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. 2023 May 1;13(6):e3024. doi: 10.1002/brb3.3024

TABLE 1.

Tabulation of study characteristics and findings

Author (year) Study design Place of study Duration of study Mode of assessment of ACEs Mode of MS assessment Outcomes measured Findings
Eid et al. (2022) Prospective cohort Norway 1999–2008 Self‐administered questionnaires Revised McDonald Criteria*

  • MS development

Exposure to emotional abuse, HR 1.40 (95% CI 1.03 to 1.90), physical abuse, HR 1.31(95% CI 0.83 to 2.06), and sexual abuse, HR 1.65 (95%CI 1.13 to 2.39) was positively associated with subsequent MS development. Moreover, when exposed to two (HR 1.66, 95% CI 1.04 to 2.67), or three categories of childhood abuse (HR 1.93, 95% CI 1.02 to 3.67), women were at even more risk of developing MS.
Horton et al. (2022) Case control Northern California 2006–2014 Computer‐assisted telephone interview (CATI), 9 ACE questions Diagnosed by a Neurologist

  • Age of MS onset

  • Progressive MS subtype (relapsing‐remitting, secondary progressive, primary progressive, or relapsing‐progressive)

  • Current walking ability

  • Disease severity

 No significant association between ACE and the risk of MS (OR = 1.01 95% CI: 0.87, 1.18).
Shaw et al. (2017) Retrospective cohort Stony Brook, New York July 2014 to June 2015 10‐item ACE tool Diagnosed by a Neurologist

  • Age of MS onset

  • Disease severity via Premorbid IQ (assessed through reading recognition test‐WRAT‐3)

Significant and inverse correlation between ACEs scores and age of MS onset (r = −0.30, p = .04).

Performance on the WRAT‐3 reading recognition was significantly linked to participants’ ACE scores (r = −0.25, p = .04), indicating that childhood adversity was also predictive of premorbid IQ.
Eilam‐Stock et al. (2021) Prospective cohort New York N/A 10‐item ACE tool Revised McDonald Criteria

  • Health‐related quality of life and emotional well‐being in patients diagnosed with MS (assessed via SeMaS Anxiety scale, SeMaS depression scale, and SF‐36 scale

 Significant association between ACE scores and SeMaS Anxiety scale (Adjusted R 2 = 0.12, F = 4.29, p = .049). However, no significant association was observed between ACEs score and the SF‐36 scale (Adjusted R 2 = −0.02, F = 0.38, p = .54) or SeMaS depression scale (Adjusted R 2 = −0.01, F = 0.79, p = .38)
Spitzer et al. (2012) Case control Germany N/A

28‐item Childhood Trauma Questionnaire

(CTQ)

 Revised McDonald Criteria

  • MS onset

  • Relapse rate

  • Functional impairment

No significant association between severe abuse and MS onset and functional impairment. Physical abuse and emotional neglect were associated with higher relapse rates ((β = 0.22, p = .033 and (β = −0.31, p = .048, respectively).

Severe abuse participants had a significantly higher mean relapse rate of 0.89 (0.68) than the mean relapse rate of 0.62 (0.54) of participants who had no history of severe abuse (F = 5.4, p = .022, d = 0.44).
Pust et al. (2020) Retrospective cohort Germany July 2018 to March 2019

28‐item Childhood Trauma Questionnaire

(CTQ)

 Self‐reported diagnosis of MS

  • Fatigue in MS individuals (assessed via CTQ scale)

 A significant association between emotional abuse (p < .001), physical abuse (p < .01), physical neglect (p < .001), emotional neglect (p < .001), and fatigue symptoms in MS patients.
Nielsen et al. (2014) Retrospective cohort Denmark 1968–2011 N/A Allison or Poser criteria and McDonald criteria

  • Risk for MS development

Exposure to a minimum of 1 SFLE has a 1.11 times greater risk for the development of MS (RR = 1.11) ‐ Males (RR = 1.14) and Females (RR = 1.10).

Exposure to a single SFLE has an 11% greater risk for MS than NE subjects (RR = 1.11).

Exposure to more than one SFLE has a relatively higher risk for MS (RR = 1.17). Exposure to parental divorce has a 13% increased risk for MS (RR = 1.13). Exposure to parental or sibling death does not significantly increase the risk for MS. No significant association between the risk for MS and age at parental divorce (p = .68) or age since the parental divorce (p = .37) was observed.
Briones‐Buixassa et al. (2019) Case control Spain May 2014 to June 2015 Early‐life stress via CTQ‐SF McDonald criteria

  • Coping processes

  • Perceived social support

  • Trait anxiety

  • Alexithymia

No significant association between early‐life stress in pwMS (p = .65).

When compared to the control group, pwMS reported higher levels of avoidance coping mechanisms (p = .003), high trait anxiety (p = .002), and alexithymia (p = .04).

pwMS reported significantly lower levels of perceived social support (p = .001).
Eftekharian et al. (2016) Case control Hamadan, Iran N/A Interview questionnaire Diagnosed by a neurologist

  • Risk for MS development

 There is a significant association between physical child abuse 2–3 times/week (OR = 18.81 95% CI 4.46–79.38) with increased risk for MS.
Warren et al. (1982) Case control Canada 1 Year Interview questionnaire Schumacher criteria

  • Development of MS

 There is no significant difference between the controls and pwMS based on the emotional climate of their homes during childhood and adolescence.
Gunnarsson et al. (2015) Case control Sweden 1 Jan 1952 to 31 Dec 1956 N/A ICD, 340 recorded on Swedish NPR

  • Risk MS development

Exposure to a more crowded household in childhood (4–8 years) is associated with reduced risk for MS (p = .007).

There is no significant association between parental occupation and risk of MS development (p = .438).

MS: multiple sclerosis; E: exposed; NE: not exposed; CTQ‐SF: Childhood Trauma Questionnaire‐Short Form; pwMS: people with multiple sclerosis; ACE: adverse childhood experience; HR: hazard ratio; OR: odds ratio; WRAT‐3: Wide Range Achievement Test‐third edition; IQ: intelligence quotient; SF‐36, Study Short Form–36 Items; SeMaS: Self‐Management Screening; CTQ: Childhood Trauma Questionnaire; OCD: obsessive‐compulsive disorder; SFLE: stressful life event; ICD: International Classification of Diseases; NPR: National Patient Register.

*

MS assessment scale details are provided in the Supplementary file.