Psychological stress and multiple sclerosis

This article gives an overview of research on the correlation between the course of multiple sclerosis (MS) disease and stress. It also discusses the most frequently verified hypotheses and methodological difficulties that researchers must face. Results presented here indicate that the relationship between MS and stress is very complex and is dependent on a variety of biological and psychological factors. Importance of the following aspects is considered: the prevalence and intensity of stressful events, strategies to cope with stress, personality, viral infections, cardiovascular and immunological systems activity and neurodegenerative processes. The reciprocal relation between stress and MS is also analyzed. Recent hypotheses focus on the impact of stress on changes in endocrine and immunological systems and their role in the dynamics of the disease. The foundations of such reasoning are the results of studies on the effects of stress on the immune system via the hypothalamic-pituitary-adrenal axis (HPA) and autonomic nervous system. Although there are a number of hypotheses about the activity of the HPA in the course of MS, we still do not know whether it is conducive to progression of the disease or it is the consequence of neurodegenerative processes. All the knowledge gathered so far gives no grounds for an unequivocal conclusion on how stress influences the biological response and the worsening of the disease associated with it. In spite of their ambiguity, the results of previous studies encourage specific therapeutic interventions, examples of which the reader will find in this article.