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C反应蛋白水平和钆增强病变与新诊断多发性硬化症的抑郁症状程度相关。

C-Reactive Protein Levels and Gadolinium-Enhancing Lesions Are Associated With the Degree of Depressive Symptoms in Newly Diagnosed Multiple Sclerosis.

作者信息

Yalachkov Yavor, Anschuetz Victoria, Jakob Jasmin, Schaller-Paule Martin A, Schaefer Jan Hendrik, Reilaender Annemarie, Friedauer Lucie, Behrens Marion, Foerch Christian

机构信息

Department of Neurology, University Hospital Frankfurt, Frankfurt, Germany.

Department of Neurology, Universitätsmedizin Mainz, Mainz, Germany.

出版信息

Front Neurol. 2021 Oct 26;12:719088. doi: 10.3389/fneur.2021.719088. eCollection 2021.

Abstract

Inflammation is essential for the pathogenesis of multiple sclerosis (MS). While the immune system contribution to the development of neurological symptoms has been intensively studied, inflammatory biomarkers for mental symptoms such as depression are poorly understood in the context of MS. Here, we test if depression correlates with peripheral and central inflammation markers in MS patients as soon as the diagnosis is established. Forty-four patients were newly diagnosed with relapsing-remitting MS, primary progressive MS or clinically isolated syndrome. Age, gender, EDSS, C-reactive protein (CRP), albumin, white blood cells count in cerebrospinal fluid (CSF WBC), presence of gadolinium enhanced lesions (GE) on T1-weighted images and total number of typical MS lesion locations were included in linear regression models to predict Beck Depression Inventory (BDI) score and the depression dimension of the Symptoms Checklist 90-Revised (SCL90RD). CRP elevation and GE predicted significantly BDI (CRP: = 0.007; GE: = 0.019) and SCL90RD (CRP: = 0.004; GE: = 0.049). The combination of both factors resulted in more pronounced depressive symptoms ( = 0.04). CSF WBC and EDSS as well as the other variables were not correlated with depressive symptoms. CRP elevation and GE are associated with depressive symptoms in newly diagnosed MS patients. These markers can be used to identify MS patients exhibiting a high risk for the development of depressive symptoms in early phases of the disease.

摘要

炎症在多发性硬化症(MS)的发病机制中至关重要。虽然免疫系统对神经症状发展的作用已得到深入研究,但在MS背景下,对于诸如抑郁症等精神症状的炎症生物标志物却知之甚少。在此,我们测试抑郁症是否在MS患者确诊后就与外周和中枢炎症标志物相关。44例患者新诊断为复发缓解型MS、原发进展型MS或临床孤立综合征。年龄、性别、扩展残疾状态量表(EDSS)、C反应蛋白(CRP)、白蛋白、脑脊液白细胞计数(CSF WBC)、T1加权图像上钆增强病灶(GE)的存在情况以及典型MS病灶位置的总数被纳入线性回归模型,以预测贝克抑郁量表(BDI)评分和症状自评量表90修订版(SCL90RD)的抑郁维度。CRP升高和GE显著预测了BDI(CRP: = 0.007;GE: = 0.019)和SCL90RD(CRP: = 0.004;GE: = 0.049)。这两个因素的组合导致更明显的抑郁症状( = 0.04)。CSF WBC和EDSS以及其他变量与抑郁症状无关。CRP升高和GE与新诊断的MS患者的抑郁症状相关。这些标志物可用于识别在疾病早期出现抑郁症状高风险的MS患者。

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