Beyond Biology: The Role of Psychosocial Factors in Neurodegenerative Diseases

Abstract

Neurodegenerative diseases such as Alzheimer’s Disease, Parkinson’s Disease, and Amyotrophic Lateral Sclerosis (ALS) are characterised by progressive neuronal loss, with no current effective treatments. Emerging research emphasises the role of psychosocial factors—specifically stress, chronic pain, and mental health—in exacerbating neurodegeneration through mechanisms like neuroinflammation and oxidative stress. Chronic stress disrupts the hypothalamic-pituitary-adrenal (HPA) axis, contributing to excessive neuroinflammation and oxidative stress, which in turn accelerate neuronal damage. Chronic pain, often comorbid with both chronic stress as well as neurodegenerative diseases, perpetuates neuroinflammation via pain-induced activation of microglia, while mental health conditions such as depression and anxiety are both risk factors and common comorbidities in neurodegeneration. This review highlights the intricate interplay between these psychosocial factors and neurobiological processes that drive disease progression. It argues for a multidisciplinary approach to neurodegenerative disease management, integrating psychosocial interventions like cognitive-behavioural therapy (CBT), mindfulness, and physical activity-based therapies. Such treatments can modulate neuroinflammation, alleviate pain, improve mental health, and potentially slow disease progression, enhancing patient outcomes and quality of life.