Subjective and physiological stress measurement in a multiple sclerosis sample and the relation with executive functions performance

  • Morgana SchefferEmail author
  • Jefferson Becker
  • Lucas Araújo de Azeredo
  • Rodrigo Grassi-Oliveira
  • Rosa Maria Martins de AlmeidaEmail author
Psychiatry and Preclinical Psychiatric Studies - Original Article


In multiple sclerosis (MS), hypothalamic–pituitary–adrenal (HPA) axis functioning may be dysregulated due to the high cortisol levels involved in the disease activity. HPA axis dysregulation can affect cognitive performance, including executive functions. This study aimed to evaluate hair cortisol concentration and perceived stress as well as verify the association with the performance of executive function in both individuals diagnosed with MS and control individuals. Hair cortisol concentration and perceived stress were evaluated and their association with the performance of healthy individuals (n = 33) and those with MS (n = 64), most of them with remitting-relapsing multiple sclerosis (RRMS) assessed using the Expanded Disability Status Scale (EDSS). Instruments that were employed to measure perceived stress and health aspects included the Behavioral Assessment Dysexecutive Syndrome, Wisconsin Card Sorting Test, Stroop Test, and Perceived Stress Scale. No significant statistical difference was found in the comparison of means among the groups; however, an association was found when using statistical correlation tests between cortisol and cognitive performance in the clinical group (r = 0.31, p = 0.10). Further, an absence of correlations with perceived stress measure was noted. It was possible to observe interaction between group factors and low level of cortisol and problem-solving/cognitive flexibility in the MS group. The results indicated that stress measures used in the present study seem to influence the performance of inhibitory control and problem-solving/cognitive flexibility, the latter with low levels of cortisol in individuals with MS. We suggest studies that examine different measures of physiological stress and characteristics of the disease such as more time of stress.


Executive functioning Cortisol Perceived stress Autoimmune disease 



This research received grant from CNPq number 6599740764475980. The funding was used for the hair cortisol analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Morgana Scheffer
    • 1
    Email author
  • Jefferson Becker
    • 2
    • 3
  • Lucas Araújo de Azeredo
    • 4
    • 5
  • Rodrigo Grassi-Oliveira
    • 4
    • 5
  • Rosa Maria Martins de Almeida
    • 1
    Email author
  1. 1.Programa de Pós-Graduação em Psicologia, LPNeC, (Laboratório de Psicologia Experimental, Neurociência e Comportamento), Instituto de PsicologiaUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
  2. 2.Escola de Medicina, NeurologiaPontifícia Universidade Católica do Rio Grande do Sul (PUCRS)Porto AlegreBrazil
  3. 3.Instituto do Cérebro do Rio Grande do Sul (InsCer)Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Hospital São Lucas da PUCRSPorto AlegreBrazil
  4. 4.Centro de Pesquisa Clínica, Instituto do Cérebro do Rio Grande do Sul-Brain Institute (BraIns)Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)Porto AlegreBrazil
  5. 5.Escola de Medicina, Programa de Pós-Graduação em Medicina e Ciências da SaúdePontifícia Universidade Católica do Rio Grande do Sul (PUCRS)Porto AlegreBrazil

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