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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. and Hoepner, R. and Fleischer, V. and Heldt, M. and Gisevius, B. and Motte, J. and Ruprecht, K. and Schneider, R. and Fisse, A.L. and Grüter, T. and Lukas, C. and Berthele, A. and Giglhuber, K. and Flaskamp, M. and Mühlau, M. and Kirschke, J. and Bittner, S. and Groppa, S. and Lüssi, F. and Bayas, A. and Meuth, S. and Heesen, C. and Trebst, C. and Wildemann, B. and Then Bergh, F. and Antony, G. and Kümpfel, T. and Paul, F. and Nischwitz, S. and Tumani, H. and Zettl, U. and Hemmer, B. and Wiendl, H. and 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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