April 1, 2004
Boston Cure Project
A group of researchers at the University of California, San Francisco, performed a meta-analysis of 14 studies examining the relationship between stressful life events and relapses. After reviewing all of the papers carefully, they concluded that the evidence clearly and consistently shows that stressful events are associated with an increased risk of subsequent exacerbations. Although it seems reasonable to infer from this that stressful events help cause relapses (perhaps by inducing the release of inflammatory molecules), other explanations are possible. For instance, it could be that the formation of a new lesion might itself result in higher sensitivity to stress, before producing noticeable MS symptoms. Imaging studies and other experiments exploring the physiological effects of stress would help determine the basis for the stress/relapse relationship. Conducting trials of stress reduction therapies to see whether they decrease relapse risk would also be informative.
The authors point out that the connection between stressful events and relapses applies to people with MS in general. Therefore specific stressors can't be linked with relapses, and people with MS should not feel as though they are responsible for their exacerbations.
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