Brain, Vol. 109, No. 4, 585-597, 1986
© 1986 Guarantors of Brain
research-article |
STRUCTURAL BRAIN CORRELATES OF EMOTIONAL DISORDER IN MULTIPLE SCLEROSIS
From the Departments of Psychiatry and Behavioral Sciences and Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA
Correspondence to:
Correspondence to Dr Peter Rabins, Meyer 279, Johns Hopkins Hospital, 600 N. Wolfe St, Baltimore, MD 21205, USA
SUMMARY
Eighty-seven patients with definite multiple sclerosis (MS) were examined neurologically and administered the Mini-mental State examination (MMS) to asses cognitive disability at the beginning and end of a one-year study. A CT scan was performed in 37. A group of 16 patients with stable spinal cord injuries (SCI) were studied in a similar manner. Of the MS patients, 47% had a mean General Health Questionnaire (GHQ) score in the abnormal range. This was a higher rate than in SCI patients (p = 0.004). Mean depression scores were similar in MS and SCI patients, but MS patients with brain involvement were more depressed than those with cord lesions only (p = 0.05). Depression score was unrelated to functional disability but was correlated with the degree of neurological impairment (p = 0.03). Euphoric patients were more likely to have brain involvement (P = 0.006), to have progressive MS (P < 0.0001), and to have enlarged ventricles (P = 0.04) and were more impaired cognitively (P = 0.04) than noneuphoric patients. These results suggest that depression in MS patients is partly determined by the presence of brain involvement, but that it is also an emotional reaction to the disorder Euphoria and cognitive disorder are reflections of brain involvement.
Received June 4, 1985. Revised September 10, 1985. Accepted .
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