December 9, 2003
Multiple Sclerosis Society
Relapsing remitting MS (RRMS) is unpredictable and the factors that trigger a relapse are not known. However, relapses have been linked to a number of factors, including stress, but there is very little scientific evidence for this - much of the evidence is anecdotal.
This study aimed to assess whether life events, perceived as stressful by participants in this study, were associated with a higher chance of having a relapse. Stressful events included illness/death in the family, financial problems, job stress, marriage problems and events related to house and car (e.g. theft).
Participants filled out a weekly diary reporting any stressful events, and these were collected every 8 weeks. Anyone reporting a suspected relapse was assessed by a neurologist. A four-week period after the report of a stressful event was defined as a high-risk period. The relapse rate of participants during a high-risk period was compared against those not with high risk (i.e. no stressful event). Stress judged as being caused by MS itself was excluded from the study.
Of the 73 people with RRMS who took part, 70 reported at least one stressful event. During the average monitoring time of 1.4 years, overall 134 relapses occurred in 56 of the 73 participants, which worked out as an average of 1.3 relapses a year. The risk of a relapse was double in the four-week period after a stressful event than after four weeks with no stress.
The authors highlight that the mechanism between increased stress and an increased risk of relapse is not fully understood. They suggest this could be mediated through stress triggering the release of hormones, and that in future studies, it would be beneficial to measure levels of hormones related to stress. This would also provide a measurable marker of the ?amount? of stress experienced. Knowledge that these events may be associated with relapses can add important information about the unpredictable nature of the disease to people affected by MS.
This report was published in the British Medical Journal, September
2003. Vol. 327, pages 646 - 649.
Copyright © 2003, Multiple Sclerosis Society