Having Multiple Sclerosis With Depression Raises Mortality Risk

Multiple Sclerosis (MS) is a chronic inflammatory, autoimmune and neurodegenerative disease of the central nervous system (CNS). MS affects approximately 2.5 million people worldwide. High prevalence of MS is seen in northern parts of Europe and North America. Nearly 1 million are living with MS in the United States, according to a study funded by the National MS Society.

Most people are diagnosed between the ages of 20 and 50, although MS can occur in young children and older adults.  In general, MS is more common in areas furthest from the equator. However, prevalence rates may differ significantly among groups living in the same geographic area regardless of distance from the equator.

The recent prevalence study shows MS is three times more common in women than in men, suggesting that hormones may also play a significant role in determining susceptibility to MS. Research has demonstrated that MS occurs in most ethnic groups, including Black, Asians and Hispanics/Latinx, but is most common amongst white people of European descent.

Scientists believe MS is an autoimmune disease where a person’s body attacks the myelin sheath (the covering surrounding the nerves), resulting in abnormal conduction of electrical impulses through the nerves in the brain and spinal cord.

People with MS may experience various symptoms including altered vision, muscle weakness, incoordination, numbness, pain, trouble with memory or focus, tremors and depression.

A new study published in Neurology, the Official Journal of the American Academy of Neurology, showed that people with multiple sclerosis (MS) and depression had about a 5.4 times increased risk of death from all causes compared to people without MS and depression. People with MS with and without depression also had an increased risk of vascular diseases such as heart attack and stroke. 

The study findings emphasize the importance of identifying and treating depression and other cardiovascular (CV) risk factors in people with MS. The paper in Neurology quotes previous studies showing that people without MS but with depression have a 30% increased risk of developing vascular disease and a 70% greater risk of death from all causes.

According to the neurologist Dr. Barbara Giesser, MD from the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA, the take-home message is that these are risk factors outside of the direct neurologic impact of MS that need to be identified and treated. Depression certainly should be screened for and addressed, as well as risk factors for vascular disease such as diabetes, hypertension and hyperlipidemia.

Current available treatments for MS are based on immunosuppression and some modifying immunomodulatory agents. They are not able to stop the progressive neurodegenerative process in this condition. Thus, the cell replacement therapy with stem cells approach that aims to overcome the neuronal cell loss and remyelination failure and increase endogenous myelin repair capacity is considered as an alternative treatment option.