A study led by Michigan Medicine finds that stressors throughout life, such as poverty, abuse, and divorce, are linked to worsening health and functional outcomes in people with multiple sclerosis.

Researchers found that stressful events in both childhood and adulthood significantly contributed to participants’ level of disability, based on survey data from over 700 people with MS.

The results are published in Brain and Behavior.

“Multiple sclerosis (MS) is the primary cause of non-traumatic disability in young adults. Further research is necessary to identify external factors contributing to disability, such as stress, in order to improve functional outcomes,” noted Tiffany Braley, M.D., M.S., who is the director of the Multiple Sclerosis/Neuroimmunology Division and Multidisciplinary MS Fatigue and Sleep Clinic at the University of Michigan Health.

“This knowledge is essential for informing MS research and clinical care. Referrals to resources, such as mental health or substance use support, could help reduce the impact of stress and enhance wellbeing,” Braley explained.

Over 2.8 million individuals worldwide have multiple sclerosis (MS), an autoimmune condition that affects the brain and spinal cord. In this condition, the protective layer of nerve cells is attacked by the body’s immune system. People with MS can experience unique, often painful, exacerbations of their symptoms, known as relapses or “flares”.

In the study, both childhood and adult stressors were initially found to be significantly linked to a greater burden caused by relapse after the onset of the COVID-19 pandemic. However, the link between childhood stressors and disease burden became less significant when also considering experiences in adulthood.

In the study, both childhood and adult stressors were initially found to be significantly linked to a greater burden caused by relapse after the onset of the COVID-19 pandemic. However, the link between childhood stressors and disease burden became less significant when also considering experiences in adulthood.

Carri Polick, Ph.D., R.N., the first author of the study, found that adverse childhood experiences (ACEs) and other childhood stressors can impact immune, inflammatory, and behavioral processes throughout life, reducing resilience to adult stress.

“We need to take a lifespan approach in our future work to gain a better understanding of patterns and to inform symptom management. For instance, we are building on this research to explore the mechanistic pathways involving sleep, smoking, and mental health. These pathways may demonstrate how stressors can contribute to worse outcomes in MS, such as increased disability, pain, and fatigue.”