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Multiple sclerosis' link to stress isn't clear

8:14 PM, Aug 26, 2012   |    comments
By Chip Somodevilla, Getty Images Ann Romney greets husband Mitt's supporters Aug. 11 in Ashland, Va. She uses horseback riding as multiple sclerosis therapy.
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By Janice Lloyd, USA TODAY
Stress might not be the total bad guy it's cracked up to be in people with multiple sclerosis, experts say.

No one knows what causes multiple sclerosis, an unpredictable disease of the central nervous system, but stresses, both psychological and physical, have gotten plenty of blame over the years for bringing on symptoms. The incurable disease can cause problems in balance, vision, speech and cognition. Ann Romney, diagnosed 14 years ago, suffered an attack following the March 6 Super Tuesday primaries and talked about falling "flat on my behind." She said her ability to speak was also impaired.

Romney has since traveled to the London Olympics and Tuesday night is set to speak at the Republican National Convention in Tampa where her husband will be nominated for president.

How, or even if, these life events affect her disease are impossible to predict, but "there's no evidence to suggest she has to slow herself down," says physician Richard Ransohoff, director of the neuroinflammation research center at the Cleveland Clinic. Romney is not his patient.

"In the past it has been felt, mostly without evidence, that stress can worsen MS, meaning life stresses can bring on attacks," says Ransohoff. "This doesn't seem to be the case."

About 400,000 people in the USA have the disease, thought to be an autoimmune disorder that damages the myelin protective insulation surrounding nerves, according to the National Multiple Sclerosis Society. Several drug treatments slow the progression and manage symptoms. Many sufferers go for long periods without symptoms, brought on by disruption in the communication between the brain and rest of the body. One way physicians monitor the disease is by doing brain studies with magnetic resonance imaging to look for brain lesions.

"The only questions for her is what's the burden of disease and what's her ability to tolerate it," says Ransohoff. "If you take two people with MS and they have identical cases (same number of MRI lesions), some people repair these areas of injuries better than others and do not progress for reasons that are mysterious to us."

The perception of stress, Ransohoff adds, also comes into play. One person can view it negatively, while another person might thrive on it. The findings of a small study published in July in Neurology suggest management of stress could play a positive role in the disease. Patients who attended six months of stress-management sessions had fewer brain lesions and a slower disease progression compared to people who didn't attend the sessions.

Stress can be a positive part of living an engaged life, says lead author David Mohr, professor of preventive medicine at Northwestern University in Chicago.

"I think people with MS should not be encouraged to retreat from life," says Mohr. "In the case of Ann Romney, depending on how she perceives being on the campaign trail, it could be very beneficial for her."

Stress clearly doesn't get a free ride in the disease. Mohr says his findings and other research confirm stress can play a role. That became clear, he says, when the stress management stopped and brain lesions started developing again, but "stress doesn't cause them," both he and Ronsohoff say. It is just part of the process.

Romney has talked about taking medication for MS and enjoying horseback riding as therapy.

Ransohoff says physical activity helps.

"People who exert themselves tend to do better (with MS)," he says. "They might be able to exert themselves more. The evidence favors everything our mothers told us about good vascular health: Don't smoke, don't take in too many calories, don't drink to excess and exercise on a regular basis."

USA TODAY

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