Coexistence of emotional reactions and atrophic brain changes in patients with clinically isolated syndrome of multiple sclerosis

Purpose
Atrophic processes of the brain affect the quality of life of patients whose cognitive functions and daily activity are already affected at the stage of the clinically isolated syndrome (CIS) of multiple sclerosis (MS). It is possible that in addition to pathogenic processes, the patient’s emotions at the diagnostic stage can coexist with the course of the disease. We have evaluated the coexistence of emotional reactions in patients with CIS with the formation of atrophic brain changes in patients with MS as well as their association with the functional disability of the patient.

Methods
Thirty patients were examined at the CIS stage and during a repeated clinical attack of MS. The patient’s emotional reaction was assessed at the time of the CIS diagnosis and one week later. For the estimation of atrophic processes of the brain, according to the MRI data on its dynamics, 23 linear parameters and 14 indices were used.

Results
The corpus callosum index was the most significant area of brain atrophy in a repeated attack of MS. There was a strong correlation between the negative emotional response to the diagnosis (shock and denial) and the degree of atrophy of the corpus callosum during repeated clinical attack of the disease as well as with a greater functional failure of the patient. Patients who reported experiencing anxiety or relief did not show increased atrophy.

Conclusions
The emotional response in the form of shock or denial of the diagnosis coexists with corpus callosum atrophy. The patient’s emotional background affects the prognosis and the level of functional disability during the repeated clinical attack.