title: Depression-like changes of the sleep-EEG during high dose corticosteroid treatment in patients with multiple sclerosis.
abstract: Acute exacerbations of multiple sclerosis (MS) are commonly treated with high doses of corticosteroids that can influence sleep regulation and hypothalamo-pituitary-adrenal (HPA) activity. We examined the sleep-EEG (including conventional and spectral EEG analysis) in 9 female patients with relapsing-remitting MS (and no psychiatric disorder) just prior to and on days 2 and 10 of high dose corticosteroid treatment (500 mg/day methylprednisolone given IV for 5 days, then PO taper down) and age-matched healthy female controls. Before treatment with corticosteroids, MS patients compared to controls showed few changes of the sleep EEG, namely a significant increase in slow wave sleep (SWS) and a decrease in stage 2 sleep. In contrast, on day 10, but not day 2 of treatment, MS patients showed a number of sleep-EEG changes typically observed in patients with depression, including a reduction in REM latency, an increase in REM density, a decrease in the SWS and delta sleep ratio and a decrease in sigma EEG activity. However, no concomitant effect of treatment on mood was noted. In summary, unlike acute treatment with methylprednisolone, prolonged treatment induces several changes of the sleep-EEG in MS patients, that are also observed in patients with an acute depressive episode. Further prospective studies with longer-term follow-up are needed to examine the clinical relevance of our preliminary data.
authors.affiliation: Max Planck Institute of Psychiatry, Department of Psychiatry, Munich, Germany.
authors.forename: Irina A
authors.initials: IA
authors.lastname: Antonijevic
authors.forename: Axel
authors.initials: A
authors.lastname: Steiger
mesh_terms: D000328:Adult; D003863:Depression / Q000139:chemically induced / Q000503:physiopathology; D004569:Electroencephalography / Q000187:drug effects*; D004679:Encephalomyelitis / Q000503:physiopathology; D005260:Female; D006801:Humans; D008775:Methylprednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000503:physiopathology*; D017286:Polysomnography / Q000187:drug effects; D012893:Sleep Wake Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D012895:Sleep, REM / Q000187:drug effects; D013997:Time Factors
chemical_list: D008775:Methylprednisolone