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REVIEW ARTICLE

Pathophysiology and treatment of psychosomatic symptoms in multiple sclerosis: A narrative review

Elissa El Toum1,2,3 ,  Youssef El Toum4*
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1 Department of Neurology, Saint Georges University Medical Center, Beirut, Lebanon
2 Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
3 Neurosciences Research Center, Lebanese University, Hadath, Lebanon
4 Faculty of Medical Sciences, Sain Joseph University, Beirut, Lebanon
JCBP, 025350067 https://doi.org/10.36922/JCBP025350067
Received: 31 August 2025 | Revised: 9 November 2025 | Accepted: 24 November 2025 | Published online: 8 December 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Multiple sclerosis (MS) is a chronic and immune-mediated disorder of the central nervous system that extends beyond motor and sensory dysfunction to include a wide range of psychosomatic complications. This review focuses on the pathophysiology and management of mood disorders, cognitive impairment, fatigue, pain, sleep disturbances, and pseudobulbar affect in MS. These manifestations are highly prevalent, and the pathophysiology is not well elucidated because it often results from overlapping mechanisms including lesion-related changes, neuroinflammation, neurotransmitter imbalance, neurodegeneration, endocrine dysregulation, and psychosocial stressors. They significantly reduce quality of life, contribute to disability, and impose socioeconomic burdens. Conventional treatments, such as antidepressants, cognitive behavioral therapy, analgesics, neurostimulation, and sleep-modulating agents, offer partial relief but often require individualized selection. Complementary and alternative medicine, particularly dietary interventions and antioxidant supplementation, show potential immunomodulatory and neuroprotective benefits, though stronger clinical evidence is needed. A multidisciplinary approach is often required for improving patient well-being, functional outcomes, and long-term disease management.

Keywords
Multiple sclerosis
Psychosomatic symptoms
Mood-related disorders
Cognitive impairment
Complementary and alternative medicine
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Print ISSN: 3060-8562, Published by AccScience Publishing
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