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This version was published on March 1, 2007
Multiple Sclerosis, Vol. 13, No. 2, 143-148 (2007)
DOI: 10.1177/1352458506070772
© 2007 SAGE Publications

Reviews

Stress regulation in multiple sclerosis-current issues and concepts

C Heesen

Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, heesen{at}uke.uni-hamburg.de

D C Mohr

Departments of Psychiatry and Neurology, University of California, San Francisco, VAMC, San Francisco, CA, USA

I Huitinga

Netherlands Institute for Neuroscience and MS Centre, VUmc, AZ Amsterdam, The Netherlands

F Then Bergh

Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig, Leipzig, Germany

J Gaab

Klinische Psychologie und Psychotherapie, Psychologisches Institut, Universität Zürich, Zürich, Switzerland

C Otte

Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

S M Gold

Multiple Sclerosis Program, Department of Neurology and Cousins Center for Psychoneuroimmunology, Neuropsychiatric Institute, UCLA School of Medicine, Los Angeles, CA, USA

Since its first description by Charcot, psychological stress has been considered a triggering factor for exacerbations in multiple sclerosis, but until recently the clinical evidence for a causal relation was weak. Over the past years, a growing number of studies have started to elucidate this association and highlight potential mechanisms, including brain-immune communication. On 5 June 2005, a panel of international researchers discussed the current evidence. This article summarizes the observational, animal experimental, as well as human experimental findings on stress regulation in MS, as well as studies on the functioning of the major stress response systems, ie, the hypothalamo-pituitary-adrenal (HPA) axis and the autonomous nervous system (ANS) in MS. Consensus statements from the group to these aspects are given. Research objectives and strategies are delineated, as well as clinical implications.

Key Words: adrenoreceptor • autonomous nervous system • experimental stress • glucocorticoids • hypothalamo-pituitary-adrenal axis • stressful life events


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