Coping style as a protective factor for emotional consequences of structural neuropathology in multiple sclerosis

Introduction: In people with multiple sclerosis (MS), depression symptoms could be a direct consequence of neuropathological processes or a secondary consequence of coping with debilitating illness. We investigated the interaction of white matter structure and patient coping style in predicting positive and negative emotion symptoms of depression. Method: Participants completed a neuropsychological battery, including the Chicago Multiscale Depression Inventory (CMDI) and a measure of coping strategies that has Active Coping (more adaptive) and Avoidant Coping (less adaptive) scales. Participants also completed a diffusion tensor imaging (DTI) scan, from which fractional anisotropy (FA) was calculated to assess integrity in tracts of interest, and the interaction of FA and coping style was analyzed to predict depression symptoms. Results: Significant FA and Active Coping interaction effects for predicting CMDI Negative Emotion scores were found for the anterior thalamic radiation and uncinate fasciculus white matter tracts. For people with MS who showed relatively reduced integrity of these tracts, use of more Active Coping moderated the relationship of microstructure and negative emotion symptoms of depression. This moderating relationship was not seen with other tracts of interest or with positive emotion. Conclusion: There was a protective effect of adaptive coping style against the experience of negative emotion among people with MS who showed compromised regional white matter integrity of certain tracts that connect temporal and thalamic regions to frontal cortex.