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Fortschr Neurol Psychiatr 2006; 74(10): 567-574
DOI: 10.1055/s-2005-919090
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Stress und Krankheitsverlauf der Multiplen Sklerose

Stress and Progression in Multiple SclerosisA.  Apel1 , T.  Klauer2 , U.  K.  Zettl1
  • 1Universität Rostock, Klinik und Poliklinik für Neurologie (Direktor: Prof. Dr. Reiner Benecke)
  • 2Universität Rostock, Klinik und Poliklinik für Psychosomatik und Psychotherapeutische Medizin (Direktor: Prof. Dr. Dr. Wolfgang Schneider)
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Publication History

Publication Date:
02 January 2006 (online)

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Zusammenfassung

Zusammenhänge zwischen Stress und klinischer Manifestation der Multiplen Sklerose bzw. Krankheitsprogression werden seit langem diskutiert. Die aktuellen klinischen Studien weisen auf eine Koinzidenz zwischen Stress und Krankheitsprogression hin. In der vorliegenden Arbeit werden neben dem aktuellen Forschungsstand zum Thema verschiedene Stressmodelle vorgestellt und die Beziehungen zwischen Krankheit, Ressourcen und Coping erörtert. Dabei wird neben dem Einfluss belastender Lebensereignisse auf die Krankheit auch der Einfluss krankheitsspezifischer Charakteristika auf das Copingverhalten berücksichtigt. Aus den Ergebnissen der vorgestellten Studien und den dargestellten Stressmodellen kann geschlussfolgert werden, dass in Zukunft die Möglichkeiten stressvermeidender Interventionsprogramme stärker berücksichtigt werden sollten.

Abstract

The hypothesis that stress might be connected to causation or exacerbation of multiple sclerosis has been under discussion for a long time. The current studies indicate that there is a coincidence between stress and disease progression. Besides the state of art in research different stress models will be introduced in the paper and the relations between disease, resources and coping will be discussed. Besides the influence of distressing life events on disease, the effect of illness-related characteristics on the coping behaviour will be considered in this regard. From the results of the presented studies and the described stress models it was concluded that the possibilities of stress avoiding intervention programs should be taken into account more strongly in the future.

Literatur

  • 1 Flachenecker P, Zettl U K. Epidemiologie. In: Schmidt RM, Hoffmann F (Hrsg). Muliple Sklerose, 4. Auflage. München, Jena: Urban & Fischer 2006 in press
    Search in Google Scholar
  • 2 Kurtzke J F. Epidemiology of multiple sclerosis. In: Hallpike JF, Adams CWM, Tourtellotte WW (Hrsg). Multiple sclerosis: pathology, diagnosis and management. London: Capman and Hall 1983: 47-95
    Search in Google Scholar
  • 3 Sadovnik A D, Remick R A, Allen J. et al . Depression and multiple sclerosis.  Neurology. 1996;  46 628-632
    CrossrefPubMedSearch in Google Scholar
  • 4 Feinstein A. The neuropsychiatry of multiple sclerosis.  Can J Psychiatry. 2004;  49 157-63
    PubMedSearch in Google Scholar
  • 5 Goodin D S, Ebers G C, Johnson K P. et al . The relationship of MS to physical trauma and psychological stress: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.  Neurology. 1999;  52 1737-1745
    PubMedSearch in Google Scholar
  • 6 Mohr D C, Hart S L, Julian L. et al . Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis.  BMJ. 2004;  328 731-733
    CrossrefPubMedSearch in Google Scholar
  • 7 Warren S, Greenhill S, Warren K G. Emotional stress and the development of multiple sclerosis: case-control evidence of a relationship.  J Chronic Dis. 1982;  35 821-831
    CrossrefPubMedSearch in Google Scholar
  • 8 Grant I, Brown G W, Harris T. et al . Severely threatening events and marked life difficulties preceding onset or exacerbation of multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1989;  52 8-13
    PubMedSearch in Google Scholar
  • 9 Warren S, Warren K G, Cockerill R. Emotional stress and coping in multiple sclerosis (MS) exacerbations.  J Psychosom Res. 1991;  35 37-47
    CrossrefPubMedSearch in Google Scholar
  • 10 Sibley W A. Risk factors in multiple sclerosis. In: Raine CS, McFarland HF, Tourtellotte WW (Hrsg). Multiple sclerosis: clinical and pathogenetic basis. London: Chapman and Hall 1997: 141-148
    Search in Google Scholar
  • 11 Nisipeanu P, Korczyn A D. Psychological stress as risk factor for exacerbations in multiple sclerosis.  Neurology. 1993;  43 1311-1312
    PubMedSearch in Google Scholar
  • 12 Franklin G M, Nelson L M, Heaton R K. Stress and its relationship to acute exacerbations in multiple sclerosis.  J Neurol Rehabil. 1988;  2 7-11
    PubMedSearch in Google Scholar
  • 13 Rabins P V, Brooks B R, O'Donnell P. et al . Structural brain correlates of emotional disorder in multiple sclerosis.  Brain. 1986;  109 585-597
    CrossrefPubMedSearch in Google Scholar
  • 14 Gaiatto G, Loperfido A, Fortunaso P. Eventi stressanti e ricadute nella sclerosi multipla; Uno studio pilota [Stressful events and exacerbations in multiple sclerosis: A pilot study].  Medicina Psicosomatica. 1992;  37 19-27
    PubMedSearch in Google Scholar
  • 15 Stip E, Truelle J L. Organic personality syndrome in multiple sclerosis and effect of stress on recurrent attacks.  Can J Psychiatry. 1994;  39 27-33
    PubMedSearch in Google Scholar
  • 16 Morrison W, Nelson J. Environmental triggers in multiple sclerosis. Fact or fallacy?.  Axone. 1994;  16 23-26
    PubMedSearch in Google Scholar
  • 17 Gasperini C, Grasso M G, Fiorelli M. et al . A controlled study of potential risk factors preceding exacerbation in multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1995;  59 303-305
    PubMedSearch in Google Scholar
  • 18 Palumbo R, Fontanillas L, Salmaggi A. et al . Stressful life events and multiple sclerosis: a retrospective study.  Ital J Neurol Sci. 1998;  19 259-260
    PubMedSearch in Google Scholar
  • 19 Mohr D C, Goodkin D E, Bacchetti P. et al . Psychological stress and the subsequent appearance of new brain MRI lesions in MS.  Neurology. 2000;  55 55-61
    CrossrefPubMedSearch in Google Scholar
  • 20 Ackerman K D, Stover A, Heyman R. et al . 2002 Robert Ader New Investigator award. Relationship of cardiovascular reactivity, stressful life events, and multiple sclerosis disease activity.  Brain Behav Immun. 2003;  17 141-151
    CrossrefPubMedSearch in Google Scholar
  • 21 Buljevac D, Hop W C, Reedeker W. et al . Self reported stressful life events and exacerbations in multiple sclerosis: prospective study.  BMJ. 2003;  327 646
    CrossrefPubMedSearch in Google Scholar
  • 22 Filippini G, Munari L, Incorvaia B. et al . Interferons in relapsing remitting multiple sclerosis.  Lancet. 2003;  361 545-552
    CrossrefPubMedSearch in Google Scholar
  • 23 MS-Therapie Konsensus Gruppe (MSTKG) . Immunmodulatorische Stufentherapie der multiplen Sklerose.  Nervenarzt. 1999;  70 371-386
    CrossrefPubMedSearch in Google Scholar
  • 24 Rieckmann R, Toyka K V. MSTCG . Escalating immunotherapy of multiple sclerosis.  J Neurol. 2004;  251 1329-1339
    CrossrefPubMedSearch in Google Scholar
  • 25 Biondi M. Effects of stress on immune functions. In: Ader R, Felten DL, Cohen N (Hrsg). Psychoneuroimmunology. San Diego: Academic Press 2001: 189-226
    Search in Google Scholar
  • 26 Ben-Eliyahu S, Shakhar G. The impact of stress, catacholamines and the menstrual cycle on NK activity and tumor development. In: Ader R, Felten DL, Cohen N (Hrsg). Psychoneuroimmunology. San Diego: Academic Press 2001: 545-564
    Search in Google Scholar
  • 26b Gold S M, Mohr D C, Huitinga I, Flachenecker P, Sternberg E M, Heesen C. The role of stress-response systems for the pathogenesis and progression of MS.  Trends Immunol. 2005;  26 644-652
    CrossrefPubMedSearch in Google Scholar
  • 27 Baggiolini M. Chemokines and leukocyte traffic.  Nature. 1998;  392 565-568
    CrossrefPubMedSearch in Google Scholar
  • 28 Ransohoff R M. Mechanisms of inflammation in MS tissue: adhesion molecules and chemokines.  J Neuroimmunol. 1999;  98 57-68
    CrossrefPubMedSearch in Google Scholar
  • 29 Wiendl H, Hohlfeld R. Therapeutic approaches in multiple sclerosis: lessons from failed and interrupted treatment trials.  BioDrugs. 2002;  16 183-200
    PubMedSearch in Google Scholar
  • 30 Lucchinetti C F, Brück W, Lassmann H. Evidence for pathogenic heterogeneity in multiple sclerosis.  Ann Neurol. 2004;  56 308
    CrossrefPubMedSearch in Google Scholar
  • 31 Lucchinetti C F, Parisi J, Brück W. The pathology of multiple sclerosis.  Neurol Clin. 2005;  23 77-105
    CrossrefPubMedSearch in Google Scholar
  • 32 Noseworthy J H, Lucchinetti C, Rodriguez M. et al . Multiple sclerosis.  N Engl J Med. 2000;  343 938-952
    CrossrefPubMedSearch in Google Scholar
  • 33 Kieseier B C, Hartung H P. Multiple paradigm shifts in multiple sclerosis.  Curr Opin Neurol. 2003;  16 247-252
    CrossrefPubMedSearch in Google Scholar
  • 34 Aikens J E, Fischer J S, Namey M. et al . A replicated prospective investigation of life stress, coping, and depressive symptoms in multiple sclerosis.  J Behav Med. 1997;  20 433-445
    CrossrefPubMedSearch in Google Scholar
  • 35 Kroencke D C, Denney D R. Stress and coping in multiple sclerosis: exacerbation, remission and chronic subgroups.  Mult Scler. 1999;  5 89-93
    CrossrefPubMedSearch in Google Scholar
  • 36 Schwartz C E, Foley F W, Rao S M. et al . Stress and course of disease in multiple sclerosis.  Behav Med. 1999;  25 110-116
    PubMedSearch in Google Scholar
  • 37 Charcot J M. Lectures on the disease of the nervous system. London: New Sydenham Society 1879
    Search in Google Scholar
  • 38 Klausner I. Ein Beitrag zur Aetiologie der multiplen Sklerose.  Arch Psychiatr Nervenk. 1901;  34 841-868
    PubMedSearch in Google Scholar
  • 39 US Department of Health and Human Services . Types of injuries and impairments due to injuries. National Health Survey.  PHS. 1986;  159 8-26
    PubMedSearch in Google Scholar
  • 40 McAlpine D, Compston N. Some aspects of the natural history of disseminated sclerosis.  Q J Med. 1952;  21 135-167
    PubMedSearch in Google Scholar
  • 41 Kurland L T, Westlund N. Epidemiologic factors in the etiology and prognosis of multiple sclerosis.  Ann N Y Acad Sci. 1954;  58 682-701
    PubMedSearch in Google Scholar
  • 42 Alter M, Speer J. Clinical evaluation of possible etiologic factors in multiple sclerosis.  Neurology. 1968;  18 109-115
    PubMedSearch in Google Scholar
  • 43 Sibley W A, Bamford C R, Clark K C. et al . A prospective study of physical trauma and multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1991;  54 584-589
    PubMedSearch in Google Scholar
  • 44 Siva A, Radhakrishnan K, Kurland L T. et al . Trauma and multiple sclerosis: a population-based cohort study from Olmsted County, Minnesota.  Neurology. 1993;  43 1878-1882
    PubMedSearch in Google Scholar
  • 45 Gusev E, Boiko A, Lauer K. et al . Environmental risk factors in MS: a case-control study in Moscow.  Acta Neurol Scand. 1996;  94 386-394
    PubMedSearch in Google Scholar
  • 46 Strenge H. Zur Beziehung von psychologischem Stress und klinischem Verlauf der multiplen Sklerose. Eine aktuelle Bestandsaufnahme.  Psychother Psychosom Med Psychol. 2001;  51 166-175
    PubMedSearch in Google Scholar
  • 47 Mohr D C, Genain C. Social support as a buffer in the relationship between treatment for depression and T-cell production of interferon gamma in patients with multiple sclerosis.  J Psychosom Res. 2004;  57 155-158
    CrossrefPubMedSearch in Google Scholar
  • 48 Seyle H. The stress of life. New York: McGraw-Hill 1956
    Search in Google Scholar
  • 49 Lazarus R S. Psychological stress and the coping process. New York: McGraw-Hill 1966
    Search in Google Scholar
  • 50 Lazarus R S, Folkman S. Stress, appraisal and coping. New York: Springer 1996
    Search in Google Scholar
  • 51 Folkman S, Lazarus R S. An analysis of coping in a middle-aged community sample.  J Health Soc Behav. 1980;  21 219-239
    CrossrefPubMedSearch in Google Scholar
  • 52 Hobfoll S E. The ecology of stress. Washington, DC: Hemisphere 1988
    Search in Google Scholar
  • 53 Hobfoll S E. The influence of culture, community, and the nested-self in the stress process: Advancing Conservation of Resources theory.  Applied Psychology. 2001;  50 337-369
    CrossrefPubMedSearch in Google Scholar
  • 54 Moos R H, Schaefer J A. Coping ressources and processes: current concepts and measures. In: Goldberger L, Breznitz S (Hrsg). Handbook of stress. New York: The Free Press 1993: 234-257
    Search in Google Scholar
  • 55 Maes S, Leventhal H, de Ridder D. Coping with chronic disease. In: Zeidner M, Endler NS (Hrsg). Handbook of coping. New York: Wiley 1996: 221-251
    Search in Google Scholar
  • 56 Leppin A, Schwarzer R. Social support and physical health: An updated metaanalysis. In: Schmidt LR, Schwenkmezger P, Weinman J, et al (Hrsg). Theoretical and applied aspects of health and psychology. Chur, Switzerland: Harwood 1988: 185-202
    Search in Google Scholar
  • 57 Ader R, Cohen N. Behaviorally conditioned immunosuppression.  Psychosomatic Medicine. 1975;  37 333-340
    PubMedSearch in Google Scholar
  • 58 Kiecolt-Glaser J K, McGuire L, Robles T F. et al . Psychoneuroimmunology and psychosomatic medicine: back to the future.  Psychosom Med. 2002;  64 15-28
    PubMedSearch in Google Scholar
  • 59 Buske-Kirschbaum A, Geiben A, Hellhammer D. Psychobiological aspects of atopic dermatitis: An overview.  Psychother Psychosom. 2001;  70 6-16
    PubMedSearch in Google Scholar
  • 60 Dhabhar F S, McEwen B S. Bidirectional effects of stress and glucocorticoid hormones on immune function: possible explanations for paradoxical observations. In: Ader R, Felten DL, Cohen N (Hrsg). Psychoneuroimmunology. San Diego: Academic Press 2001: 301-338
    Search in Google Scholar
  • 61 Stefferl A, Storch M K, Linington C. et al . Disease progression in chronic relapsing experimental allergic encephalomyelitis is associated with reduced inflammation-driven production of corticosterone.  Endocrinology. 2001;  142 3616-3624
    CrossrefPubMedSearch in Google Scholar
  • 62 Keegan M, Konig F, McClelland R. et al . Relation between humoral pathological changes in multiple sclerosis and response to therapeutic plasma exchange.  Lancet. 2005;  366 579-582
    CrossrefPubMedSearch in Google Scholar
  • 63 Prat A, Antel J. Pathogenesis of multiple sclerosis.  Curr Opin Neurol. 2005;  18 225-230
    PubMedSearch in Google Scholar
  • 64 Brück W, Stadelmann C. The spectrum of multiple sclerosis: new lessons from pathology.  Curr Opin Neurol. 2005;  18 221-224
    CrossrefPubMedSearch in Google Scholar
  • 65 Schauenstein K, Haas H S, Liebmann P M. Neuroimmunologie bei Autoimmunerkrankungen. In: Schulz K-H, Kugler J, Scvhedlowski M (Hrsg). Psychoneuroimmunologie. Bern: Hans Huber 1997: 307-313
    Search in Google Scholar
  • 66 Meichenbaum D. Intervention bei Stress. Anwendung und Wirkung des Stressimpfungstrainings. Bern: Huber 1991
    Search in Google Scholar

Dipl.-Psych. Annett Apel

Universität Rostock · Klinik und Poliklinik für Neurologie

Gehlsheimer Str. 20

18147 Rostock

Email: annett.apel@med.uni-rostock.de