Glucose, multiple sclerosis, cognition and depression
- Yavor Yalachkov
- Apr 17
- 2 min read
🍭 Can glucose and other metabolic alterations mediate the link between inflammation and neurodegeneration in multiple sclerosis (MS)?
💪Lilith Hauck, an outstanding neurologist and brilliant scientist, together with other members of my lab NRGY (Neuroimmunology Research Group/Yalachkov’s Lab), addressed exactly this question in a study that has just been published in Metabolic Brain Disease.
👀 What makes this study so special?
🔬We investigated n = 88 newly diagnosed, treatment-naïve MS patients, meaning our results were not biased by disease-modifying therapies or long disease duration. All glucose measurements were performed before any corticosteroid treatment. We measured glucose not only in serum but also in cerebrospinal fluid (CSF), providing direct insight into CNS-specific processes. We additionally assessed CSF lactate and other clinical metabolic parameters. Last but not least, we captured not only conventional clinical outcomes such as EDSS, but also “invisible symptoms” including cognition, depression, and fatigue.
🧐 What insights does this study provide?
📈 CSF glucose levels were significantly associated with
👨🦯EDSS
👩💻 cognition (SDMT), and
😔 depression (BDI),
even after adjusting for age, sex, and the CSF/serum albumin quotient.
🧠 No significant associations were found between serum glucose and clinical outcomes, suggesting that the observed effects may be driven by CNS-intrinsic processes.
❓Whether increased CSF glucose levels in patients with greater disability, more pronounced cognitive deficits, and stronger depressive symptoms represent a compensatory mechanism in response to CNS damage or rather a marker of mitochondrial dysfunction that may further drive neuroinflammation and neurodegeneration remains unclear.
↗️ Further research—some of which is already underway within NRGY—is needed to elucidate the role of glucose-related metabolic processes in MS.
✅ These processes may ultimately represent an important mechanism influencing CNS-intrinsic inflammation and degeneration.
🤝 Many thanks to Lilith who is an outstanding clinician and scientist, always giving at least 150% driven by an astonishing intrinsic motivation; all the members of NRGY who are the best example that the next generation of clinicians and scientists are wonderful people working together to reach their goals: thank you, Carolin Franz, Dr. Kimberly Körbel, Dr. med. Michelle Maiworm, Valentin Krüger, Robin Zeltner, Antonia Hermanns, Clara Bänsch, Hendrik Becker, Dilara Dabanli for your outstanding work and for being such a wonderful team. My sincere gratitude goes also to PD Dr. Sharmili Edwin Thanarajah for being such a great colleague, collaborator and friend. Her expertise and enthusiasm helped this exciting project about CNS, inflammation and metabolism arise from a brief brainstorming between scientific sessions during a conference to an important paper!
Read the paper here: https://rdcu.be/fdTps
