Life’s Stressors Linked to Health Decline in Multiple Sclerosis Patients

A study spearheaded by Michigan Medicine has found that individuals diagnosed with multiple sclerosis (MS) suffer a decline in their health and functional capabilities due to life-long stressors, including poverty, abuse, and divorce.

This research was grounded in survey data obtained from over 700 MS patients. The investigation revealed that stress events from both childhood and adulthood significantly influenced the level of disability endured by the participants.

The findings have been published in the journal Brain and Behavior.

Tiffany Braley, M.D., M.S., a co-author of the study, stated, “MS is the leading cause of non-traumatic disability among young adults, and additional research is needed to identify these external drivers of disability that can be addressed or prevented, including stress, to improve functional outcomes.” She serves as the director of the Multiple Sclerosis/Neuroimmunology Division and Multidisciplinary MS Fatigue and Sleep Clinic at the University of Michigan Health.

Braley further underscored the importance of this knowledge in directing MS research and patient care. She proposed that access to resources such as mental health or substance misuse support could mitigate the effects of stress and enhance wellbeing.

MS is an autoimmune condition affecting over 2.8 million individuals worldwide. It impacts the brain and spinal cord, with the body’s immune system attacking the protective layer of nerve cells. Those with MS may experience unique and often painful symptom flare-ups, also known as relapses or exacerbations.

In the initial phase of the study, both childhood and adult stressors were found to be significantly associated with an increased burden of relapse following the emergence of the COVID-19 pandemic. However, when accounting for adult experiences, the correlation between childhood stressors and disease burden was not statistically significant.

Researchers suggest that studies on stress and MS that do not consider the individual’s full lifespan may miss crucial information or exaggerate the relationship between childhood stressors and health outcomes.

Carri Polick, Ph.D., R.N., the lead author of the study, said, “Adverse Childhood Experiences, which we call ACEs, and other childhood stressors could impact immune, inflammatory and behavioural processes throughout life, and reduce resilience to adult stress.” She completed this work at the U-M School of Nursing and currently holds a postdoctoral fellowship in the National Clinician Scholars Programme at Duke University.

Polick advocated for future studies to use a lifespan approach to better comprehend patterns and enhance symptom management. She stated, “For example, we are expanding upon this work to investigate mechanistic pathways through sleep, smoking and mental health, through which stressors may lead to worse MS outcomes including increased disability, pain and fatigue.”

The study’s additional authors were Robert Ploutz-Snyder, Ph.D., Cathleen M. Connell, Ph.D., and Sarah A. Stoddard, Ph.D., all from the University of Michigan.

This research was partly funded by the National Institutes of Health and the National Institute of Nursing Research.

The paper, titled “Associations among stressors across the lifespan, disability, and relapses in adults with Multiple Sclerosis,” was published in Brain and Behavior.

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