Depression, cognitive impairment often complicate MS

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Depression, cognitive impairment often complicate MS

Postby MSUK » Wed Sep 07, 2011 3:02 am

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Patients with multiple sclerosis often also manifest major depression or cognitive impairments, but these associated conditions frequently go undiagnosed or untreated, experts said at the annual congress of the European College of Neuropsychopharmacology.

"The data are strong now that depression is common" in patients with multiple sclerosis (MS), with a lifetime prevalence in MS patients of about 50%, said Dr. Anthony Feinstein, professor of psychiatry at the University of Toronto. "There must be something particular about MS that predisposes patients to depression.

"You know that [many MS] patients are going to have major behavioral disturbances. The MS rating scales do not take this into account. They are very oriented to motor symptoms, and ignore to a large degree cognitive and behavioral disturbances," he said in an interview. "The behavioral disturbances can be profound."... Read More - http://www.msrc.co.uk/index.cfm/fuseact ... ageid/2304
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Re: Depression, cognitive impairment often complicate MS

Postby ThisIsMA » Sun Jun 08, 2014 9:15 am

Wasn't sure where else to post this. Here is a fascinating research article that hints at the fact that depression may be part of the disease process, may make MS disease progression, lesions, etc. worse, and that treating the depression with SSRI's may also treat the MS because Cytokines increase inflammation, and SSRI's reduce Cytokines:

Neuropsychiatric manifestations of depression in multiple sclerosis: neuroinflammatory, neuroendocrine, and neurotrophic mechanisms in the pathogenesis of immune-mediated depression

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181849/

That is the first plausible explanation I've seen of why a small study showed that people who took Prozac had fewer new lesions.

Multiple Sclerosis Activity May Be Affected By Prozac

http://www.medicalnewstoday.com/articles/106150.php
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Re: Depression, cognitive impairment often complicate MS

Postby jimmylegs » Sun Jun 08, 2014 10:00 am

interestingly, magnesium deficiency can be used as a model for depression to test the efficacy of pharma and herbal antidepressant therapies:

Magnesium-deficient diet alters depression- and anxiety-related behavior in mice—influence of desipramine and Hypericum perforatum extract
http://www.sciencedirect.com/science/ar ... 0804002588

a nutrient that is typically suboptimal (low normal) in chronic disease (including ms), as well as those with anxiety and depression.

Assessment of serum magnesium, copper, and zinc levels in multiple sclerosis (MS) patients
http://ijpbs.mazums.ac.ir/browse.php?a_ ... lc_lang=fa
"serum magnesium level differences according to sex in MS patients referred to neurology clinics of Kashan 2004-2005
MS Patient......1.87 ± 0.37
Healthy..........2.22 ± 0.24"

note that 1) even the healthy group aren't really getting to optimal and 2) a MAJOR failing of this study is the failure to give units for the serum measures... obviously these are mg/dL results, but still.

Magnesium and depression: a systematic review
http://www.maneyonline.com/doi/abs/10.1 ... 0000000044
"A higher intake of dietary magnesium seems to be associated with lower depression symptoms though reverse causality cannot be excluded."

yes, and scurvy might be causing the vit C deficiency, rickets might be causing the vit D deficiency, etc :S
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Re: Depression, cognitive impairment often complicate MS

Postby ThisIsMA » Sun Jun 08, 2014 11:42 am

Hi Jimmylegs,

Wow, that's an interesting article you sent. Both for the information on magnesium, but also for how twisted or to put it neutrally "different" the Pharm industry thinking is!!! Instead of saying HEY, this magnesium stuff works, and maybe a magnesium deficiency is the reason why people get depressed, they say, "hey, look, we can make these mice depressed by depriving them of magnesium, and then find new expensive drugs (probably with side affects) to treat them so that they seem o.k. even though their real problem is that they still have a magnesium deficiency!"

Separate from that, I really need to start taking a magnesium supplement!!! I've been getting about 5 or six cups of green veggies/half a beet/half a carrot/ and some colorful fruit every day as two vitamix smoothies for close to a month now. Its clearly helping to reduce my fatigue and cog fog, but unfortunately its not helping to reduce my poor memory/word finding, feeling dumb issues, at least not yet. But hey, its an absolute miracle that I feel less fatigue! So I ain't complaining.

And to get back to magnesium, I haven't been doing as well about adding healthy meats to my diet. I basically don't cook meat, I buy it in restaurants from time to time, and have been buying from two local restaurants that sell organic poultry and wild caught sea food. That's expensive so I don't do it as often as I should, which means I'm eating less meat than I'd like to.

Can you explain to me if I can overdose on magnesium and about how much I should supplement a day? Or can I get enough from the raw veggies I'm now eating in my smoothies (Kale, Purple Cabbage, Bok Choi, Carrots, Red Beets)?

Also, I wish I knew how often to drink the beet juice. Since beets increase brain perfusion (which is something I definitely need as per my MRI results) I'm wondering if what I'm actually doing is causing twice a day reperfusion injuries (Cheer had a link to an article about reperfusion injuries, which are not a good thing). Maybe I should be sipping beet juice all day long? But if I do that, what's the chance that the beet juice is rapidly becoming oxidized as its sitting there in the glass, and then causing me more harm that good! I also wish I knew how long my smoothies stay good in the fridge. I definitely feel like my own guinea pig sometimes! :-D

And to get back to depression, I wonder if anyone has looked to see if magnesium deficiency increases the production of Cytokines? ... OMG, look at this:

Pathobiology of magnesium deficiency: a cytokine/neurogenic inflammation hypothesis.

http://www.ncbi.nlm.nih.gov/pubmed/1384353

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Re: Depression, cognitive impairment often complicate MS

Postby jimmylegs » Sun Jun 08, 2014 1:38 pm

lol 'creative problem solving with a pecuniary twist?'

if you want to get your mag from greens, spinach and chard are the way to go. adding 3c of cooked spinach and green swiss chard (white stems) to the daily smoothie recipe would get you there. you cook it to increase the nutrient density and to reduce the oxalic acid content associated with such high greens intake. other than that, consider picking up a magnesium glycinate supplement. i've had them in either 100mg or 180mg powder capsules. if you get total 400mg per day of elemental mag from supplements and diet when you feel good, that should be enough. 600mg per day when you don't feel so great.

re meat, have i already asked if you would consider eating oysters? before they succumb to ocean acidification that is?? :S they're good for zinc, iron, copper, b12, selenium, all good stuff :)

i'm no sort of pro on beet juice, i'm afraid!

also, nice find re the mag deficiency study :)
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Re: Depression, cognitive impairment often complicate MS

Postby cheerleader » Sun Jun 08, 2014 3:26 pm

Depression and MS are linked by atrophy of the hippocampus. "Something particular to MS that links pwMS and depression??" Well, researchers--why not look at brain changes on MRI?
The Role of Hippocampal Atrophy in Depression
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2577751/

Researchers at UCLA were looking at this particular region of the brain in people with MS back in 2010. Here's a blog post I wrote about the research.

There's an article and podcast in Scientific American this week regarding a new study completed at UCLA. It looks at physical brain changes in pwMS who have depression. The researchers found on MRI that the hippocampus is smaller in pwMS, and that the HPA axis (the neuroendocrine system which regulates stress and other functions) is hyperactive.

http://www.scientificamerican.com/podca ... -10-07-03/

Those with hypoxic injury show atrophy of the hippocampus and hyperactive HPA axis. Just like people with MS.
Here are some studies to back this up:

Several reports suggest that the activity of the hypothalamo-pituitary-adrenal axis (HPA-axis) is increased following hypoxia/ischaemia and that this might be associated with increased neuronal vulnerability-

http://www.ncbi.nlm.nih.gov/pubmed/7496805

Hypoxia damages multiple organ systems especially those with high oxygen utilization such as the central nervous system. The purpose of this study was to compare the neuropathological and neuropsychological effects of hypoxia in patients with either carbon monoxide poisoning or obstructive sleep apnea. Neuroimaging revealed evidence of hippocampal atrophy in both groups.

http://journals.cambridge.org/action/di ... aid=195135

http://ccsviinms.blogspot.com/2010/07/s ... s-and.html

Hypoxia due to slowed cerebral perfusion might be involved in this process, as well as mineral deficiencies that JL mentions. A glass of beet juice a day is fine, MA, you can drink it all at once--it won't cause any harm.

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Re: Depression, cognitive impairment often complicate MS

Postby jimmylegs » Sun Jun 08, 2014 3:43 pm

doesn't look like too many people have looked hard at whether hippocampal atrophy and mag depletion could be connected, but i did find this hint of a possible relationship:

Acute treatment with MgSO4 attenuates long-term hippocampal tissue loss after brain trauma in the rat
http://onlinelibrary.wiley.com/doi/10.1 ... 5/abstract
"Treatment with MgSO4 significantly reduced progressive tissue loss in the hippocampus (P < 0.001). These findings are the first to demonstrate long-term neuroprotection of hippocampal tissue by an acute treatment in a TBI model. These data also show that the previously reported broad efficacy of MgSO4 or NPS 1506 observed shortly after brain trauma could not be detected 8 months post-injury."
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