benefited from NIBS was fatigue, while the least to benefit was motor performance. In addition, we found that disability score was associated with fatigue improvement. Thus, these findings support the idea that NIBS could have some promising effects on specific MS symptoms. It is also important to underscore that studies are very heterogeneous regarding the parameters of stimulation, and this may also have influenced the effects on some specific behavioral domains.

Exploring the relation between reserve and fatigue in multiple sclerosis.

Intellectual enrichment and brain reserve modulate the expression of cognitive and motor disability in multiple sclerosis (MS). Their association with fatigue, one of the most debilitating and common symptoms of MS, has never been explored. Forty-eight MS patients underwent clinical and MRI examination at baseline and after 1 year. Physical and cognitive MS-related fatigue were evaluated via Modified Fatigue Impact subscales (MFIS-P and MFIS-C). Differences in reserve indexes between fatigued and non-fatigued patients were tested. The relationship between clinico-demographic features, global brain structural damage, indexes of reserve (age-adjusted intracranial volume and cognitive reserve index) and fatigue were tested via correlations and hierarchical linear/binary logistic regression, to predict MFIS-P and MFIS-C (at baseline) or new-onset fatigue and meaningful worsening in MFIS (at follow-up). At baseline, although a significant difference was identified for cognitive reserve questionnaire between fatigued and non-fatigued patients (18.19±4.76 versus 15.15±3.56, p=0.015), only depression accounted for significant variance in MFIS-P and MFIS-C (R2=0.248, p=0.002; R2=0.252, p<0.001). MFIS-T, MFIS-P and MFIS-C changes over time were associated to depression changes over time (r=0.56, r=0.55, and r=0.57, respectively; all p<0.001). Indexes of reserve did not differ between non-fatigued patients and patients developing new-onset fatigue at follow-up. None of the baseline features was able to predict the new-onset fatigue or meaningful worsening in MFIS at follow-up. Among the explored features, only depression was strongly associated to both physical and cognitive fatigue. Intellectual enrichment and brain reserve did not seem to affect fatigue symptoms in MS patients.

Effects of N-acetylcysteine on oxidative stress biomarkers, depression, and anxiety symptoms in patients with multiple sclerosis.

N-acetylcysteine (NAC), a thiol-containing antioxidant and glutathione (GSH) precursor, attenuates oxidative stress, and possibly improves psychiatric disorders. This study aimed to evaluate the effects of oral NAC on oxidative stress, depression, and anxiety symptoms in patients with multiple sclerosis (MS). This clinical trial was conducted on 42 MS patients randomly assigned to intervention (n = 21) and control (n = 21) groups. The intervention group received 600 mg of NAC twice daily for 8 weeks, and the control group received a placebo with the same prescription form. An analysis of serum malondialdehyde (MDA), serum nitric oxide (NO), and erythrocyte GSH was carried out on both groups, along with a complete blood count. The Hospital Anxiety and Depression Scale (HADS) was used to assess symptoms of depression (HADS-D) and anxiety (HADS-A). Compared to the control group, NAC consumption significantly decreased serum MDA concentrations (-0.33 [-5.85-2.50] vs. 2.75 [-0.25-5.22] μmol/L; p = 0.03) and HADS-A scores (-1.6 ± 2.67 vs. 0.33 ± 2.83; p = 0.02). No significant changes were observed in serum NO concentrations, erythrocyte GSH levels, and HADS-D scores (p > 0.05). Based on the findings of the present study, NAC supplementation for 8 weeks decreased lipid peroxidation and improved anxiety symptoms in MS patients. The aforementioned results suggest that adjunctive therapy with NAC can be considered an effective strategy for MS management. Further randomized controlled studies are warranted.

Effects of intrathecal Baclofen in reducing tremors in patients with multiple sclerosis

Symptomatic treatment of Multiple Sclerosis (MS) is crucial, since it helps to lessen the limitations that affect patients' daily lives. Tremors are a significant and frequent symptom in MS patients. However, there is still a lack of evidence supporting a specific therapeutic approach for MS patients' tremors. A 41-year-old man with a history of MS is presented in this study. He exhibited stiffness and tremors at the follow-up clinic, which affected his daily activities. For his spasticity, he received intrathecal baclofen (ITB). The patient's symptoms responded well to this treatment, as both stiffness and tremors decreased. In an MS patient, ITB therapy thus unexpectedly reduced and improved tremor symptoms.

Effects of pelvic floor muscle training applied with telerehabilitation in patients with multiple sclerosis having lower urinary track symptoms: A randomized controlled trial

In this study, the researchers aimed to investigate the effects of pelvic floor muscle training (PFMT) applied with telerehabilitation on urinary symptoms, quality of life, and subjective perception of improvement and satisfaction in multiple sclerosis (MS) patients having lower urinary tract symptoms. Patients were randomly divided into PFMT (n:21) and control (n:21) groups. The PFMT group received PFMT via telerehabilitation for 8 weeks and lifestyle advice, while the control group received only lifestyle advice. Although lifestyle advice alone was not effective, PFMT applied with telerehabilitation was an effective method in the management of lower urinary tract symptoms in MS patients. PFMT applied with telerehabilitation can be considered as an alternative method.

Machine learning corroborates subjective ratings of walking and balance difficulty in multiple sclerosis.

Machine learning can discern meaningful information from large datasets. Applying machine learning techniques to raw sensor data from instrumented walkways could automatically detect subtle changes in walking and balance. Multiple sclerosis (MS) is a neurological disorder in which patients report varying degrees of walking and balance disruption. This study aimed to determine whether machine learning applied to walkway sensor data could classify severity of self-reported symptoms in MS patients. Ambulatory people with MS (n = 107) were asked to rate the severity of their walking and balance difficulties, from 1-No problems to 5-Extreme problems, using the MS-Impact Scale-29. Those who scored less than 3 (moderately) were assigned to the “mild” group (n = 35), and those scoring higher were in the “moderate” group (n = 72). Three machine learning algorithms were applied to classify the “mild” group from the “moderate” group. The classification achieved 78% accuracy, a precision of 85%, a recall of 90%, and an F1 score of 87% for distinguishing those people reporting mild from moderate walking and balance difficulty. This study demonstrates that machine learning models can reliably be applied to instrumented walkway data and distinguish severity of self-reported impairment in people with MS.

Visit-to-visit systolic blood pressure variability is associated with increased fatigue symptoms in multiple sclerosis patients

ObjectiveTo evaluate the relationship between visit-to-visit systolic blood pressure variability (SBPv) and fatigue symptoms in Multiple Sclerosis (MS) patients. MethodsThis is a cross-sectional study using data for MS patients who completed the Fatigue Subscale in the Performance Scales (PS), a validated, self-reported measure of MS-related disability, between 2011 and 2015 at an academic medical center. Those who had at least 3 available SBP measures within the prior 12 months of the survey were included in the analysis. Ordinal logistic regression was used to model fatigue as a function of SBP variability, adjusting for demographic factors and mean SBP. ResultsData for 91 MS subjects were analyzed. We found that, compared to those with the lowest SBP variability (Tertile 1), subjects in Tertile 2 had 2.2 times higher odds (OR = 2.19; 95% CI, 0.82–5.87; p = 0.120) and those in Tertile 3 (highest variability) 4.2 times higher odds (OR = 4.16; 95% CI, 1.56–11.13; p = 0.005) of being in a higher fatigue level group, independent of age, sex, race/ethnicity, and mean SBP. ConclusionsOur data show that MS patients with higher SBP variability had a greater degree of fatigue. Future research is needed to further explore this relationship and the potential for therapeutic opportunities to improve fatigue.

Lavender improves fatigue symptoms in multiple sclerosis patients: A double-blind, randomized controlled trial

BackgroundFatigue is one of the most common complications of Multiple Sclerosis (MS) patients. Several pharmacological and non-pharmacological interventions have been recommended to control this complication. Lavender is one of the plants considered by Persian Medicine (PM) and recommended by scholars of past centuries in the treatment of neurological diseases. This study aimed to investigate the efficacy of lavender capsule on improving fatigue symptoms in MS patients. Material and methodsIn a double-blind, controlled trial, using a computer block randomization approach, 48 confirmed MS patients with eligibility criteria of being 18 years or older, Modified Fatigue Impact Scale (MFIS) ≥25, relapsing-remitting MS patients, EDSS ≤6, not pregnant, not breastfeeding, and not suffering from other diseases that cause fatigue, were randomized to receive capsules containing 600mg of lavender flowers as the intervention group or capsules containing 600mg cornstarch as the control group. Patients were randomized after completing the MFIS and were asked to take one capsule three times daily for 60 days. The MFIS again checked to assess the impact of two interventions. Analysis of Covariance (ANCOVA) was used to assess the impact of two interventions. Results24 patients included in each group. The mean (standard deviation) of MFIS was 40.56 (7.63) in the intervention and 41.43 (7.89) in the control groups (p=0.706) before the intervention. However, there was a significant reduction (p0.001˂) in the intervention group, 7.04 (4.91) compared to the control group, 38.17 (9.78) after the intervention. ConclusionIn comparison to cornstarch capsules, consuming the capsules of lavender flowers decreased the MFIS in MS patients.

Network alterations underlying anxiety symptoms in early multiple sclerosis

BackgroundAnxiety, often seen as comorbidity in multiple sclerosis (MS), is a frequent neuropsychiatric symptom and essentially affects the overall disease burden. Here, we aimed to decipher anxiety-related networks functionally connected to atrophied areas in patients suffering from MS.MethodsUsing 3-T MRI, anxiety-related atrophy maps were generated by correlating longitudinal cortical thinning with the severity of anxiety symptoms in MS patients. To determine brain regions functionally connected to these maps, we applied a technique termed “atrophy network mapping”. Thereby, the anxiety-related atrophy maps were projected onto a large normative connectome (n = 1000) performing seed‐based functional connectivity. Finally, an instructed threat paradigm was conducted with regard to neural excitability and effective connectivity, using transcranial magnetic stimulation combined with high-density electroencephalography.ResultsThinning of the left dorsal prefrontal cortex was the only region that was associated with higher anxiety levels. Atrophy network mapping identified functional involvement of bilateral prefrontal cortex as well as amygdala and hippocampus. Structural equation modeling confirmed that the volumes of these brain regions were significant determinants that influence anxiety symptoms in MS. We additionally identified reduced information flow between the prefrontal cortex and the amygdala at rest, and pathologically increased excitability in the prefrontal cortex in MS patients as compared to controls.ConclusionAnxiety-related prefrontal cortical atrophy in MS leads to a specific network alteration involving structures that resemble known neurobiological anxiety circuits. These findings elucidate the emergence of anxiety as part of the disease pathology and might ultimately enable targeted treatment approaches modulating brain networks in MS.

The Efficacy of Cannabis on Multiple Sclerosis-Related Symptoms.

Multiple sclerosis (MS) is known as an autoimmune disease that damages the neurons in the central nervous system. MS is characterized by its most common symptoms of spasticity, muscle spasms, neuropathic pain, tremors, bladder dysfunction, dysarthria, and some intellectual problems, including memory disturbances. Several clinical studies have been conducted to investigate the effects of cannabis on the relief of these symptoms in MS patients. The efficacy of Cannabis sativa (C. Sativa) in the management of MS outcomes such as spasticity, pain, tremors, ataxia, bladder functions, sleep, quality of life, and adverse effects were assessed in this review. Most clinical studies showed the positive effects of cannabinoids with their different routes of administration, such as oromucosal spray and oral form, in reducing most MS symptoms. The oromucosal spray Nabiximols demonstrated an improvement in reducing MS spasticity, pain, and quality of life with a tolerated adverse effect. Oral cannabinoids are significantly effective for treating MS pain and spasticity, while the other symptoms indicate slight improvement and the evidence is quite inconsistent. Oromucosal spray and oral cannabis are mainly used for treating patients with MS and have positive effects on treating the most common symptoms of MS, such as pain and spasticity, whereas the other MS symptoms indicated slight improvement, for which further studies are needed.

Evaluation of neuropsychiatric symptoms in patients with multiple sclerosis

Purpose: The aim of this study was to comprehensively assess the neurophyschiatric symptoms of multiple sclerosis (MS) such as apathy and pseudobulbar affect and their correlation with other concomitant factors.&#x0D; Materials and Methods: Montreal Cognitive Assessment (MoCA), Apathy Evaluation Scale (AES), Fatigue severity scale (FSS), Center for Neurologic Study-Lability Scale (CNS-LS), Beck Depression Inventory (BDI) are applied to 258 MS patients. Correlation and regression analysis are conducted between scales and other possible causers.&#x0D; Results: 53.6% of the patients have psuedobulbar affect, 76.2% of patient population have fatigue. Pseudobulbar affect had positive correlation with fatigue and also depression while apathy negatively correlate with pseudobulbar affect or fatigue. Additionally, apathy and depression correlated negatively. There was no relation between cognition and depression and/or disease duration and/or other scales’ scores. &#x0D; Conclusion: Pseudobulbar affect and apathy are quite common symptoms in MS patients, that are cross-cutting issues. Also, apathy may be an independent neuropyschiatric symptom of MS that need to be approached separately.

Dopaminergic Receptors as Neuroimmune Mediators in Experimental Autoimmune Encephalomyelitis.

The dopaminergic system plays an essential role in maintaining homeostasis between the central nervous system (CNS) and the immune system. Previous studies have associated imbalances in the dopaminergic system to the pathogenesis of multiple sclerosis (MS). Here, we examined the protein levels of dopaminergic receptors (D1R and D2R) in different phases of the experimental autoimmune encephalomyelitis (EAE) model. We also investigated if the treatment with pramipexole (PPX)-a dopamine D2/D3 receptor-preferring agonist-would be able to prevent EAE-induced motor and mood dysfunction, as well as its underlying mechanisms of action. We report that D2R immunocontent is upregulated in the spinal cord of EAE mice 14days post-induction. Moreover, D1R and D2R immunocontents in lymph nodes and the oxidative damage in the spinal cord and striatum of EAE animals were significantly increased during the chronic phase. Also, during the pre-symptomatic phase, axonal damage in the spinal cord of EAE mice could already be found. Surprisingly, therapeutic treatment with PPX failed to inhibit the progression of EAE. Of note, PPX treatment inhibited EAE-induced depressive-like while failed to inhibit anhedonic-like behaviors. We observed that PPX treatment downregulated IL-1β levels and increased BNDF content in the spinal cord after EAE induction. Herein, we show that a D2/D3 receptor-preferred agonist mitigated EAE-induced depressive-like behavior, which could serve as a new possibility for further clinical trials on treating depressive symptoms in MS patients. Thus, we infer that D2R participates in the crosstalk between CNS and immune system during autoimmune and neuroinflammatory response induced by EAE, mainly in the acute and chronic phase of the disease.

The effect of therapeutic exercise on depressive symptoms in people with multiple sclerosis

Introduction: Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system. It involvesa wide range of symptoms, with depression being one of the main sources of disability for patients living with MS. Aim: The aim of this study was to perform a review of the literature on the effects of exercise on depressive symptoms in patients with MS, with the main focus on the benefits of physiotherapy, therapeutic exercise, and telerehabilitation. Methods: The review was performed using the databases of Medline, PubMed, and other sources, such as Google Scholar and Elsevier. The keywords used for the conduction were therapeutic exercise, physiotherapy, physical therapy, rehabilitation, telerehabilitation, depression, and multiple sclerosis. The inclusion criteria consisted of studies: a) published between 2010-2021, b) looking into the effects of depression and/or therapeutic exercise in patients living with MS, and c) written in English. The exclusion criteria used were:a) patients not diagnosed with MS, b) pilot studies, c) case studies, and d) studies published prior to 2010. Results:Of the 211 potentially relevant studies detected,33 were included for qualitative synthesis. The full texts of these articles were carefully evaluated by four different examiners in different timeframes. Conclusion:Utilizing physical therapy through therapeutic exercise and/orwith telerehabilitation protocols can help improve depressive symptoms in MS patients. However, further research should be conducted regarding the parameters of different forms of intervention in order to create clinical guidelines for therapists and patients to follow.