The neuropsychiatry of multiple sclerosis: a review of recent developments

Author(s): Ghaffar O, Feinstein A


Purpose of review:The aim of this review is to summarize the current literature on the neuropsychiatry of multiple sclerosis (MS).

Recent findings:Data from community samples have supported earlier findings from tertiary referral centres of high rates of depression in MS patients. Neuroimaging offers important clues as to the pathogenesis of depression, but psychosocial factors cannot be ignored and emerge as equally important predictors. Cognitive-behavioural therapy is an effective treatment, rivalling standard dosing of sertraline in patients with depression. An allied disorder--pseudobulbar affect--occurs in up to 10% of MS patients and responds well to a combination of dextromethorphan and quinidine. Cognitive dysfunction affects approximately 40% of MS patients. Markers of cerebral atrophy have emerged as more important correlates of impaired cognition than lesion volume. Moreover, functional MRI studies have demonstrated the brain's ability to compensate, in part, for damage. Should the disease burden be too severe, however, compensatory mechanisms fail and cognitive deficits increase accordingly.

Summary:Neuropsychiatric abnormalities are common in MS patients. No aspect of mentation is spared. Advances in neuroimaging are increasing our understanding of the pathogenesis of these disorders. Translating these findings into improved methods of treatment for patients presents researchers with pressing challenges.

Similar Articles

An exploration of anger phenomenology in multiple sclerosis

Author(s): Nocentini U, Tedeschi G, Migliaccio R, Dinacci D, Lavorgna L, et al.

Depression associated with multiple sclerosis

Author(s): Feinstein A, Feinstein K

Triggering of acute myocardial infarction onset by episodes of anger

Author(s): Mittleman MA, Maclure M, Sherwood JB, Mulry RP, Tofler GH, et al.

Styles of emotion regulation and their associations with perceived health in patients with rheumatoid arthritis

Author(s): van Middendorp H, Geenen R, Sorbi MJ, Hox JJ, Vingerhoets AJ, et al.

Emotion regulation abilities and the quality of social interaction

Author(s): Lopes PN, Salovey P, Coté S, Beers M

The role of angry rumination and distraction in blood pressure recovery from emotional arousal

Author(s): Gerin W, Davidson KW, Christenfeld NJ, Goyal T, Schwartz JE

Effects of anger and anger regulation styles on pain in daily life of women with fibromyalgia: a diary study

Author(s): van Middendorp H, Lumley MA, Moerbeek M, Jacobs JW, Bijlsma JW, et al.

Perceived behavioral changes in early multiple sclerosis

Author(s): Lima FS, Simioni S, Bruggimann L, Ruffieux C, Dudler J, et al.

Multiple sclerosis and depression

Author(s): Feinstein A

Depression in multiple sclerosis: a review

Author(s): Siegert RJ, Abernethy DA

Depression in multiple sclerosis

Author(s): Minden SL, Orav J, Reich P

The role of anger in generalized anxiety disorder

Author(s): Deschênes SS, Dugas MJ, Fracalanza K, Koerner N

Age, anger regulation and well-being

Author(s): Phillips LH, Henry JD, Hosie JA, Milne AB

Specific impairments of emotion perception in multiple sclerosis

Author(s): Phillips LH, Henry JD, Scott C, Summers F, Whyte M, et al.

Attentional lapses, emotional regulation and quality of life in multiple sclerosis

Author(s): Phillips LH, Saldias A, McCarrey A, Henry JD, Scott C, et al.