ArticleJournal of neurology2025
Wartime stress and relapse risk in people with multiple sclerosis: a prospective cohort study.
Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPsychological stress has been proposed as a trigger for disease activity in multiple sclerosis (MS), but findings have been inconsistent. While prior research has focused largely on chronic stressors, little is known about how people with MS (pwMS) cope with acute, large-scale stress events such as war.
objectiveExamine the effects of wartime stress following the October 7, 2023 attack on disease activity in pwMS, and to assess whether emotional factors are associated with relapse risk during this period.
methodsClinical data on relapses and disability progression were collected retrospectively for the year preceding October 7, 2023, and prospectively for the year following that date. Participants completed standardized questionnaires assessing stress, anxiety, depression, fatigue, and coping flexibility between April and June 2024.
resultsFrom the 145 pwMS included in the prospective study, 38% experienced at least one relapse in the post-war year, compared to 23% in the year prior. Perceived fatigue was significantly higher among those who experienced relapses, while anxiety, depression, and perceived stress were not significantly associated with relapse frequency. Coping flexibility did not moderate the relationship between psychological distress and relapse count. No significant change was observed in disability progression across the two time periods.
conclusionsWartime conditions were associated with increased relapse activity in pwMS. Fatigue may serve as a sensitive marker of disease vulnerability during stress. Coping flexibility, as measured in this study, did not appear to buffer the effects of psychological distress on relapse risk.
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