Feel to Heal: Negative Emotion Differentiation Promotes Medication Adherence in Multiple Sclerosis

Multiple Sclerosis (MS) is a debilitating chronic autoimmune disease of the central nervous system that results in lower quality of life. Medication adherence is important for reducing relapse, disease progression, and MS-related symptoms, particularly during the early stages of MS. However, adherence may be impacted by negative emotional states. Therefore, it is important to identify protective factors. Past research suggests that the ability to discriminate between negative emotional states, also known as negative emotion differentiation (NED), may be protective against enactment of maladaptive risk-related behaviors. However, less is known as to how NED may promote adaptive health behaviors such as medication adherence. Utilizing weekly diaries, we investigated whether NED moderates the association between negative affect and medication adherence rates across 58 weeks among patients (n = 27) newly diagnosed with MS (following McDonald criteria). Results revealed that NED significantly moderated the relationship between negative affect and medication adherence. Specifically, greater negative affect was associated with lower adherence only for individuals reporting low NED. However, this link disappeared for those reporting moderate to high NED. Building upon past research, our findings suggest that NED may promote adaptive health behaviors and have important clinical implications for the treatment and management of chronic illness.

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What do we currently know about the clinically isolated syndrome suggestive of multiple sclerosis? An update

Reviews in the Neurosciences ◽

10.1515/revneuro-2019-0084 ◽

2020 ◽

Vol 31 (3) ◽

pp. 335-349

Author(s):

Tomasz Grzegorski ◽

Jacek Losy

Keyword(s):

Multiple Sclerosis ◽

Predictive Factors ◽

Clinically Isolated Syndrome ◽

Clinical Image ◽

Double Blind ◽

Beneficial Effects ◽

Mcdonald Criteria ◽

Clinical Episode ◽

The Central Nervous System ◽

Large Groups

AbstractMultiple sclerosis (MS) is a chronic, demyelinating, not fully understood disease of the central nervous system. The first demyelinating clinical episode is called clinically isolated syndrome (CIS) suggestive of MS. Although the most common manifestations of CIS are long tracts dysfunction and unilateral optic neuritis, it can also include isolated brainstem syndromes, cerebellar involvement, and polysymptomatic clinical image. Recently, the frequency of CIS diagnosis has decreased due to the more sensitive and less specific 2017 McDonald criteria compared with the revisions from 2010. Not all patients with CIS develop MS. The risk of conversion can be estimated based on many predictive factors including epidemiological, ethnical, clinical, biochemical, radiological, immunogenetic, and other markers. The management of CIS is nowadays widely discussed among clinicians and neuroscientists. To date, interferons, glatiramer acetate, teriflunomide, cladribine, and some other agents have been evaluated in randomized, placebo-controlled, double-blind studies relying on large groups of patients with the first demyelinating event. All of these drugs were shown to have beneficial effects in patients with CIS and might be used routinely in the future. The goal of this article is to explore the most relevant topics regarding CIS as well as to provide the most recent information in the field. The review presents CIS definition, classification, clinical image, predictive factors, and management. What is more, this is one of very few reviews summarizing the topic in the light of the 2017 McDonald criteria.

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Evaluation of Demographic, Clinical and Beyond Clinical Characteristics in Patients with Multiple Sclerosis in Rafsanjan City, Iran

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v2i2.61 ◽

2017 ◽

Vol 2 (2) ◽

pp. 63

Author(s):

Amir Moghaddamahmadi ◽

Pouria Yazdian-Anari ◽

Siamak Kazemisufi ◽

Alireza Vakilian ◽

Aliasghar Ranjbartotoei ◽

...

Keyword(s):

Multiple Sclerosis ◽

Clinical Characteristics ◽

Demographic Data ◽

Cross Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Mcdonald Criteria ◽

Male Female Ratio ◽

The Central Nervous System ◽

The Mean

Background and objectives: Multiple sclerosis is a chronic and progressive autoimmune disease of the central nervous system that causes motor and sensory impairment and physical disability in patients. This study was conducted to determine the demographic, clinical, and beyond clinical characteristics in patients with multiple sclerosis to help identify common disabilities and better understand of the specific needs of these ones.Materials and methods: This descriptive cross-sectional study was carried out on 50 MS patients in Rafsanjan, Iran. A definitive diagnosis has been done according to neurologist and McDonald criteria. The neurologist conducted examinations. The demographic data were recorded using questionnaire. MRI images were analyzed with the help of radiologist and all data were analyzed using SPSS software.Results: The mean age was 33.81±8.38 years and male/female ratio was 7/42. According to data, 66.7% of the patients were suffering from relapsing-remitting type (RR) disease, and most lesions on MRI in these patients were observed in pyramidal and JuxtaCortical areas. The mean EDSS scores of patients was 1.46. The duration of disease and the number of attacks had a significant correlation with educational level (P<0.05); age was significantly associated with pyramidal, mental and sphincter symptoms (P<0.05).Conclusion: These results suggest that the prevalence of MS in women is higher than in men, especially among housekeeper women. Relapsing and remitting disease showed higher frequency.

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COMBINATION OF MULTIPLE SCLEROSIS AND HEREDITARY OPTICAL LEBER’S NEUROPATHY. CLINICAL CASE

SCIENTIFIC MEDICAL BULLETIN OF UGRA ◽

10.25017/2306-1367-2021-30-4-50-54 ◽

2021 ◽

Vol 30 (4) ◽

pp. 50-54

Author(s):

Azalia Aisarovna Sokolova ◽

◽

Leonid Sergeevich Zemlyanushin ◽

Elvira Aysarovna Vashkulatova ◽

Sofia Mikhailovna Zemlyanushina

Keyword(s):

Multiple Sclerosis ◽

Central Nervous System ◽

Nervous System ◽

Genetic Testing ◽

Optic Nerve ◽

Clinical Case ◽

Demyelinating Disease ◽

Mcdonald Criteria ◽

The Central Nervous System ◽

Hereditary Optic Atrophy

The article discusses a clinical case of demyelinating disease of the central nervous system, multiple sclerosis in combination with Leber’s hereditary optic atrophy of the optic nerve (Harding syndrome). The debut of the disease at the age of 24 in the form of a simultaneous bilateral decrease in vision, with subsequent atrophy of the optic nerves in both eyes. The diagnosis of multiple sclerosis was confi rmed according to the 2017 McDonald criteria, the diagnosis of Leber’s disease was confi rmed by genetic testing. An important point in the diff erential diagnosis was the identifi cation of the G3460A mutation in the ND1 gene and intrathecal synthesis of oligoclonal immunoglobulin G.

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Negative Emotion Differentiation Attenuates the Within-Person Indirect Effect of Daily Stress on Nightly Sleep Quality Through Calmness

Frontiers in Psychology ◽

10.3389/fpsyg.2021.684117 ◽

2021 ◽

Vol 12 ◽

Author(s):

Tanja Lischetzke ◽

Lea Schemer ◽

Julia A. Glombiewski ◽

Tina In-Albon ◽

Julia Karbach ◽

...

Keyword(s):

Sleep Quality ◽

Indirect Effect ◽

Affect Regulation ◽

Protective Factor ◽

Stress Reactivity ◽

Negative Emotion ◽

Community Sample ◽

Emotional States ◽

Daily Stress ◽

Emotion Differentiation

The ability to differentiate between negative emotional states [negative emotion differentiation (NED)] has been conceptualized as a trait that facilitates effective emotion regulation and buffers stress reactivity. In the present research, we investigated the role of NED in within-person processes of daily affect regulation and coping during times of stress (the first COVID-19-related pandemic lockdown in April 2020). Using intensive longitudinal data, we analyzed whether daily stress had an indirect effect on sleep quality through calmness in the evening, and we tested whether NED moderated this within-person indirect effect by buffering the link between daily stress and calmness in the evening. A non-representative community sample (n = 313, 15–82 years old) participated in a 21-day ambulatory assessment with twice-daily surveys. The results of multilevel mediation models showed that higher daily stress was related to within-day change in calmness from morning to evening, resulting in less calmness in the evening within persons. Less calmness in the evening, in turn, was related to poorer nightly sleep quality within persons. As expected, higher NED predicted a less negative within-person link between daily stress and calmness in the evening, thereby attenuating the indirect effect of daily stress on nightly sleep quality through calmness. This effect held when we controlled for mean negative emotions and depression. The results provide support for a diathesis-stress model of NED, and hence, for NED as a protective factor that helps to explain why some individuals remain more resilient during times of stress than others.

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Pediatric Multiple Sclerosis: Current Concepts and Consensus Definitions

Autoimmune Diseases ◽

10.1155/2013/673947 ◽

2013 ◽

Vol 2013 ◽

pp. 1-12 ◽

Cited By ~ 10

Author(s):

Joaquin A. Pena ◽

Timothy E. Lotze

Keyword(s):

Multiple Sclerosis ◽

Clinical Symptoms ◽

Distinctive Features ◽

Pediatric Multiple Sclerosis ◽

Mcdonald Criteria ◽

Clinical Disorders ◽

Adults And Children ◽

The Central Nervous System ◽

Demyelinating Disorders ◽

Inflammatory Autoimmune Disease

Multiple sclerosis (MS), a chronic inflammatory autoimmune disease of the central nervous system (CNS) commonly diagnosed in adults, is being recognized increasingly in children. An estimated 1.7%–5.6% of all patients with MS have clinical symptoms before reaching the age of 18 years. In comparison with adults, the diagnosis of MS in children can be more difficult, being dismissed or misdiagnosed as other clinical disorders. Although adults and children share basic aspects of the disorder, children have distinctive clinical features, neuroimaging, laboratory, and courses of the disease. The 2010 McDonald criteria have simplified the requirements for establishing the diagnosis of MS and have been proposed to be applicable for the diagnosis of pediatric MS, mainly in children 12 years and older. This paper describes the distinctive features of common pediatric demyelinating disorders, including MS, and summarizes the most recent advances based on the available literature.

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Determinants of disability development in patients with multiple sclerosis

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x-anp-2020-0338 ◽

2021 ◽

Vol 79 (6) ◽

pp. 489-496

Author(s):

Fatma Kara ◽

Mehmet Fatih Göl ◽

Cavit Boz

Keyword(s):

Multiple Sclerosis ◽

Central Nervous System ◽

Age Of Onset ◽

Neurological Diseases ◽

First Episode ◽

Clinical Parameters ◽

Clinical Factors ◽

Mcdonald Criteria ◽

Kaplan Meier ◽

The Central Nervous System

Abstract Background: Multiple sclerosis (MS) is one of the most common chronic neurological diseases affecting the central nervous system in young adults. Objective: To investigate demographic and clinical factors that are effective in the development of irreversible disability from the onset of MS, and to identify factors that affect the transformation from the relapse-remitting MS (RRMS) phase to the progressive MS (PMS) phase. Methods: Retrospective study on 741 patients who were diagnosed with RRMS and PMS according to the McDonald criteria, and were enrolled into the Turkish MS database of the Department of Neurology MS Polyclinic, at the Faculty of Medicine, Karadeniz Technical University, in Trabzon, Turkey. Kaplan-Meier analysis was used to evaluate the time taken to reach EDSS 4 and EDSS 6 from the onset of disease, and the time taken between EDSS 4 and EDSS 6. Results: Age of onset >40 years; having polysymptomatic-type onset, pyramidal or bladder-intestinal system-related first episode; ≥7 episodes in the first 5 years; and <2 years between the first two episodes were found to be effective for MS patients to reach EDSS 4 and EDSS 6. The demographic and clinical parameters that were effective for progression from EDSS 4 to EDSS 6 were: pyramidal or bladder-intestinal system-related first episode; 4‒6 episodes in the first 5 years; >2 years until start of first treatment; and smoking. Conclusions: Our findings reveal important characteristics of MS patients in our region. However, the associations between these parameters and MS pathophysiology remain to be elucidated.

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Visual Field Changes in Multiple Sclerosis

QJM ◽

10.1093/qjmed/hcaa058.023 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

D E A Mansour ◽

A M E Abdelhamid ◽

S S M Fahmy

Keyword(s):

Multiple Sclerosis ◽

Visual Field ◽

Demyelinating Disease ◽

Visual Field Loss ◽

University Hospitals ◽

Mcdonald Criteria ◽

International Panel ◽

Relapsing Remitting ◽

The Central Nervous System ◽

Multiple Sclerosis Patients

Abstract Background multiple sclerosis (MS) is a demyelinating disease of the central nervous system and the leading cause of disability in young adults. Afferent pregeniculate visual pathways (retina, optic nerves, chiasm, and tracts) are preferential targets of inflammation, demyelination, and axonal degeneration. Aim of the Work in our study was to find and correlate visual field findings in multiple sclerosis patients with clinical data. Patients and Methods this study included 30 eyes of 17 patients previously diagnosed as multiple sclerosis according to the international panel on diagnosis of MS (McDonald criteria 2001) and its revision by Polman etal 2005. All our cases were from both sexes and of different age group ranging from 18 years old to 51 years old. there were subtypes of MS included in our study which were relapsing remitting (RR), and secondary progressive (SP). All cases were from Ain-shams university hospitals, outpatient clinics. Results this study was conducted in Ain-shams university hospitals out-patient clinics, it included 17 patients previously diagnosed as MS. The age in our study was ranging from 18 to 51 years old with mean age of 33.67± 9.37.Our cases were from both sex with prevelance of female patients. Conclusion these findings illustrate the role of perimetry in detecting both clinically overt & and clinically occult optic nerve involvement in patients with MS. It quantifies the depth of visual field loss, identifies atypical cases of optic neuritis, aids in counseling patients about prognosis.

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Clinical features of patients with multiple sclerosis from a survey in Shanghai, China

Multiple Sclerosis Journal ◽

10.1177/1352458507087844 ◽

2008 ◽

Vol 14 (5) ◽

pp. 671-678 ◽

Cited By ~ 20

Author(s):

Q Cheng ◽

L Miao ◽

J Zhang ◽

YT Guan ◽

ZG Liu ◽

...

Keyword(s):

Multiple Sclerosis ◽

Clinical Features ◽

Age At Onset ◽

Case Series ◽

Mcdonald Criteria ◽

Mild Disability ◽

History Of ◽

The Central Nervous System ◽

Demyelinating Disorders ◽

Almost All

Objective To describe clinical features of patients with multiple sclerosis (MS) in Shanghai, China. Methods Prevalent patients with MS were identified and investigated by a network of physicians in 11 districts of Shanghai during the period from 1 September 2004 to 31 August 2005. Admission registries of each hospital in the study area were checked systematically for patients with a diagnosis of MS, neuromyelitis optica or other demyelinating disorders. All patients with collected information were evaluated by four senior neurologists according to the McDonald criteria. Results There were 249 (146 female and 103 male) patients with a confirmed MS diagnosis, at a female-to-male ratio of 1.4. The mean age at onset of MS was 37.4 years for the 249 patients with MS and, on the prevalence day, 42.7 years. The most frequent location of clinical MS lesions in the central nervous system was the spinal cord (61%), followed by the cerebrum (55%) and optic nerves (41%). Nearly all (96%) of the patients with MS had been examined by magnetic resonance imaging, and 226 (94%) patients of those examined were suggestive of MS. No family history of MS was found in any of the patients. Most (86%) of the patients had no or mild disability on the prevalence day (31 December 2004). Almost all (96%) patients with MS had been treated with corticosteroids. Conclusion Clinical features of patients with MS are described based on the information from the largest case series reported among Chinese. Comparisons and discussions are made with findings from the other populations.

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Security motives and personal well-being during the early months of the COVID-19 pandemic

10.31234/osf.io/xwtmy ◽

2021 ◽

Author(s):

David L. Rodrigues ◽

Giulia Zoppolat ◽

Rhonda Nicole Balzarini ◽

Richard B. Slatcher

Keyword(s):

Social Support ◽

Negative Affect ◽

Health Behaviors ◽

Social Interactions ◽

Regulatory Focus ◽

Perceived Social Support ◽

Past Research ◽

Well Being ◽

Stressful Events ◽

Negative Consequences

Objective: Past research suggests that having a stronger ability to regulate feelings and behaviors can help individuals cope during stressful events, but little is known about why and when this might be the case. We examined if being more focused on prevention (i.e., health security motives) impacted personal well-being during the COVID-19 pandemic. We also examined possible underlying mechanisms for this effect, and whether perceived social support buffered it.Design: We conducted a pre-registered longitudinal study over one month (N = 1,269).Main outcome measures: Regulatory focus, worry for health (T1), adherence to preventive measures (T2, two weeks after T1), loneliness, negative and positive affect, frequency of social interactions, and perceived social support (T3, two weeks after T2).Results: Prevention scores (T1) increased the adherence to health behaviors (T2), which then predicted negative affect (T3). Exploratory results further showed that prevention scores predicted more loneliness and more negative affect (T3), but only for individuals with fewer social interactions and less perceived social support.Conclusions: Security motives in threatening times can be a double edge sword, with benefits for health behaviors and negative consequences for personal well-being. Having a strong social network during these times appears to alleviate these consequences.

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Application of digital health for improving medication adherence in MS patients

10.37766/inplasy2021.10.0058 ◽

2021 ◽

Author(s):

Farhad Mahmoudi ◽

◽

Mahtab Mokarram ◽

Sadegh Sabouhi ◽

Sara Hashemi ◽

...

Keyword(s):

Multiple Sclerosis ◽

Medication Adherence ◽

Digital Health ◽

Chronic Inflammatory Disease ◽

Focal Lesions ◽

Primary Demyelination ◽

Review Question ◽

The Central Nervous System ◽

Genetic And Environmental Factors ◽

Multiple Sclerosis Patients

Review question / Objective: The aim of this study is to evaluate the efficacy of digital health interventions in monitoring and improving medication adherence in Multiple Sclerosis patients. Condition being studied: Multiple sclerosis (MS) is the most prevalent chronic inflammatory disease of the central nervous system (CNS), which leads to focal lesions in the white matter, characterized by selective primary demyelination with partial preservation of axons and reactive astrocytic gliosis. The disease is thought to be due to a complex interaction between different genetic and environmental factors. The prevalence of MS is rising all over the world, due on one hand to earlier diagnosis and prolonged survival, and on the other to a true increase in incidence of the disease. The diagnosis of MS remains clinical despite recent advances in diagnostics and relies on demonstrating dissemination in space and time while excluding alternative diagnoses.

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