Endocrine and immune substrates of depressive symptoms and fatigue in multiple sclerosis patients with comorbid major depression

Stefan M Gold (1) , Schulamith Krueger (1) , Kristin J Ziegler (1) , Thorsten Krieger (1) , Karl-Heinz Schulz (1) , Christian Otte (1) , Christoph Heesen (1)

1 University Hospital Eppendorf

Objective: Depression and fatigue are among the most common symptoms of multiple sclerosis (MS). These symptoms frequently co-occur and partially overlap in MS but their underlying biological substrates are unclear. In this study, we examined the relative role of cytokines and hypothalamic-pituitary-adrenal (HPA) axis activity for depression and fatigue in patients with relapsing-remitting MS (RRMS). Methods: HPA axis function and frequency of stimulated cytokine (IFN γ and TNF α) producing T cells was measured cross-sectionally in 44 female patients with RRMS. All subjects completed a neurological exam, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and self-report questionnaires. Results: Ten patients met diagnostic criteria for MDD. MS patients with comorbid MDD showed normal morning but elevated evening salivary cortisol levels resulting in a flattened slope. While higher frequency of cytokine producing CD8+ T cells was also seen in MS patients with MDD, these markers were more closely associated with fatigue than depression. Conclusions: This study supports a role of HPA axis hyperactivity for major depression in MS. In addition, inflammatory and neuroendocrine factors may differentially mediate fatigue and depressive symptoms.

Mots clés: DEPRESSION; MULTIPLE SCLEROSIS; NEUROENDOCRINOLOGY; NEUROIMMUNOLOGY; PSYCHIATRY

Stefan M Gold, Schulamith Krueger, Kristin J Ziegler, Thorsten Krieger, Karl-Heinz Schulz, et al.. Endocrine and immune substrates of depressive symptoms and fatigue in multiple sclerosis patients with comorbid major depression. Journal of Neurology, Neurosurgery and Psychiatry, 2011, 82 (7), pp.814. ⟨10.1136/jnnp.2010.230029⟩. ⟨hal-00613259⟩