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| Item Type: | Article |
|---|---|
| Title: | Factors associated with depressive mood at the onset of multiple sclerosis - an analysis of 781 patients of the German NationMS cohort |
| Creators Name: | Salmen, A., Hoepner, R., Fleischer, V., Heldt, M., Gisevius, B., Motte, J., Ruprecht, K., Schneider, R., Fisse, A.L., Grüter, T., Lukas, C., Berthele, A., Giglhuber, K., Flaskamp, M., Mühlau, M., Kirschke, J., Bittner, S., Groppa, S., Lüssi, F., Bayas, A., Meuth, S., Heesen, C., Trebst, C., Wildemann, B., Then Bergh, F., Antony, G., Kümpfel, T., Paul, F., Nischwitz, S., Tumani, H., Zettl, U., Hemmer, B., Wiendl, H., Zipp, F. and Gold, R. |
| Abstract: | BACKGROUND: Depression has a major impact on the disease burden of multiple sclerosis (MS). Analyses of overlapping MS and depression risk factors [smoking, vitamin D (25-OH-VD) and Epstein-Barr virus (EBV) infection] and sex, age, disease characteristics and neuroimaging features associated with depressive symptoms in early MS are scarce. OBJECTIVES: To assess an association of MS risk factors with depressive symptoms within the German NationMS cohort. DESIGN: Cross-sectional analysis within a multicenter observational study. METHODS: Baseline data of n = 781 adults with newly diagnosed clinically isolated syndrome or relapsing-remitting MS qualified for analysis. Global and region-specific magnetic resonance imaging (MRI)-volumetry parameters were available for n = 327 patients. Association of demographic factors, MS characteristics and risk factors [sex, age, smoking, disease course, presence of current relapse, expanded disability status scale (EDSS) score, fatigue (fatigue scale motor cognition), 25-OH-VD serum concentration, EBV nuclear antigen-1 IgG (EBNA1-IgG) serum levels] and depressive symptoms (Beck Depression Inventory-II, BDI-II) was tested as a primary outcome by multivariable linear regression. Non-parametric correlation and group comparison were performed for associations of MRI parameters and depressive symptoms. RESULTS: Mean age was 34.3 years (95% confidence interval: 33.6-35.0). The female-to-male ratio was 2.3:1. At least minimal depressive symptoms (BDI-II > 8) were present in n = 256 (32.8%), 25-OH-VD deficiency (<20 ng/ml) in n = 398 (51.0%), n = 246 (31.5%) participants were smokers. Presence of current relapse [coefficient (c) = 1.48, p = 0.016], more severe fatigue (c = 0.26, p < 0.0001), lower 25-OH-VD (c = -0.03, p = 0.034) and smoking (c = 0.35, p = 0.008) were associated with higher BDI-II scores. Sex, age, disease course, EDSS, month of visit, EBNA1-IgG levels and brain volumes at baseline were not. CONCLUSION: Depressive symptoms need to be assessed in early MS. Patients during relapse seem especially vulnerable to depressive symptoms. Contributing factors such as fatigue, vitamin D deficiency and smoking, could specifically be targeted in future interventions and should be investigated in prospective studies. |
| Keywords: | CIS, Clinically Isolated Syndrome, Cohort Study, Depression, MRI, MS, Neuropsychological Symptoms, Relapse, Sex, Smoking, Vitamin D |
| Source: | Therapeutic Advances in Neurological Disorders |
| ISSN: | 1756-2856 |
| Publisher: | Sage Publications |
| Volume: | 16 |
| Page Range: | 17562864231197309 |
| Date: | 8 September 2023 |
| Official Publication: | https://doi.org/10.1177/17562864231197309 |
| PubMed: | View item in PubMed |
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