110 - - Considering race in biopsychosocial stress moderators of clinical outcomes of Multiple Sclerosis

• Published in: Psychoneuroendocrinology 2024-02, Vol.160
• Main Authors: Moody, Shannin, Moody, Shannin N., Manuel, Morganne, Lovera, Jesus, Copeland, Brian, Willette, Auriel, Shirtcliff, Elizabeth Birdie, Devier, Deidre
• Format: Article
• Language: English
• ISSN: 0306-4530; 1873-3360
• DOI: 10.1016/j.psyneuen.2023.106903

Black Americans experience increased incidence, disease severity, and earlier mortality due to Multiple sclerosis (MS), a debilitating neurodegenerative disease marked by demyelination and central nervous system lesions. Black Americans can also encounter high levels of stress (e.g. racism), which can alter the hypothalamic-pituitary-adrenal axis and culminate into negative impacts on neurological health. This study examines racial differences in how perceived social stress (PSS) and cortisol, a biological marker of stress, impact brain atrophy and clinical outcomes of MS. 105 “Black” (N=47) and “White” (N=58) MS participants of which 82% identified as female were recruited from a longitudinal study examining novel measures on cognitive decline in patients with neurological diseases. Higher reports of PSS were associated with lower symbol digit modality test (SDMT) scores in White participants. In Black participants, PSS moderated the relationship between the third ventricle width and SDMT. High cortisol was associated with worse scores on the SDMT in all participants but only remained significant in White participants. Higher cortisol was also associated with larger ventricle widths in White participants. Cortisol moderated the relationship between the third ventricle and SDMT whereas it was associated with worse SDMT performance in Black participants with larger third ventricles. Biopsychosocial stress was associated with worse clinical outcomes of MS. In Black individuals, stress moderated the relationship between brain atrophy and clinical outcomes. There is a need to approach MS as a biopsychosocial disease where markers of stress may exacerbate the clinical decline in MS.