Factors associated with depressive mood at the onset of multiple sclerosis - an analysis of 781 patients of the German NationMS cohort

Salmen, Anke; Hoepner, Robert; Fleischer, Vinzenz; Heldt, Milena; Gisevius, Barbara; Motte, Jeremias; Ruprecht, Klemens; Schneider, Ruth; Fisse, Anna Lena; Grueter, Thomas; Lukas, Carsten; Berthele, Achim; Giglhuber, Katrin; Flaskamp, Martina; Muehlau, Mark; Kirschke, Jan; Bittner, Stefan; Groppa, Sergiu; Luessi, Felix; Bayas, Antonios; Meuth, Sven; Heesen, Cristoph; Trebst, Corinna; Wildemann, Brigitte; Then Bergh, Florian; Antony, Gisela; Kuempfel, Tania; Paul, Friedemann; Nischwitz, Sandra; Tumani, Hayrettin; Zettl, Uwe; Hemmer, Bernhard; Wiendl, Heinz; Zipp, Frauke und Gold, Ralf (2023): Factors associated with depressive mood at the onset of multiple sclerosis - an analysis of 781 patients of the German NationMS cohort. In: Therapeutic Advances in Neurological Disorders, Bd. 16, 1,75629E+16

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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Munich Cluster for Systems Neurology (SyNergy)
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Sprache: Englisch
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 390857198