The stress-axis in multiple sclerosis: Clinical, cellular, and molecular aspects

Jeroen Melief, Inge Huitinga, Stefan M Gold

Research output: Contribution to journal/periodicalArticleScientificpeer-review


Altered activity of the hypothalamus-pituitary-adrenal (HPA) stress-axis has been implicated in the pathogenesis and progression of multiple sclerosis (MS) and linked to the development of specific symptoms and comorbidities such as mood disorders, fatigue, or cognitive dysfunction. Overall the HPA-axis is activated or hyperresponsive in MS, though a hyporesponsive HPA-axis has been observed in a subgroup of MS patients that has a more severe course of the disease. Here we provide an overview of the possible causes of HPA-axis activation, sex- and subtype dependent differences, pathological, cellular, and molecular effects, and the clinical correlates of HPA-axis activity in MS.

Original languageEnglish
Pages (from-to)119-126
Number of pages8
JournalHandbook of Clinical Neurology
Publication statusPublished - 2021


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