Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress
Abstract Objectives Psychological stress has been suggested as a contributory factor in the onset and progression of multiple sclerosis (MS). The 7 October 2023 terrorist attacks in Israel caused significant psychological stress, providing a unique context to study its impact on MS activity. This st...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.52241 |
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| author | Omri Zveik Tal Friedman‐Korn Ariel Rechtman Tal Ganz Garrick Hoichman Lyne Shweiki Dana Ekstein Adi Vaknin‐Dembinsky |
| author_facet | Omri Zveik Tal Friedman‐Korn Ariel Rechtman Tal Ganz Garrick Hoichman Lyne Shweiki Dana Ekstein Adi Vaknin‐Dembinsky |
| author_sort | Omri Zveik |
| collection | DOAJ |
| description | Abstract Objectives Psychological stress has been suggested as a contributory factor in the onset and progression of multiple sclerosis (MS). The 7 October 2023 terrorist attacks in Israel caused significant psychological stress, providing a unique context to study its impact on MS activity. This study aims to assess the impact of war‐related psychological stress on MS activity using magnetic resonance imaging (MRI) scans and clinical follow‐up. Methods This observational retrospective case–control study includes 93 patients with MS (pwMS) who had routine annual MRI scans from three periods (7 October 2021 to 7 January 2022; 7 October 2022 to 7 January 2023; and 7 October 2023 to 7 January 2024). Data were collected from medical records and MRI scans at Hadassah Medical Center. MRI scans were classified as active if new or enlarging T2 lesions and/or enhancing T1 lesions were present. Results MRI activity significantly increased among pwMS during the first 3 months of the war compared to the corresponding period in the preceding year (11/93 vs. 23/93, P = 0.0139), with an OR of 4.0 (95% confidence interval: 1.29–16.442). pwMS with an EDSS score ≥4 showed a significant increase in MRI activity (P = 0.045), whereas no significant increase was observed in patients with an EDSS score ≤3.5 (P = 0.23). Additionally, MRI activity increased later during the war compared to the previous year (P < 0.0001). Interpretation This study provides evidence of increased MRI‐detected disease activity in pwMS during periods of war‐related psychological stress. Our findings highlight the importance of considering psychological stress in MS management. Healthcare providers should be aware of the potential for increased disease activity in pwMS during extreme stress and may consider more frequent monitoring, including MRI scans, or treatment adjustments during such periods. |
| format | Article |
| id | doaj-art-ba647aff98b54fdb980e7ea0cf3aefdf |
| institution | Kabale University |
| issn | 2328-9503 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj-art-ba647aff98b54fdb980e7ea0cf3aefdf2025-01-21T05:41:42ZengWileyAnnals of Clinical and Translational Neurology2328-95032025-01-01121172510.1002/acn3.52241Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stressOmri Zveik0Tal Friedman‐Korn1Ariel Rechtman2Tal Ganz3Garrick Hoichman4Lyne Shweiki5Dana Ekstein6Adi Vaknin‐Dembinsky7Faculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelFaculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelFaculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelFaculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelFaculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelFaculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelFaculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelFaculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelAbstract Objectives Psychological stress has been suggested as a contributory factor in the onset and progression of multiple sclerosis (MS). The 7 October 2023 terrorist attacks in Israel caused significant psychological stress, providing a unique context to study its impact on MS activity. This study aims to assess the impact of war‐related psychological stress on MS activity using magnetic resonance imaging (MRI) scans and clinical follow‐up. Methods This observational retrospective case–control study includes 93 patients with MS (pwMS) who had routine annual MRI scans from three periods (7 October 2021 to 7 January 2022; 7 October 2022 to 7 January 2023; and 7 October 2023 to 7 January 2024). Data were collected from medical records and MRI scans at Hadassah Medical Center. MRI scans were classified as active if new or enlarging T2 lesions and/or enhancing T1 lesions were present. Results MRI activity significantly increased among pwMS during the first 3 months of the war compared to the corresponding period in the preceding year (11/93 vs. 23/93, P = 0.0139), with an OR of 4.0 (95% confidence interval: 1.29–16.442). pwMS with an EDSS score ≥4 showed a significant increase in MRI activity (P = 0.045), whereas no significant increase was observed in patients with an EDSS score ≤3.5 (P = 0.23). Additionally, MRI activity increased later during the war compared to the previous year (P < 0.0001). Interpretation This study provides evidence of increased MRI‐detected disease activity in pwMS during periods of war‐related psychological stress. Our findings highlight the importance of considering psychological stress in MS management. Healthcare providers should be aware of the potential for increased disease activity in pwMS during extreme stress and may consider more frequent monitoring, including MRI scans, or treatment adjustments during such periods.https://doi.org/10.1002/acn3.52241 |
| spellingShingle | Omri Zveik Tal Friedman‐Korn Ariel Rechtman Tal Ganz Garrick Hoichman Lyne Shweiki Dana Ekstein Adi Vaknin‐Dembinsky Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress Annals of Clinical and Translational Neurology |
| title | Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress |
| title_full | Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress |
| title_fullStr | Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress |
| title_full_unstemmed | Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress |
| title_short | Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress |
| title_sort | subclinical imaging activity in multiple sclerosis patients during war related psychological stress |
| url | https://doi.org/10.1002/acn3.52241 |
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