Download PDF
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)
Further Information

Publication History

Publication Date:
02 January 2006 (online)

Also available at
    Permissions and Reprints

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
    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
    Google Scholar
  • 3 Sadovnik A D, Remick R A, Allen J. et al . Depression and multiple sclerosis.  Neurology. 1996;  46 628-632
    CrossrefPubMedGoogle Scholar
  • 4 Feinstein A. The neuropsychiatry of multiple sclerosis.  Can J Psychiatry. 2004;  49 157-63
    PubMedGoogle 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
    PubMedGoogle 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
    CrossrefPubMedGoogle 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
    CrossrefPubMedGoogle 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
    PubMedGoogle 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
    CrossrefPubMedGoogle 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
    Google Scholar
  • 11 Nisipeanu P, Korczyn A D. Psychological stress as risk factor for exacerbations in multiple sclerosis.  Neurology. 1993;  43 1311-1312
    PubMedGoogle 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
    PubMedGoogle 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
    CrossrefPubMedGoogle 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
    PubMedGoogle 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
    PubMedGoogle Scholar
  • 16 Morrison W, Nelson J. Environmental triggers in multiple sclerosis. Fact or fallacy?.  Axone. 1994;  16 23-26
    PubMedGoogle 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
    PubMedGoogle 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
    PubMedGoogle 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
    CrossrefPubMedGoogle 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
    CrossrefPubMedGoogle 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
    CrossrefPubMedGoogle Scholar
  • 22 Filippini G, Munari L, Incorvaia B. et al . Interferons in relapsing remitting multiple sclerosis.  Lancet. 2003;  361 545-552
    CrossrefPubMedGoogle Scholar
  • 23 MS-Therapie Konsensus Gruppe (MSTKG) . Immunmodulatorische Stufentherapie der multiplen Sklerose.  Nervenarzt. 1999;  70 371-386
    CrossrefPubMedGoogle Scholar
  • 24 Rieckmann R, Toyka K V. MSTCG . Escalating immunotherapy of multiple sclerosis.  J Neurol. 2004;  251 1329-1339
    CrossrefPubMedGoogle 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
    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
    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
    CrossrefPubMedGoogle Scholar
  • 27 Baggiolini M. Chemokines and leukocyte traffic.  Nature. 1998;  392 565-568
    CrossrefPubMedGoogle Scholar
  • 28 Ransohoff R M. Mechanisms of inflammation in MS tissue: adhesion molecules and chemokines.  J Neuroimmunol. 1999;  98 57-68
    CrossrefPubMedGoogle Scholar
  • 29 Wiendl H, Hohlfeld R. Therapeutic approaches in multiple sclerosis: lessons from failed and interrupted treatment trials.  BioDrugs. 2002;  16 183-200
    PubMedGoogle Scholar
  • 30 Lucchinetti C F, Brück W, Lassmann H. Evidence for pathogenic heterogeneity in multiple sclerosis.  Ann Neurol. 2004;  56 308
    CrossrefPubMedGoogle Scholar
  • 31 Lucchinetti C F, Parisi J, Brück W. The pathology of multiple sclerosis.  Neurol Clin. 2005;  23 77-105
    CrossrefPubMedGoogle Scholar
  • 32 Noseworthy J H, Lucchinetti C, Rodriguez M. et al . Multiple sclerosis.  N Engl J Med. 2000;  343 938-952
    CrossrefPubMedGoogle Scholar
  • 33 Kieseier B C, Hartung H P. Multiple paradigm shifts in multiple sclerosis.  Curr Opin Neurol. 2003;  16 247-252
    CrossrefPubMedGoogle 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
    CrossrefPubMedGoogle 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
    CrossrefPubMedGoogle 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
    PubMedGoogle Scholar
  • 37 Charcot J M. Lectures on the disease of the nervous system. London: New Sydenham Society 1879
    Google Scholar
  • 38 Klausner I. Ein Beitrag zur Aetiologie der multiplen Sklerose.  Arch Psychiatr Nervenk. 1901;  34 841-868
    PubMedGoogle 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
    PubMedGoogle Scholar
  • 40 McAlpine D, Compston N. Some aspects of the natural history of disseminated sclerosis.  Q J Med. 1952;  21 135-167
    PubMedGoogle 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
    PubMedGoogle Scholar
  • 42 Alter M, Speer J. Clinical evaluation of possible etiologic factors in multiple sclerosis.  Neurology. 1968;  18 109-115
    PubMedGoogle 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
    PubMedGoogle 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
    PubMedGoogle 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
    PubMedGoogle 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
    PubMedGoogle 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
    CrossrefPubMedGoogle Scholar
  • 48 Seyle H. The stress of life. New York: McGraw-Hill 1956
    Google Scholar
  • 49 Lazarus R S. Psychological stress and the coping process. New York: McGraw-Hill 1966
    Google Scholar
  • 50 Lazarus R S, Folkman S. Stress, appraisal and coping. New York: Springer 1996
    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
    CrossrefPubMedGoogle Scholar
  • 52 Hobfoll S E. The ecology of stress. Washington, DC: Hemisphere 1988
    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
    CrossrefPubMedGoogle 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
    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
    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
    Google Scholar
  • 57 Ader R, Cohen N. Behaviorally conditioned immunosuppression.  Psychosomatic Medicine. 1975;  37 333-340
    PubMedGoogle 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
    PubMedGoogle Scholar
  • 59 Buske-Kirschbaum A, Geiben A, Hellhammer D. Psychobiological aspects of atopic dermatitis: An overview.  Psychother Psychosom. 2001;  70 6-16
    PubMedGoogle 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
    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
    CrossrefPubMedGoogle 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
    CrossrefPubMedGoogle Scholar
  • 63 Prat A, Antel J. Pathogenesis of multiple sclerosis.  Curr Opin Neurol. 2005;  18 225-230
    PubMedGoogle Scholar
  • 64 Brück W, Stadelmann C. The spectrum of multiple sclerosis: new lessons from pathology.  Curr Opin Neurol. 2005;  18 221-224
    CrossrefPubMedGoogle 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
    Google Scholar
  • 66 Meichenbaum D. Intervention bei Stress. Anwendung und Wirkung des Stressimpfungstrainings. Bern: Huber 1991
    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