Women with MS and Depression, What The Brain Does

Women with MS and depression
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In the quest to better understand multiple sclerosis (MS), a research team has discovered something unusual about women with MS and depression. It seems changes occur in a certain area of the brain among women who have a particular type of depression.

Depression and related conditions such as anxiety and fatigue are all too common among people who live with MS, so efforts to better understand these problems will hopefully result in improved ways to manage and even prevent them. Nancy Sicotte, MD, a neurologist at Cedars-Sinai Medical Center and an expert in imaging techniques and MS, headed a team that found brain changes in women with MS that may eventually help with treatment options.

They discovered that women who had a common type of depression called depressive affect, which is characterized by a loss of interest in life and depressed mood, showed a reduction in the size of the right hippocampus on magnetic resonance imaging (MRI) scans. The left side of the hippocampus did not change.

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The hippocampus is a seahorse-shaped area that lies deep in the brain in the medial temporal lobe. It lies on both the left and right side of the brain and is responsible for the development of long-term memories and spatial navigation.

You may have heard about the hippocampus before in reference to Alzheimer’s disease, since this brain region is one of the first that is damaged in that disease. The hippocampus also can be damaged from oxygen deprivation, epilepsy, or an infection.

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According to the authors, other types of depression are not accompanied by a reduction in the size of the hippocampus. No brain changes in size are seen in vegetative depression, for example, which is characterized by extreme fatigue.

The authors used a special type of MRI technique called automated surface mesh modeling, which allows the users to identify formerly undetectable changes in the thickness in subregions of the hippocampus.

Why this research is important
Sicotte explained that while depression and fatigue often go hand-in-hand in people who have MS, their underlying causes may be different. Studies such as this one “are designed to help us better understand how MS-related depression differs from other types,” which will hopefully lead to improved and individualized ways to treat MS patients.

Managing depression in MS: new study
The results of a systematic review appearing in BMC Neurology reveal that mindfulness based interventions are helpful in reducing stress and preventing depression relapse in people with MS. Mindfulness based interventions are practices that allow people to increase their awareness and attention to the present, or “being in the moment.”

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The reviewers evaluated three studies that involved 183 participants most of whom (146) were female. In all three studies, use of mindfulness based interventions resulted in an improvement in quality of life, depression, anxiety, fatigue, pain, and psychological factors, and some improvements were significant and still apparent at 3 and 6 months of follow-up.

Depression is a concern among people who have MS because it can have a big impact on their quality of life. The new study of depression in women with MS may provide some insight into how to better manage this life-altering symptom.

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References
Medical News Today
Simpson R et al. Mindfulness based interventions in multiple sclerosis—a systematic review. BMC Neurology 2014 Jan 17; 14(1): 15

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