#ECTRIMS2021 – Childhood Sexual, Emotional Abuse Increases MS Risk

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by Marta Figueiredo PhD |

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Editor’s note: The Multiple Sclerosis News Today team is providing in-depth coverage of the virtual 37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), Oct. 13–15. Go here to see the latest stories from the conference.

Sexual and emotional abuse during childhood is associated with a higher risk of developing multiple sclerosis (MS) later in life — with exposure to more than one type of abuse further increasing the risk — a Norwegian study shows.

These findings add to previous patient and mouse studies reporting a link between childhood trauma and MS, and further highlight the role of early life stress in the development of this autoimmune disease.

“Trauma in childhood and adolescence may alter the immune system and increase the risk of autoimmune disorders,” with “childhood sexual and emotional abuse … associated with an increased risk of developing MS,” the researchers wrote.

The data were shared by Karine Eid, MD, in a poster presented at the 37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), running virtually through Oct. 15. Eid is a PhD student in the clinical medicine department of the University of Bergen, in Norway.

The oral presentation was titled “Childhood abuse and the risk of multiple sclerosis. A prospective, population-based cohort study.”

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In MS, the immune system promotes abnormal attacks against myelin, the fatty, protective sheath around nerve fibers that allows fast communication between nerve cells. While the exact cause of MS is unknown, the disease is believed to result from a combination of genetic and environmental factors.

“It has been debated whether stress can influence the development of MS,” Eid said. She added that some studies have found that “big stressors, such as death and disease in close relatives, happens more often among people with MS, in the last couple of years before they received their diagnosis.”

Exposure to childhood and adolescent trauma have been suggested to affect the immune system and influence the development and progression of MS.

Previous retrospective studies on this matter have reported inconsistent results, with most finding an increased occurrence of previous sexual and emotional abuse among MS patients, but some others finding no relevant link.

Now, Eid and her colleagues conducted a prospective study in which they evaluated whether emotional, sexual, or physical abuse in individuals younger than age 18 is associated with the development of MS in adulthood.

The team analyzed the data of nearly 78,000 women participating in the Norwegian Mother, Father and Child cohort study (MoBa), which first launched in 1999. In less than a decade, by 2008, the ongoing study had recruited more than 100,000 pregnant women in Norway. The goal is to investigate the causes of disease among mothers and children through blood samples and questionnaires — which include queries regarding childhood abuse.

The mean age of the included women was 30, and they were followed until 2018.

Data showed that more than 14,000 women (18.6%) reported childhood abuse, with emotional abuse as the most common (20%). Sexual abuse was reported by 13% of these women, and physical abuse by 9%.

Women who suffered from childhood abuse were more likely to have ever smoked, to have high body mass index (suggestive of overweight or obesity), and to be exposed to adverse socioeconomic factors. These factors included nine or fewer years of elementary school, being a single mother, and having a low household income.

Their data was then linked to the Norwegian MS-Registry and the Norwegian Patient Registry to identify those who developed MS following MoBA inclusion and the completion of childhood abuse questionnaires.

The initial findings showed that a total of 306 women developed MS during the follow-up period, with “no difference in age of diagnosis or age of symptom onset between those exposed to childhood abuse and those unexposed,” Eid said.

A significantly greater proportion of women diagnosed with MS had reported a history of childhood abuse, compared with those who did not develop the disease during follow-up (24% vs. 19%).

Subsequent MS risk analysis was adjusted for potentially influencing factors, such as birth year, smoking, high body mass index, and adverse socioeconomic factors.

The results showed that both sexual and emotional abuse during childhood were significantly associated with an increased risk of MS. Specifically, those who experienced sexual abuse had a 40% higher risk of developing MS, and those who had undergone emotional abuse faced a 65% greater risk. The link with physical abuse did not reach statistical significance.

Moreover, the more categories of abuse that were reported, the higher were the chances of developing MS. According to the investigators, those findings highlight a dose-response effect of early life abuse.

In the presentation, Eid concluded that the results demonstrate an “increased risk of MS after exposure to emotional or sexual abuse,” with a “dose-response relationship with higher risk for MS with increasing number of abuse categories.”

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