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This study looks at cortisol as an indication of disease progression and or activity for people with RRMS. I found it on the PLOS (Public Library of Science) website while looking for information about the possible correlation between stress, cortisol and MS.
http://dx.plos.org/10.1371/journal.pone.0060647
"The cortisol awakening response (CAR) is a well described phenomenon which is characterized by a pronounced increase of cortisol within 20 to 30 minutes after awakening [1], [2]. While the precise mechanisms are still not entirely understood, CAR seems to be controlled by limbic regions [3], [4]"
"Conclusions
Circadian cortisol release, in particular CAR, shows a course specific pattern with most pronounced release in RRMS. There is also some evidence for greater CAR in RRMS patients with EDSS progression. As a consequence, CAR might be of predictive value in terms of neurological disability in RRMS patients. The possible role of neuroendocrine-immune interactions in MS pathogenesis is further discussed."
http://dx.plos.org/10.1371/journal.pone.0060647
"The cortisol awakening response (CAR) is a well described phenomenon which is characterized by a pronounced increase of cortisol within 20 to 30 minutes after awakening [1], [2]. While the precise mechanisms are still not entirely understood, CAR seems to be controlled by limbic regions [3], [4]"
"Conclusions
Circadian cortisol release, in particular CAR, shows a course specific pattern with most pronounced release in RRMS. There is also some evidence for greater CAR in RRMS patients with EDSS progression. As a consequence, CAR might be of predictive value in terms of neurological disability in RRMS patients. The possible role of neuroendocrine-immune interactions in MS pathogenesis is further discussed."