The influence of immunomodulation on psycho-neuroimmunological functions in benign multiple sclerosis.
OBJECTIVE
In multiple sclerosis (MS), several neuroimmunomodulatory effectors are known, including melatonin. They are able to influence disease-related neurophysiogical changes (disability or impaired vision) as well as neuropsychological performance (e.g. cognition and depression). In this study we assessed the relationship between immunomodulation on psycho-neuroimmunological functions in benign multiple sclerosis.


METHODS
We evaluated 26 young female patients with benign MS treated with/without immunomodulating therapies with regard to their physical disabilities (Expanded Disability Status Scale, EDSS), their visually evoked potentials (VEP), their plasma melatonin concentrations as well as their performance regarding emotional and cognitive tests and compared them with healthy matched controls.


RESULTS
Patients with MS showed deficits in cognitive and emotional functions compared to healthy controls, which were in accordance with their increase in EDSS over time. However, in contrast to untreated patients, patients receiving immunotherapy showed significantly increased dysfunction with respect to actual mood (p = 0.02) and a tendency to increased depression scores (p = 0.072). However, neither treatment subgroup had cognitive deficits. In untreated patients, melatonin levels correlated with reduced scores in the cognitive tests (p = 0.045) but not with depression or VEP latencies. Patients with long-standing MS (>10 years) showed a significant correlation (p = 0.01) to their increased depression scores and their melatonin levels, but no correlation with VEP or cognitive dysfunction, compared to patients with shorter disease duration (< or =10 years).


CONCLUSIONS
These results indicate that in MS all aspects of the psycho-neuroimmunological network can be affected. Despite the potential influence of immunomodulation on depression, no connection with melatonin representing the retinohypothalamic tract/pineal gland circuits could be detected. However, visual perception as well as visuoconstructive abilities were affected in MS patients. Neuropsychological tests in MS should concentrate on cognitive variables, which reflect the clinical status more accurately and may be used to monitor disease-modifying therapies.
Department of Neurology, University Hospital Essen, Essen, Germany.
Claus G
CG
Haase
Michael
M
Tinnefeld
Pedro M
PM
Faustmann
D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D003866:Depressive Disorder / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D004185:Disability Evaluation; D005074:Evoked Potentials, Visual / Q000187:drug effects / Q000276:immunology; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D008550:Melatonin / Q000097:blood / Q000378:metabolism; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000276:immunology* / Q000523:psychology*; D015213:Neuroimmunomodulation / Q000187:drug effects / Q000276:immunology*; D009483:Neuropsychological Tests / Q000592:standards; D010468:Perceptual Disorders / Q000276:immunology / Q000503:physiopathology; D010870:Pineal Gland / Q000276:immunology / Q000503:physiopathology; D011930:Reaction Time / Q000187:drug effects / Q000276:immunology; D014795:Visual Pathways / Q000276:immunology / Q000503:physiopathology
D007155:Immunologic Factors; D008550:Melatonin