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http://www.reutershealth.com/en/index.html

Last Updated: 2007-01-09 15:20:40 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Individuals who have had infectious mononucleosis have an increased risk of developing
multiple sclerosis (MS), even 30 years after infection, according to findings published in the Archives of Neurology.

While "mono" has been linked with MS before, "little is known about the characteristics of this association,"
write Dr. Trine Rasmussen Nielsen, of Statens Serum Institut, Copenhagen, and colleagues.

The researchers monitored a group of 25,234 Danish patients who had had mononucleosis for the development of MS,
starting on April 1, 1968 or in January the year after mononucleosis was diagnosed. The main outcome measure was
the ratio of observed to expected MS cases (standardized incidence ratio).

There were 104 MS cases observed versus 45.91 MS cases expected -- or 58 more cases than normal. This corresponds
to a standardized incidence ratio of 2.27, or more than twice the risk of MS, Nielsen's team reports.

The increased MS risk continued for more than 30 years after infectious mononucleosis. No differences in MS risk
were seen according to sex or age, and the severity of mononucleosis did not appear to influence risk.

The investigators hypothesize that this long-term continuation of MS risk "may reflect a change in immunological
after mononucleosis", which should be further explored.

SOURCE: Archives of Neurology, January 2007.

Hmmm ... I got diagnosed with MS two years after I was infected with infectious mononucleosis (or else EBV I thnink they call it), maybe if I get myself infected again with infectious mononucleosis, my system will return to normal ?

EBV sucks ....

PS. However when I got infectious mononucleosis I quit smoking ...

GWA,

Thanks for posting this.

Prof Giovannoni in the UK is also studying the MS and EBV link and should be reporting on his work later this year (or at least an interim report). Similar research is going on in Australia (and other countries).

What's worrying to me is that a report in 2006 by US researchers came to the same conclusion as the Danish research:

http://www.nationalmssociety.org/Research-2006Apr12.asp

There seems to be so much duplication across the research world. And the real questions never seem to be addressed. Now that we know that there is an association between MS (or the risk of getting MS) and EBV, we need to know (i) what is it about EBV that increases the risk? and (ii) is it possible to affect the apparent linkage and, if so, how?

Please, please, please, could some researcher have the balls to tackle these questions. Even I could track x'000 patients who have had mono (from doctors records) over 30 years and come up with a statistic about how many of them develop EBV etc!

Ian

Researchers have found reason to believe that a fault in the homeostatic expansion process might initiate the autoimmune process.

I find that especially interesting because it makes sense of many things capable of initiating a call for homeostatic expansion (extreme stress/depression/ebv...that pnuemonia bacterium...lpn? and others) yet none of which researchers can exclusively link to MS incidence on their own.

Another reason this one interests me is because it seems that people affected with MS (and other autoimmunes) experience depression at a higher rate than the general public and to a higher degree than you would expect even someone diagnosed with such a hideous disease. This leaves open the possibility that people with long term depression and high stress levels might be more likely to get MS which would help explain the higher numbers of depressed people with MS.

Maybe the disease doesn't cause depression, maybe depression makes contracting MS more likely? Heck, I don't know. This is all a brain fart I had during the process of writing an email the other day but it seemed sensible enough that it's stuck in my mind since then.

Bob

Lyon,

Why do you believe this true:


"Another reason this one interests me is because it seems that people affected with MS (and other autoimmunes) experience depression at a higher rate than the general public and to a higher degree than you would expect even someone diagnosed with such a hideous disease."

Depression and anxiety are frequent diagnosis made by physicians, but I am not convinced that the depression rates are higher than the general population. Have there been any studies that articulate this?

If you follow some MS groups for awhile, it is pretty clear which people are negative and possibly depressed and which people are positive and forward thinking and who are perhaps just frustrated. The negative people do not seem to be in the majority of the people in the boards that I follow.

gwa

gwa wrote:
Depression and anxiety are frequent diagnosis made by physicians, but I am not convinced that the depression rates are higher than the general population. Have there been any studies that articulate this?

If you follow some MS groups for awhile, it is pretty clear which people are negative and possibly depressed and which people are positive and forward thinking and who are perhaps just frustrated. The negative people do not seem to be in the majority of the people in the boards that I follow.
gwa

Hi gwa,
I know negative posts on this site have been an issue lately but my comment, possibly assumption, is based on what I thought seemed generally acknowledged....that people with MS are depressed more often than the general public. With that assumption in mind it seemed to me that the only question at that point was whether that depression is "only" due to being diagnosed with a disease with the reputation MS has, or if there might be some medical association.

I'm at work right now so don't have time to look up studies but you raise a good point. I should make sure something really is an acknowledge issue before I start trying to find answers.

When I get time I'll try to find some studies involving MS depression....interesting.

Bob

I believe depression is highly over diagnosed in people with MS by physicians who are unable to properly treat the disease.

Since nothing/not much can be done with us, it is easier to classify MS'ers as stressed, anxious or depressed, than to treat the patients.

My contention is that your assumption about depressed MS'ers is wrong. Perhaps your wife is depressed, which gilds your opinion. In my own case, depression is not a factor and never has been.

gwa

Hi gwa,

Actually my wife's about the most upbeat person there is....even after MS.

All I know is what I read.

http://www.nationalmssociety.org/Brochu ... ession.asp
http://www.bmj.com/cgi/content/full/315/7110/691
http://www.aafp.org/afp/20041115/1935.html
http://tinyurl.com/ylaqce
etc...

Bob

I would have to agree about doctors wanting to assume an MS patient must surely be depressed. I can't tell you how many times I've been asked that by various neurologists and they seem not to believe me when I tell them that I am not depressed! It seems to be one symptom they can fix so they hone in on it. But if you say you don't have that symptom then what?! Some people may be but others may not.
Lori

I believe that we are generally upbeat as a whole as well. We are just inundated on drug warning labels (especially the CRABs) and medical journals that we are all overly susceptible to depression and that we should all be on high alert for it. It brings to mind something my not so tactful dentist said to me. He was trying to make a positive statement not sound like a left handed compliment. He said (in so many words) "I know quite a few people with MS and they seem to be the type of people who can handle it".

I also believe that to be true. I bet if you look on the warning labels of drugs for other chronic disease sufferers that it says the same stuff about depression. I mean seriously, it's not like getting an incurable progressive disease is going to make us jump for joy. Also people tend to think that their lives need to be like a beer commercial. There will be high and low times in everyone's lives. We need to be able to handle the tough times since we are presented with some abnormally tough challenges, but I think that is what makes people like my dentist say what they do. I think he was trying to say that the people he know with MS are handling it pretty well.

There are times I've been pretty depressed about my MS. It's part of the reason I seek out places like this. But I obviously have a drive to not be overtaken by it or it would have already got me and I wouldn't even be on here since I would view it as hopeless. Do I think people who have their hope stripped away are more susceptible to depression? Yeah I do, but I don't think that is a situation unique to MS.

I can see where you all are coming from. I don't have MS, I personally don't know the answers either way.

I agree that researchers suspect but haven't proven that the depression experienced by those with MS is anything more than the depression anyone would experience being told bad news....especially bad news that isn't going to go away and probably is going to get worse.

If someone jumps for joy after being diagnosed with MS, depression is the least of their mental problems.

I personally am not on a mission to convince people with MS whether or not they suffer from depression. The only goal I have for myself and researchers is to view the available information with an open mind in the attempt to find better answers.

I do know that someone suffering from depression very seldom paints the stereotypical image of the depressed person who is constantly negative and in the dumps all the time so self diagnosing might not be the most accurate guage.

Bob

Lyon,

This is a very presumptious statement by you.

" I do know that someone suffering from depression very seldom paints the stereotypical image of the depressed person who is constantly negative and in the dumps all the time so self diagnosing might not be the most accurate guage."

Depressed people that I am familiar with are not forward looking nor are they looking to the future, ie new meds, treatments, cures, etc. I think depressed people show a lot of warning signs about their mental state.

People living with depression tend to know they are depressed, just as those of us who are not depressed know we are not depressed.

Doctors have gotten away with this faulty diagnosis far too long and need to be called on it. The results about depression statistically must be skewed due to so much inaccurate input by doctors.

There are tons of MS'ers that have been diagnosed with depression who have written in the groups about having one ---- of a time getting this off of their medical records so their illness will be taken seriously.

Any reports about percentages of depression in MS need to be taken with a grain of salt.

gwa

" I do know that someone suffering from depression very seldom paints the stereotypical image of the depressed person who is constantly negative and in the dumps all the time so self diagnosing might not be the most accurate guage."

Hi gwa,
I suppose it would have been more accurate if I hadn't used the term "seldom" because it makes it sound as if it's rare that someone with depression displays the warning signs. It seems the truth in that regard lies somewhere between your opinion and mine.

The point of my first post regarding possible faulty homeostatic expansion wasn't to point out that everyone with MS is depressed. The point was that, if true, faulty homeostatic expansion leading to autoimmunity would make sense of what has been a nonsensical situation in the past.

It seems obvious that the consistantly higher ratio of ebv in MS patients over the general population MUST have some pertinence to the disease itself, although the not too distant ratio of ebv in the general public takes some of the luster out of that statistic.

There is some evidence pointing to the relationship between other viruses and bacteria but when considering any of them separately do they show nearly enough pertinence to take them seriously as a consistant cause of MS incidence.

Whether any of us agree or not, there is some evidence pointing to a relationship between depression and the MS disease.

What I did want to point out with the link regarding homeostatic expansion was that, if true, that might mean that ANYTHING or any situation causing lymphocyte depletion might be considered a factor in the initiation of the autoimmune/MS disease process which also would make it seeme a little more understandable that we have never been able to point the finger at any one thing or situation for starting the autoimmune/MS disease process.

Bob

this is interesting to me, and not surprising. i had mono twice. after the 2nd round my health was never good, but it was over 15 years after the second time til i was diagnosed with MS. i tend to believe that the EBV virus disrupts normal immune system functioning, altering it and allowing MS or some other autoimmune process to kick in. i'm curious if any other MS patients have had EBV titer tests done and what the results were? last fall a hemotologist i was sent to, did an EBV panel on me and said along with MS i ave "chronic mono", whatever that means. when i asked him what the treatments were for it, he said "there are none". gee thanks for the info then! lol

Jill,

Welcome to the site.

I have an interest in EBV as I had a bad case of Glandular Fever (what we call Mono in the UK) at 15. I was dx with MS 24 years later age 39. One of the neuros I saw (Dr Giovannoni) seems to think there is a strong link - I attach one of the funded projects he is working on. Once infected, EBV resides in B cells for life and may reactivate - some think that this might be the reason for relapses for those with the genetic susceptibilty. Rituxan is a drug in trial which depletes B cells, so it will be interesting to see the results of the current trials for RR and PP MS.


http://www.mssociety.org.uk/go.rm?id=18366:1

All the best

Ian