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 for bringing on symptoms. The incurable disease can cause problems in balance, vision, speech and cognition. Ann Romney, who was diagnosed 14 years ago, had an attack after the Super Tuesday primaries March 6 and talked about falling "flat on my behind." She said her ability to speak also was impaired.
Romney has since traveled to the London Olympics and is set to speak Tuesday night at the Republican National Convention in Tampa, where her husband, Mitt Romney, 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," Ransohoff says. "This doesn't seem to be the case."
About 400,000 people in the USA have the disease, which is 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 patients go for long periods without symptoms, which are brought on by disruption in the communication between the brain and the rest of the body. One way physicians monitor the disease is by doing brain studies with magnetic resonance imaging to look for lesions.
"The only questions for her are what's the burden of disease and what's her ability to tolerate it," Ransohoff says. "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 says, also comes into play. One person can view it negatively, and another might thrive on it. The findings of a small study 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 with people who didn't attend the sessions.
Stress can be a positive part of 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," 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."
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