Prevalence of depressive disorders in patients with multiple sclerosis with foci of demyelination

Prevalence of depressive disorders in patients with multiple sclerosis with foci of demyelination

 

Authors

 

N.V. Zarubina

Federal State Budgetary Educational Institution of Higher Education “Yaroslavl State Medical University” of the Ministry of Health of the Russian Federation, Yaroslavl, Russian Federation

 

https://doi.org/10.26617/1810-3111-2024-2(123)-32-40

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2024; 2 (123):  32-40.

 

Abstract

Background. Depressive disorders in multiple sclerosis (MS) are largely due to the processes that occur during the development of this chronic autoimmune disease. Therefore, researchers are faced with the task of searching for MRI markers of MS progression. Objective: to identify foci of demyelination in multiple sclerosis and establish their association with depressive disorders. Material and Methods. The study involved patients with relapsing-remitting MS (n=203) (n=179 – 88.2%, mean age 38±10 years, average disease duration 8.23±6.57 years, mean age of onset 30.2±10.5 years) and secondary progressive (n=24 ‒ 11.8%, mean age 46±9 years, average disease duration 8.23±6.57 years, mean age of onset 33.33±8.02 years) during MS. Two groups were formed: group 1 – patients with multiple sclerosis without depression (n=90, 44.3%), group 2 – patients with multiple sclerosis and depression (n=113, 55.7%). According to ICD-10 criteria, a diagnosis was made: mood disorders (affective disorders) (F3). Results and Discussion. The first atrophic disorders in the brain of MS patients were documented 7 years after onset of MS. Depending on the location in the brain, statistically significant differences (p<0.001) in the foci of demyelination in the right and left hemispheres were revealed. In patients with MS and comorbid depression, subcortical foci of demyelination were found statistically significantly (p<0.05) more often in the occipital lobe of the right hemisphere, the temporal lobe of the left hemisphere, and the thalamus. In the secondary progressive course of MS, juxtacortical lesions were statistically significantly (p=0.038) more common. Based on MRI data, areas of the brain that had been significant for cognitive functioning and had been responsible for emotional regulation (emotional and personality disorders, including depressive disorders) were identified. An association between foci of demyelination and anxious, melancholic, asthenic, and apathetic forms of depression was revealed. Conclusion. Depressive disorders were associated with foci of demyelination with predominant lateralization periventricularly in the frontal lobe, subcortically in the temporal lobe, in the juxtacortical regions of the left hemisphere, in the infratentorial regions of the brain, in the cerebellum and thalamus. As the duration of MS increased, the types of depression changed. The timing of the onset of the first atrophic disorders in the brain of MS patients was established. MRI markers of anxious, melancholic, asthenic, and adynamic depression in patients with MS were determined. The immunopathogenesis of MS was associated with depressive disorders. The processes of the onset and the progression of MS were the etiological factor of depression. Timely diagnosis and adequate treatment of depression could achieve a positive effect in stopping exacerbations and slowing down the progression of MS.

 

Keywords: multiple sclerosis, depressive disorders, MRI diagnostics, brain lesions, foci of demyelination.

 

Article (pdf)

 

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For citation: Zarubina N.V. Prevalence of depressive disorders in patients with multiple sclerosis with foci of demyelination. Siberian Herald of Psychiatry and Addiction Psychiatry.2024; 2 (123): 32-40. https://doi.org/10.26617/1810-3111-2024-2(123)-32-40

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