The effect of stress on the onset and progression of Creutzfeldt-Jakob disease: Results of a German pilot case-control study

The association between Creutzfeldt-Jakob disease (CJD) and stressful life events was examined in a pilot case-control study in Germany. The study sam ple consisted of 37 CJD cases and 37 controls, both groups were frequency-m atched for age and sex. In standardised interviews of close relatives of th e cases and the controls, all stressful life events were assessed and subse quently grouped into one of the following three subgroups: psychosocial str ess events, medical operations with hospitalisation, and other serious medi cal examinations. A significantly higher proportion of CJD cases experience d stressful life events during the last six months before disease onset tha n controls (65% vs. 32%, p = 0.01), yielding an odds ratio (OR) of 3.85 (95 % confidence interval (CI): 1.33-11.30). We found the clearest distinction between cases and controls for the subgroup of medical operations where an OR of 6.97 (95% CI: 0.76-329.20) was observed. Further data indicated that stressful events seem to influence not only the onset of CJD but also the p rogression of the disease. Although based on a rather small study sample, t his pilot case-control investigation suggests evidence that stressful life events in the last six months before disease onset may influence CJD occurr ence and may modify the course of disease. This 'stress hypothesis', which is in line with findings from other epidemiological and experimental studie s in CJD, is thus a promising direction for future CJD research as it could enlighten the pathophysiological mechanisms and point towards strategies f or the prevention and therapy of CJD.