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2002 Robert Ader New Investigator award. Relationship of cardiovascular reactivity, stressful life events, and multiple sclerosis disease activity.

Abstract

Previous studies of stress in multiple sclerosis patients have suggested that life events may alter the onset and development of MS. However, results have been inconsistent because of infrequent monitoring and reporting bias. We followed fifty female MS patients for 1 year to determine characteristics of life events associated with MS exacerbations, and examine the influence of cardiovascular activity. Subjects completed weekly life-event checklists. The short- and long-term threat of each event was determined using the Life Events and Difficulties Schedule. Neurologic symptoms were also monitored weekly. MS exacerbations were confirmed by a neurologist blinded to psychosocial events. Cardiovascular reactivity to an acute psychological stressor was determined at study onset, and resting heart rate and blood pressure were monitored monthly. Forty-two percent of life events were associated with exacerbations in the subsequent 6 weeks. Logistic regression confirmed that exacerbations were more likely during at-risk periods following life events and were relatively independent of the threat level and type of stressor. Participants with higher cardiovascular reactivity to acute stress and higher baseline heart rate demonstrated a greater number of exacerbations and proportion of weeks ill. Using multiple regression, we found that disability level, medication usage, cardiovascular reactivity, baseline heart rate, and life event density explained approximately 30% of the variance in the proportion of weeks ill. These results are consistent with the hypothesis that stress is a potential trigger of MS disease activity and suggest that autonomic tone and stress reactivity may play a role in the development of stress-related exacerbations.

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  • Authors+Show Affiliations

    ,

    Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA. ackermankd@msx.upmc.edu

    , , , , , ,

    Source

    Brain, behavior, and immunity 17:3 2003 Jun pg 141-51

    MeSH

    Adaptation, Psychological
    Adult
    Awards and Prizes
    Blood Pressure
    Cardiovascular System
    Comorbidity
    Female
    Heart Rate
    Humans
    Life Change Events
    Longitudinal Studies
    Middle Aged
    Multiple Sclerosis, Relapsing-Remitting
    Neuropsychological Tests
    Regression Analysis
    Severity of Illness Index
    Stress, Psychological

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    12706412

    Citation

    Ackerman, Kurt D., et al. "2002 Robert Ader New Investigator Award. Relationship of Cardiovascular Reactivity, Stressful Life Events, and Multiple Sclerosis Disease Activity." Brain, Behavior, and Immunity, vol. 17, no. 3, 2003, pp. 141-51.
    Ackerman KD, Stover A, Heyman R, et al. 2002 Robert Ader New Investigator award. Relationship of cardiovascular reactivity, stressful life events, and multiple sclerosis disease activity. Brain Behav Immun. 2003;17(3):141-51.
    Ackerman, K. D., Stover, A., Heyman, R., Anderson, B. P., Houck, P. R., Frank, E., ... Baum, A. (2003). 2002 Robert Ader New Investigator award. Relationship of cardiovascular reactivity, stressful life events, and multiple sclerosis disease activity. Brain, Behavior, and Immunity, 17(3), pp. 141-51.
    Ackerman KD, et al. 2002 Robert Ader New Investigator Award. Relationship of Cardiovascular Reactivity, Stressful Life Events, and Multiple Sclerosis Disease Activity. Brain Behav Immun. 2003;17(3):141-51. PubMed PMID: 12706412.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - 2002 Robert Ader New Investigator award. Relationship of cardiovascular reactivity, stressful life events, and multiple sclerosis disease activity. AU - Ackerman,Kurt D, AU - Stover,Angela, AU - Heyman,Rock, AU - Anderson,Barbara P, AU - Houck,Patricia R, AU - Frank,Ellen, AU - Rabin,Bruce S, AU - Baum,Andrew, PY - 2003/4/23/pubmed PY - 2003/7/25/medline PY - 2003/4/23/entrez SP - 141 EP - 51 JF - Brain, behavior, and immunity JO - Brain Behav. Immun. VL - 17 IS - 3 N2 - Previous studies of stress in multiple sclerosis patients have suggested that life events may alter the onset and development of MS. However, results have been inconsistent because of infrequent monitoring and reporting bias. We followed fifty female MS patients for 1 year to determine characteristics of life events associated with MS exacerbations, and examine the influence of cardiovascular activity. Subjects completed weekly life-event checklists. The short- and long-term threat of each event was determined using the Life Events and Difficulties Schedule. Neurologic symptoms were also monitored weekly. MS exacerbations were confirmed by a neurologist blinded to psychosocial events. Cardiovascular reactivity to an acute psychological stressor was determined at study onset, and resting heart rate and blood pressure were monitored monthly. Forty-two percent of life events were associated with exacerbations in the subsequent 6 weeks. Logistic regression confirmed that exacerbations were more likely during at-risk periods following life events and were relatively independent of the threat level and type of stressor. Participants with higher cardiovascular reactivity to acute stress and higher baseline heart rate demonstrated a greater number of exacerbations and proportion of weeks ill. Using multiple regression, we found that disability level, medication usage, cardiovascular reactivity, baseline heart rate, and life event density explained approximately 30% of the variance in the proportion of weeks ill. These results are consistent with the hypothesis that stress is a potential trigger of MS disease activity and suggest that autonomic tone and stress reactivity may play a role in the development of stress-related exacerbations. SN - 0889-1591 UR - https://www.unboundmedicine.com/medline/citation/12706412/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0889159103000473 DB - PRIME DP - Unbound Medicine ER -