The effects were examined of high doses of intravenous methylprednisolone (MP; 1 g daily, administered for 5 days) on emotional functions in multiple sclerosis (MS) patients with clinical relapse. Thirty two patients with relapsing-remitting disease were included. The mean age was 39.4 (20-56) years, mean disease duration and mean Expanded Disability Status Scale scores were 6.6 (0.8-28) years and 4.1 (2-6.5), respectively. MS patients were subjected twice to psychological tests: immediately after MP treatment and 6 months later. Hamilton Rating Scale for Depression (HRSD) and Hopkins Symptom Check List (HSCL) were used. Thirty two control subjects (mean age 37.2 years) with ischialgia, not receiving steroids, underwent the same testing procedure. On the basis of their results in learning tests (Nonverbal Learning Test and Rey Auditory Verbal Learning Test) upon admission, MS subjects were allocated into 2 different subgroups: 20 patients were included into cognitively preserved group (cpMS) and 12 patient into the group with cognitive decline (cdMS). Immediately after MP treatment, MS patients (total group) achieved significantly higher scores than controls on the HRSD and two subclasses of the HSCL: depression with inhibition and phobic anxiety. There were no significant differences between cpMS and control subjects in HRSD and HSCL tests. CdMS patients, as compared with controls and cpMS subjects upon admission showed depressed mood, obsessive-compulsive disorder, increased anxiety and interpersonal hypersensitivity. Therapy with MP did not markedly change emotional functions in all MS patients (total group, cpMS, cdMS).
Conclusions: 1. Only cdMS patients show emotional disturbances. 2. Therapy with MP does not significantly change the emotional profile of MS patients.