Anxiety and Depression as Comorbidities of Multiple Sclerosis.
Filip Mustač, Hanna Pašić, Filip Medić, Borna Bjedov, Luka Vujević, Maša Alfirević, Branka Vidrih, Katarina Ivana Tudor, Marija Bošnjak Pašić
Abstract
=97.3%). Brain versus spinal cord lesions, as well as temporal lobe, fasciculus arcuatus, superior frontal and superior parietal lobe lesions in addition to the cerebral atrophy have been shown to be the anatomical predictors of depressive disorder in MS. Hyperactivity of the hypothalamic-pituitary-adrenal axis (HPA) and the consequent dexamethasone-insupressible hypercortisolemia, in addition to cytokine storm (IL-6, TNF-α, TGFβ1, IFNγ/IL-4) present the endocrine and inflammatory basis for development of depression. Fatigue, insomnia, cognitive dysfunction, spasticity, neurogenic bladder, pain, and sexual dysfunction have shown to be additional precipitating factors in development of anxiety and depression in MS patients.