Multiple sclerosis (MS) patients have high levels of cortisol, a stress hormone, compared to healthy controls. Also, patients categorized as non-cognitive fatigue show a higher variability in cortisol levels and perform worse on an attention task.
Those findings are documented in the study, “Relation between cognitive fatigue and circadian or stress related cortisol levels in MS patients,” published in the journal Multiple Sclerosis and Related Disorders.
The inflammation that characterizes MS is triggered by an imbalance of cytokines, small proteins that regulate the immune system.
Cytokines also stimulate specific brain regions, particularly at the hypothalamic-pituitary-adrenal (HPA) axis, to produce adrenocorticotropic hormone (ACTH), which regulates the levels of cortisol. The HPA is a key network within the neuroendocrine system that regulates stress, digestion, immune responses, mood and emotions.
Previous studies have reported that the HPA axis is hyper-activated in MS patients, who also show elevated levels of stress hormone cortisol. Additional studies also suggest that an imbalance of the HPA axis is linked to depression and chronic fatigue.
Fatigue, defined as a lack of drive and energy and a chronic feeling of tiredness, is a common symptom of MS. Yet, it remains unclear whether cortisol levels are linked to fatigue in MS.
Researchers in Germany and the Netherlands now investigated how cortisol levels change during the day and in response to fatigue in MS patients.
In total, the team analyzed 20 healthy controls and 40 MS patients, including 27 experiencing fatigue. Fatigued patients scored 28 or higher on the fatigue scale for motor and cognitive functions (MSFC).
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