title: Altered cytokine responses to cognitive stress in multiple sclerosis patients with fatigue.
abstract: This study intended to examine if the immune response to a cognitive task as a variant of psychological stress in MS patients is distinct from healthy controls. The experiment was part of a larger study on mechanisms and measurements of MS fatigue. Patients (n =23) and controls (n =25) participated in a cognitive task lasting 40 minutes, in which the heart rate was continuously monitored. Blood samples were taken at baseline and directly after the stress-inducing task Whole blood stimulated cytokine production representative of the TH-1 (i.e. IFNgamma, TNFalpha) and TH-2 paradigm (i.e. IL-10) was evaluated in relation to disability, fatigue, cognitive deficit, and anxiety. Patients scored high on a disease specific fatigue score compared to controls, whereas baseline cytokine patterns did not differ between the groups. MS patients displayed a blunted response of IFNgamma (P =0.03) whereas TNFalpha and IL-10 responses did not change. Additionally MS patients showed a significantly lower heart rate increase after the task (P <0.001). Cognitive impairment was associated with a decreased heart rate reactivity (P =0.02) while depressive symptoms correlated with stronger IL-10 responses (P =0.05). Overall, cognitive stress induces IFNgamma production in healthy controls but not in MS patients with fatigue. Furthermore, a reduced cardiac response might indicate an autonomic dysfunction in this group of patients.
authors.affiliation: Department of Neurology, University Hospital Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany. heesen@uke.uni-hamburg.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Heesen
authors.forename: Gabriele
authors.initials: G
authors.lastname: Koehler
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Gross
authors.forename: Wiebke
authors.initials: W
authors.lastname: Tessmer
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Schulz
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Gold
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000276:immunology / Q000523:psychology; D016207:Cytokines / Q000097:blood*; D003863:Depression / Q000276:immunology / Q000523:psychology; D005221:Fatigue / Q000276:immunology* / Q000523:psychology; D005260:Female; D006339:Heart Rate; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D008297:Male; D020528:Multiple Sclerosis, Chronic Progressive / Q000276:immunology* / Q000523:psychology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000276:immunology* / Q000523:psychology; D009483:Neuropsychological Tests; D013315:Stress, Psychological / Q000276:immunology* / Q000523:psychology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma