Highlights
- •Anxiety symptoms and disorders are prevalent in persons with multiple sclerosis.
- •Anxiety negatively impacts physical function, cognition, and quality of life.
- •Evidence of efficacy of pharmacotherapy and psychotherapy on anxiety is limited.
- •Exercise is a promising treatment of anxiety is persons with multiple sclerosis.
Abstract
Background
Anxiety symptoms and anxiety disorders are prevalent and burdensome, yet poorly managed
in multiple sclerosis (MS). Indeed, anxiety disorders occur in 22% of people with
MS, and anxiety can negatively impact physical function, cognition, and quality of
life. Currently, there are no treatment guidelines available for anxiety in MS, based
on limited information regarding the efficacy of pharmacotherapy and psychotherapy.
Exercise training may be a promising avenue for treatment of anxiety in MS, and this
is based, in part, on a wealth of evidence in the general population of adults. This
review provides an overview of anxiety and evidence from meta-analyses and systematic
reviews for current treatments options in the general population and MS. We further
make a case for exercise as a novel treatment approach that requires focal examination
in persons with MS.
Methods
We conducted a scoping review of available research, including systematic reviews
and meta-analyses, on anxiety and its prevalence, predictors, consequences, and treatments
in MS. We then noted limitations with existing evidence regarding treatment options,
and then provided a backdrop based on evidence from the general population for the
novel proposition of exercise as treatment of anxiety in MS.
Results
Pharmacotherapy and psychotherapy treatments of anxiety may be efficacious, but come
with significant limitations, especially for persons with MS. Exercise is a promising
novel avenue for treatment of anxiety in MS, and has a positive side-effect profile.
Conclusion
Anxiety is under-investigated and poorly treated in MS. There is a paucity of evidence
for the relationship between exercise training and anxiety in MS, but the evidence
in the general population supports the urgent need for systematic examination of the
efficacy of exercise in treating anxiety symptoms and disorders in persons with MS.
Keywords
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Article info
Publication history
Published online: April 03, 2023
Accepted:
April 2,
2023
Received in revised form:
March 22,
2023
Received:
July 27,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
