Impact of Earthquake on Multiple Sclerosis Attacks

Abstract

Objective: The association between stressful life events and subsequent multiple sclerosis (MS) attacks has been frequently reported with conflicting results. In this study, we investigated the impact of a common stressor on MS attacks. Methods: We prospectively evaluated the attack and disability status of 48 consecutive relapsing remitting (RRMS) or secondary progressive MS (SPMS) patients (Group 1) exposed to 1999 Izmit earthquake in comparison to 34 consecutive MS patients (Group 2) with similar demographic and clinical features and living outside the earthquake zone. Results: An increased proportion of patients had relapses in Group 1 within the 3month period after earthquake with no difference in EDSS in a 1year followup period. Furthermore, Group 1 patients with attacks exhibited significantly increased numbers of relapses in a 1year followup period compared to Group 1 patients without attacks and Group 2 patients with or without attacks. Alternatively, the average annual attack rates in Group 1 patients without attacks were significantly reduced. Logistic regression analysis revealed the exposure to earthquake as a predictor of MS attacks. There was no statistically significant association between MS attacks and occurrence of posttraumatic stress disorder. Conclusion: Our results suggest that stress has opposing effects on MS attacks in different patients.(Archives of Neuropsychiatry 2010; 47: 324-7)