5/13/2026
According to a recent study published in Brain, Behavior, & Immunity – Health, people with axial spondyloarthritis (axSpA) are significantly more likely to experience depression and anxiety, which appear closely tied to higher systemic inflammation and changes in brain-related proteins involved in neuroplasticity. The findings suggest that inflammation may play a role in both physical symptoms and mood changes. They also point to the idea that mental health symptoms in axSpA are not only a psychological response to chronic illness and pain, but may also have a biological basis. This means that better control of inflammation could also help improve mental health in axSpA.
Researchers studied 74 people with axSpA and compared them to 79 healthy individuals of similar age and sex. Participants filled out standard questionnaires measuring depression and anxiety, along with assessments of disease activity and physical function. Blood samples were also taken to measure inflammation markers (such as CRP and IL-6) and neurotrophic factors (such as BDNF, proBDNF, and sortilin, which are proteins involved in brain health and neuron communication). The goal was to understand how mental health symptoms relate to both inflammation and these brain-related biological signals.
The results showed that depression and anxiety were significantly more common in the axSpA group than in healthy controls. People with worse disease activity and higher CRP levels reported more severe depression and anxiety, along with worse physical function and lower quality of life.
Biologically, axSpA patients had lower levels of BDNF (brain-derived neurotrophic factor, a protein that supports the survival, growth, and plasticity of brain cells) overall. Higher CRP levels were also associated with both worse mood symptoms and lower BDNF levels. Women with axSpA tended to have higher anxiety and lower BDNF than men, indicating possible sex-related differences in how inflammation affects mental health.
The study has several important limitations. Mental health was measured using questionnaires rather than clinical diagnoses, which may be less precise. The study also included mostly patients with mild to moderate disease activity, which could limit how broadly the findings apply. Additionally, other brain or immune markers were not measured, and imaging of brain function was not included. Despite these limitations, the findings suggest that inflammation and neurotrophic dysregulation may be biologically connected to mental health symptoms in axSpA, pointing toward the possibility that better control of inflammation may improve both physical symptoms and mental health outcomes.
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