Mental Health Changes

Human Brain

     MS can cause mental health changes, including depression, anxiety, and cognitive dips. Mood disruptions largely result from reactions to the diagnosis and frustrations with physical and other life changes associated with it, but may also be associated with changes to the brain itself. These can all affect mental functioning, as confusion and memory loss may accompany MS relapses and progression1,2. “Altered functional connectivity” in brain tissue3 has been linked to decreased performance, generally within five years of MS diagnosis1, though also occurring later in different parts of the brain4.

  • Wahls Protocol: In a controlled clinical study in RRMS patients, the Wahls Protocol diet was associated with 16.2% increased mental quality of life according to standardized scoring (compared to a 1.5% decrease in the control group). All eight Wahls subjects (100%) demonstrated improved mental health scores of at least 5 points, whereas only three out of nine controls (33%) experienced similar improvements5. In a single group study in PPMS and SPMS patients, the Wahl’s Protocol’s multiple modality approach resulted in improved mood and cognitive symptoms6.

  • OMS Diet: Greater diet quality according to OMS criteria was significantly associated with less severe depression risk7.

  • Anti-inflammatory Diet: Following 12 weeks with the anti-inflammatory diet, MS patients demonstrated a significant reduction in cognitive and psychological fatigue as measured by the Modified Fatigue Impact Scale (MFIS), as well as a significant increases in mental health quality of life (p<0.001)8.

  • Massage: Massage has demonstrated a beneficial effect on depression9.

  • Reflexology: Foot reflexology has been found to be effective in reducing anxiety and improving quality of life in MS10; Dilek Doğan and Han, 2021).

  • Supplements associated with improvements in mental aspects of brain function include the following (each covered in their own section):

    • Coenzyme Q10

    • Citicoline

    • Ginkgo biloba

    • Lion’s mane

    • N-acetyl cysteine

    • Omega-3 fatty acids

    • Vitamin B1 in cases of deficiency

    • Vitamin B12 in cases of deficiency

References

1. Koubiyr I, Broeders TA, Deloire M, et al. Altered functional brain states predict cognitive decline 5 years after a clinically isolated syndrome. Mult Scler. Oct 2022;28(12):1973-1982. doi:10.1177/13524585221101470

2. Pozzilli V, Cruciani A, Capone F, et al. A true isolated cognitive relapse in multiple sclerosis. Neurol Sci. Oct 8 2022;doi:10.1007/s10072-022-06441-w

3. Huang J, Li M, Li Q, et al. Altered Functional Connectivity in White and Gray Matter in Patients With Multiple Sclerosis. Front Hum Neurosci. 2020;14:563048. doi:10.3389/fnhum.2020.563048

4. Dekker I, Schoonheim MM, Venkatraghavan V, et al. The sequence of structural, functional and cognitive changes in multiple sclerosis. Neuroimage Clin. 2021;29:102550. doi:10.1016/j.nicl.2020.102550

5. Irish AK, Erickson CM, Wahls TL, Snetselaar LG, Darling WG. Randomized control trial evaluation of a modified Paleolithic dietary intervention in the treatment of relapsing-remitting multiple sclerosis: a pilot study. Degener Neurol Neuromuscul Dis. 2017;7:1-18. doi:10.2147/DNND.S116949

6. Lee JE, Bisht B, Hall MJ, et al. A Multimodal, Nonpharmacologic Intervention Improves Mood and Cognitive Function in People with Multiple Sclerosis. J Am Coll Nutr. Mar-Apr 2017;36(3):150-168. doi:10.1080/07315724.2016.1255160

7. Simpson-Yap S, Nag N, Probst Y, Jelinek G, Neate S. Higher-quality diet and non-consumption of meat are associated with less self-determined disability progression in people with multiple sclerosis: A longitudinal cohort study. Eur J Neurol. Jan 2022;29(1):225-236. doi:10.1111/ene.15066

8. Mousavi-Shirazi-Fard Z, Mazloom Z, Izadi S, Fararouei M. The effects of modified anti-inflammatory diet on fatigue, quality of life, and inflammatory biomarkers in relapsing-remitting multiple sclerosis patients: a randomized clinical trial. Int J Neurosci. Jul 2021;131(7):657-665. doi:10.1080/00207454.2020.1750398

9. Field T. Massage therapy research review. Complement Ther Clin Pract. Aug 2016;24:19-31. doi:10.1016/j.ctcp.2016.04.005

10. Heidari Z, Shahrbanian S, Chiu C. Massage therapy as a complementary and alternative approach for people with multiple sclerosis: a systematic review. Disabil Rehabil. Aug 1 2021:1-12. doi:10.1080/09638288.2021.1949051

 

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