Bridging the gap: A symptom network analysis of depression, anxiety, and fatigue in multiple sclerosis

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2026-05-01 Epub Date: 2026-03-02 DOI:10.1016/j.msard.2026.107102

Charles J. Strathdee , Isabel Krug , Charles Malpas , Litza Kiropoulos

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引用次数: 0

Abstract

Background

Depressive, anxiety, and fatigue symptoms are highly prevalent in people with multiple sclerosis (pwMS) and have been found to co-occur. Together, these symptoms result in poorer outcomes for pwMS. However, the network topology of comorbid depression, anxiety, and fatigue in pwMS has been to be investigated.

Methods

We estimated depressive, anxiety, and fatigue symptom networks using data from the same people with multiple sclerosis at two time points: at baseline (N = 272) and at 6-months follow-up (N = 141). Expected influence (EI) centrality analyses were performed to estimate the relative influence of each symptom within the two networks. Bridge EI and community analyses were performed to identify potential bridge symptoms and densely connected symptom groups.

Results

‘Worthlessness’ and ‘anhedonia’ emerged with the highest EI at baseline and follow-up, respectively. In terms of bridging symptoms, ‘worthlessness’, ‘afraid something awful would happen’, and ‘fatigue severity’ emerged as potential bridging symptoms that clustered depressive, anxiety, and fatigue symptoms in pwMS. This changed to ‘restlessness’, ‘uncontrollable worry’, and ‘suicidal ideation’ at follow-up. Further analyses indicated that the two networks remained similar with respect to global strength (p = .97)

Conclusions

Our findings demonstrate that depressive, anxiety, and fatigue symptoms are highly interconnected in MS. Identifying bridging symptoms may allow for a renewed therapeutic focus and avenue for symptomatic improvement across board areas of psychopathology in MS.

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弥合差距：多发性硬化症中抑郁、焦虑和疲劳的症状网络分析。

背景：抑郁、焦虑和疲劳症状在多发性硬化症（pwMS）患者中非常普遍，并且被发现是共同发生的。这些症状共同导致pwMS的预后较差。然而，在pwMS共病的抑郁，焦虑和疲劳的网络拓扑结构已被调查。方法：我们使用来自同一多发性硬化症患者的两个时间点的数据来估计抑郁、焦虑和疲劳症状网络：基线（N = 272）和6个月随访（N = 141）。预期影响（EI）中心性分析用于估计两个网络中每个症状的相对影响。进行桥式EI和社区分析，以确定潜在的桥式症状和紧密联系的症状组。结果：“无价值”和“快感缺乏”分别在基线和随访时出现最高的EI。在桥接症状方面，“无价值”、“害怕可怕的事情会发生”和“疲劳严重程度”作为潜在的桥接症状出现，聚集了pwMS的抑郁、焦虑和疲劳症状。在随访中，这一症状转变为“不安”、“无法控制的担忧”和“自杀意念”。进一步的分析表明，这两个网络在整体强度方面保持相似（p = 0.97）。结论：我们的研究结果表明，在多发性硬化症中，抑郁、焦虑和疲劳症状是高度相互关联的。识别桥接症状可能会为多发性硬化症的精神病理领域提供新的治疗重点和症状改善途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.