Chronic fatigue syndrome, depression, and anxiety symptoms due to
relapsing-remitting multiple sclerosis are associated with reactivation
of Epstein-Barr virus and Human Herpesvirus 6.
Abstract
Relapsing-remitting multiple sclerosis (RRMS) is defined by elevated
IgG/IgA/IgM responses targeting Epstein-Barr Virus (EBV) nuclear antigen
1 (EBNA) and deoxyuridine-triphosphatases (dUTPases) of Human
herpsesvirus-6 (HHV-6) and EBV. These responses suggest that the viruses
are being replicated and reactivated. An increased prevalence of chronic
fatigue syndrome, depression, and anxiety is associated with signs of
immune activation in RRMS. Nevertheless, there is a lack of data
regarding the association between viral reactivation and
neuropsychiatric symptoms of RRMS. This study investigated the
IgG/IgA/IgM responses to EBNA, and EBV and HHV-6-dUTPases, in 58
remitted RRMS patients and 63 normal controls. The McDonald criteria
were employed to establish the diagnosis of MS. The Expanded Disability
Status Scale (EDSS) and the Multiple Sclerosis Severity Score were
employed to evaluate disabilities caused by RRMS. We evaluated the
scores of the Hamilton Depression (HAMD) and Anxiety (HAMA) Rating
Scales, and Fibro-Fatigue (FF) scale. One latent construct was extracted
from the EDSS, MSSS, FF, HAMD, and HAMA scores. We discovered that the
combined effects of IgG and IgM-HHV-6-dUTPAses accounted for 63.7% of
the variance in this construct. Furthermore, the total FF, HAMA, and
HAMD scores were substantially associated with the IgG and
IgM-HHV-6-dUTPAses, accounting for approximately 38.7% to 51.0% of the
variance. The three neuropsychiatric rating scale scores were also
significantly correlated with IgA reactivity directed to both dUTPases
and IgG/IgA/IgM to EBNA. In conclusion, the reactivation and replication
of HHV-6 and EBV significantly contributes to chronic fatigue syndrome,
as well as symptoms of depression and anxiety due to RRMS.