Stress regulation in multiple sclerosis - current issues and concepts

¹ Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
² Departments of Psychiatry and Neurology, University of California, San Francisco, VAMC, San Francisco, CA, USA
³ Netherlands Institute for Neuroscience and MS Centre, VUmc, AZ Amsterdam, The Netherlands
⁴ Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig, Leipzig, Germany
⁵ Klinische Psychologie und Psychotherapie, Psychologisches Institut, Universität Zürich, Zürich, Switzerland
⁶ Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
⁷ Multiple Sclerosis Program, Department of Neurology and Cousins Center for Psychoneuroimmunology, Neuropsychiatric Institute, UCLA School of Medicine, Los Angeles, CA, USA

^* To whom correspondence should be addressed.

	Abstract

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

First published on January 29, 2007, doi:10.1177/1352458506070772

Multiple Sclerosis 2007;13:143.

A more recent version of this article appeared on March 1, 2007


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