Depression-like changes of the sleep-EEG during high dose corticosteroid treatment in patients with multiple sclerosis

• Published in: Psychoneuroendocrinology Vol. 28; no. 6; pp. 780 - 795
• Main Authors: Antonijevic, Irina A., Steiger, Axel
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-08-2003; Elsevier
• Subjects: Adult; Behavioral psychophysiology; Biological and medical sciences; Corticosteroid; Depression - chemically induced; Depression - physiopathology; EEG; Electroencephalography - drug effects; Electrophysiology; Encephalomyelitis - physiopathology; Female; Fundamental and applied biological sciences. Psychology; HPA; Humans; Major depression; Medical sciences; Methylprednisolone - adverse effects; Methylprednisolone - therapeutic use; Middle Aged; Multiple sclerosis; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Multiple Sclerosis, Relapsing-Remitting - drug therapy; Multiple Sclerosis, Relapsing-Remitting - physiopathology; Neurology; Polysomnography - drug effects; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Sleep; Sleep Wake Disorders - chemically induced; Sleep Wake Disorders - diagnosis; Sleep Wake Disorders - physiopathology; Sleep, REM - drug effects; Time Factors; HPA; Corticosteroid; Multiple sclerosis; Sleep; Major depression; EEG; Mood disorder; Human; Immunopathology; Vigilance; Nervous system diseases; Hypothalamohypophysoadrenal axis; Electrophysiology; Autoimmune disease; Depression; Electroencephalography; Rapid eye movement sleep; Spectral analysis; Inflammatory disease; Central nervous system disease
• ISSN: 0306-4530; 1873-3360
• DOI: 10.1016/S0306-4530(02)00085-9

Acute exacerbations of multiple sclerosis (MS) are commonly treated with high doses of corticosteroids that can influence sleep regulation and hypothalamo-pituitary-adrenal (HPA) activity. We examined the sleep-EEG (including conventional and spectral EEG analysis) in 9 female patients with relapsing–remitting MS (and no psychiatric disorder) just prior to and on days 2 and 10 of high dose corticosteroid treatment (500 mg/day methylprednisolone given IV for 5 days, then PO taper down) and age-matched healthy female controls.
Before treatment with corticosteroids, MS patients compared to controls showed few changes of the sleep EEG, namely a significant increase in slow wave sleep (SWS) and a decrease in stage 2 sleep. In contrast, on day 10, but not day 2 of treatment, MS patients showed a number of sleep-EEG changes typically observed in patients with depression, including a reduction in REM latency, an increase in REM density, a decrease in the SWS and delta sleep ratio and a decrease in sigma EEG activity. However, no concomitant effect of treatment on mood was noted.
In summary, unlike acute treatment with methylprednisolone, prolonged treatment induces several changes of the sleep-EEG in MS patients, that are also observed in patients with an acute depressive episode. Further prospective studies with longer-term follow-up are needed to examine the clinical relevance of our preliminary data.