Do positive or negative stressful events predict the development of new brain lesions in people with multiple sclerosis?
Do positive or negative stressful events predict the development of new brain lesions in people with multiple sclerosis?
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DOI：
10.1017/s0033291713000755
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发表时间：
2014-01-01
影响因子：
6.9
通讯作者：
Mohr, D. C.
中科院分区：
文献类型：
--
作者：
Burns, M. N.;Nawacki, E.;Mohr, D. C.
背景长期以来，人们一直怀疑应激性生活事件与多发性硬化（MS）疾病活动有关。为数不多的研究探讨了压力事件和神经影像学标记物之间的关系，这些研究规模很小，而且不一致。本研究探讨是否不同类型的压力事件和感知压力可以预测脑insulines.MethodThis的发展是一个次要的分析121例MS患者，随后为48周的随机对照试验比较压力管理治疗MS（SMT-MS）的候补控制（WLC）。患者每8周接受一次磁共振成像（MRI）扫描。每个月，患者完成一项评估压力性生活事件的访谈措施，以及感知压力、焦虑和抑郁症状的自我报告措施，这些措施用于预测29-62天后MRI扫描中钆增强（Gd+）和T-2病变的存在。参与者将压力事件分为积极或消极的。负性事件被认为是“重大”，如果他们涉及身体威胁或威胁到病人的家庭结构，和“中度”otherwise.ResultsPositive应激事件预测降低风险，为随后的Gd+病变在对照组[比值比（OR）0.53为每个额外的积极的应激事件，95%置信区间（CI）0.30-0.91]，无论分组如何，新发或扩大T-2病变的风险较低（OR 0.74，95% CI 0.55-0.99）。在各组中，主要负性应激事件预测Gd+病变（OR 1.77，95% CI 1.18-2.64）和新发或扩大的T-2病变（OR 1.57，95%CI 1.11-2.23）而中度负性压力事件，感知压力，结论主要负性应激事件可预测Gd+和T-的风险增加2病变，而积极的压力事件预测风险降低。
BackgroundStressful life events have long been suspected to contribute to multiple sclerosis (MS) disease activity. The few studies examining the relationship between stressful events and neuroimaging markers have been small and inconsistent. This study examined whether different types of stressful events and perceived stress could predict the development of brain lesions.MethodThis was a secondary analysis of 121 patients with MS followed for 48 weeks during a randomized controlled trial comparing stress management therapy for MS (SMT-MS) to a waitlist control (WLC). Patients underwent magnetic resonance imaging (MRI) scans every 8 weeks. Every month, patients completed an interview measure assessing stressful life events and self-report measures of perceived stress, anxiety and depressive symptoms, which were used to predict the presence of gadolinium-enhancing (Gd+) and T-2 lesions on MRI scans 29-62 days later. Participants classified stressful events as positive or negative. Negative events were considered 'major' if they involved physical threat or threat to the patient's family structure, and 'moderate' otherwise.ResultsPositive stressful events predicted decreased risk for subsequent Gd+ lesions in the control group [odds ratio (OR) 0.53 for each additional positive stressful event, 95% confidence interval (CI) 0.30-0.91] and less risk for new or enlarging T-2 lesions regardless of group assignment (OR 0.74, 95% CI 0.55-0.99). Across groups, major negative stressful events predicted Gd+ lesions (OR 1.77, 95% CI 1.18-2.64) and new or enlarging T-2 lesions (OR 1.57, 95% CI 1.11-2.23) whereas moderate negative stressful events, perceived stress, anxiety and depressive symptoms did not.ConclusionsMajor negative stressful events predict increased risk for Gd+ and T-2 lesions whereas positive stressful events predict decreased risk.