From:  Multiple sclerosis with comorbidity depression and its association with vitamin D deficiency in a narrative review of the current literature

Common features/similarities to pathophysiological mechanisms in MS and comorbidity depression

CriteriaDepression/mood disordersMS
HPA-axis dysfunction/stress/elevated cortisol release[24, 28, 37, 38][26, 27, 30, 34–36]
Imbalance of proinflammatory and antiinflammatory cytokines[39–42, 44][12, 98, 154, 261]
sNfL, an early biomarker for neuronal damage (“troponin of the neurologist”)[45–47, 50–53][56–60, 62]
sGFAP for diagnostics to detect “smoldering MS” and monitor the severity of the depression[65, 68, 70][66, 69, 70]
BBB disorders[113–119][109, 110, 113]
Microglial pathology[20, 123, 128, 129][124–126]
Gut microbiome disorders[150, 151, 154, 156–158][145, 146]
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