Danish Multiple Sclerosis Society Research Articles

Employment, Health Care Utilization, Mental Health, and Mortality in Parents With a Chronically Ill Child: A Nationwide Population-Based Cohort Study

Background: Chronic diseases in children can impact their parents; this may be overlooked in a clinical setting. Our objective was to investigate associations of chronic diseases in children with their parents’ employment, health care utilization, mental health, and mortality. Methods: In a matched cohort study using nationwide and population-based data in Denmark we included parents to children (<18 years) with acute disseminated encephalomyelitis, multiple sclerosis, type 1 diabetes, inflammatory bowel disease and rheumatoid arthritis during 2008–15. The reference group was parents to sex- and age-matched unaffected children. Outcomes were employment (early retirement, cash benefits, income), health care utilization (e.g. general practitioner, or hospital visits), mental health (visits to psychiatry/psychology clinics, antidepressant drug redemptions), and mortality. Findings: We included 13,769 parents with a chronically ill child and 138,606 control parents. One-parent families had an increased annual income after the child’s disease onset. Two-parent families had increased hazard of early retirement of 25% (95% CI=1∙01–1∙54, p=0∙04). Parents with a chronically ill child had a) increased rate of antidepressant drug redemptions or psychology/psychiatry visits (hazard ratio 1∙37; 95% CI=1∙28‒1∙46 at 1-year follow-up); b) increased health care utilization, with an increased marginal mean in primary care of 1% (95% CI=1∙00–1∙02; p=0∙005), hospital-affiliated visits of 19% (95% CI=1∙14–1∙24; p<0∙0001), and hospital admissions of 14% (95% CI=1∙09–1∙20; p<0∙0001); c) 69% increased mortality hazard (95% CI 1∙30–2∙18, p<0∙0001) in parents younger than 50 years with no comorbidities, albeit small in absolute numbers. Interpretation: Pediatric chronic diseases were negatively associated with parental employment, mental health, and increased health care utilization. Parents to a chronically ill child who were younger than 50 years and who had no comorbidities also had increased mortality hazard. Funding Statement: Danish MS Society, Dagmar Marshalls Fond, Axel Muusfeldts Fond, Bent Boghs Fond, Viggo Bruuns Fond. Declaration of Interests: Dr. Boesen has served on a scientific advisory board for Teva; has received speaker honoraria for lecturing from Novartis, and support for congress participation from Teva, Novartis and Roche. Dr. Blinkenberg has served on scientific advisory boards for Genzyme, Roche, Biogen, Merck, Novartis and Teva; has received speaker honoraria from Genzyme, Biogen, Merck, Novartis, Teva and Roche; has received consulting honoraria from the Danish Multiple Sclerosis Society, Biogen, Teva, Roche and Merck; and has received funding for travel from Genzyme, Roche and Biogen. Dr. Thygesen has received honoraria for lecturing from Rigshospitalet (Copenhagen, Denmark), Statistics Denmark and Sanofi Aventis. Dr. Uldall reports no disclosures. Dr. Born has received speaker honoraria from Novartis and has served on advisory boards for Biogen, Novartis and Roche. Dr Magyari has served on the scientific advisory board for Biogen, Sanofi, Teva, Roche, Novartis, and Merck; has received honoraria for lecturing from Biogen, Merck, Novartis, Sanofi, Genzyme, and support for congress participation from Biogen, Genzyme, Teva, and Roche. Dr. Eriksson reports no disclosures. Ethics Approval Statement: The Danish Health and Medicines Authority waived the requirement for patient informed consent to access medical records (case number: 3-3013-896/1). The study was approved by the Danish Data Protection Agency (30-1423/03567) and the Danish Health Data Authority (FSEID: 00003621/DST: 707103).

Efficacy of High-Intensity Progressive Aerobic Exercise on Brain Atrophy Measures in Multiple Sclerosis: A Randomized, Controlled, Cross-Over, Phase-2 Trial

Background: Accelerated brain atrophy is a main determinant of the progressing disabilities clinically characterizing people with multiple sclerosis (MS). Preliminary data from animal studies and human phase 1 studies indicate a possible disease-modifying effect of physical exercise. We therefore assessed whether high-intensity progressive aerobic exercise (PAE) affects brain atrophy in MS. Methods: We conducted a 24-week randomized, controlled, cross-over, phase 2 trial, including an exercise group (24 weeks of supervised PAE followed by self-guided physical activity) and a waitlist group (24 weeks of habitual lifestyle followed by supervised PAE). Participants were recruited at four Danish hospitals. MS patients aged 18-65 years with an Expanded Disability Status Scale score of 0-6 willing to travel to the trial and training facility were randomly assigned (1:1) by the sealed envelope principle, stratified by sex. The primary outcome was percentage brain volume change (PBVC) after 24 weeks, analyzed using an intention-to-treat linear mixed effects model. Findings: A total of 86 participants were recruited from 28 April 2016 to 10 October 2017 (43 patients were assigned to each group). PBVC was -0·29% (SD 0·63) in the exercise group; -0·17% (0·99) in the placebo group (between-group change +0·12%, 95% CI -0·27-0·51; p=0·545). We observed higher grey matter parenchymal fraction (+1·13 percentage points, 0·00-2·26; p=0·05) and cardiorespiratory fitness (+3·5 mL O2/min/kg, 2·0-5·1; p<0·0001) and lower annualized relapse rate (p=0·0023) in the exercise group. No serious adverse events were observed. Interpretation: These findings do not support a ‘whole brain’ neuroprotective effect of PAE (i.e. total brain atrophy) in people with MS. Oppositely, improved cardiorespiratory fitness was accompanied by a ‘regional brain’ neuroprotective effect (i.e. grey matter parenchymal fraction) and a relapse rate of zero. These findings justify recommending PAE as a possible adjunct disease-modifying treatment in MS and warrant further long-term, large-scale phase 3 investigations. Trial Registration Number: ClinicalTrials.gov identifier: NCT02661555. Funding Statement: Jascha Fonden, Fonden for Neurologisk Forskning, The Danish Multiple Sclerosis Society, Aase og Ejnar Danielsens Fond, Knud og Edith Eriksens Fond, Augustinus Foundation, Direktor Emil C. Hertz og Hustru Inger Hertz’ Fond, Else og Mogens Wedell-Wedellsborgs Fond, and Karen A. Tolstrups Fond. Declaration of Interests: ML-C has received teaching honoraria from Novartis. UD has received research support, travel grants, and/or teaching honoraria from Biogen Inc., Merck Serono, Novartis, and Sanofi. LGH has received research support, travel grant, and/or teaching honoraria from Biogen Inc. and Sanofi. TP has received research support from Biogen Inc., Merck, Roche, Alexion, Sanofi, and Novartis. No other authors have any disclosures. Ethics Approval Statement: Ethics approval was obtained from the ethical committee of the Central Denmark Region, Denmark (record no. 1-10-72-291-15).

Cerebrospinal Fluid Biomarkers for Predicting Development of Multiple Sclerosis in Acute Optic Neuritis: A Population-Based Prospective Cohort Study

Background: Long-term outcome in multiple sclerosis (MS) depends on early treatment. We investigated markers in cerebrospinal fluid (CSF), which may predict conversion to MS in acute optic neuritis (ON) patients. Methods: Forty patients with acute ON were recruited in a population-based prospective cohort with median 29 months (range 19-41) follow-up. CSF samples were taken prior to treatment within 38 days of onset (median 14 days; range 2-38). Prospectively, 16/40 patients were diagnosed with MS (MS-ON) and 24 patients continued to manifest isolated ON (ION). Levels of cytokines and neurofilament light chain (NF-L) were measured and compared to healthy controls (HC). Significance levels were corrected for multiple comparisons (q). Findings: CSF TNF-α, IL-10 and CXCL13 levels were increased in MS-ON compared to ION patients (q=0·021, 0·004, and 0·0006, respectively). MS-ON patients had increased CSF pleocytosis, IgG indices and oligoclonal bands (OCB) compared to ION (q=0·0007, q=0·0058 and q=0·0021, respectively). CSF levels of IL-10, TNF-a, IL-17A and CXCL13 in MS-ON patients correlated with leukocyte counts (r>0·69 and p 0·55, p<0·037). CSF NF-L levels were increased in ON patients compared to HC (q=0·0077). In MS-ON, an increase in NF-L levels were observed at 7 to 14 days after disease onset (r=0·73, p<0·0065). Receiver operating characteristic (ROC) curves for two multivariable prediction models were generated, with IL-10, CXCL13, and NF-L in one (candidate) and IgG index, OCB, and leukocytes in another (routine). Area under the curve was 0·89 [95% C.I.: 0·77-1] and 0·86 [0·74-0·98], respectively. Predictions of the risk of MS were illustrated by two nomograms. Interpretation: CSF TNF-α, IL-10, CXCL13 and NF-L levels were associated with development of MS, suggesting that the inflammatory and neurodegenerative processes occurred early in acute ON. The nomogram predictions may be useful in clinical diagnostics for MS. Funding: Region of Southern Denmark, Danish MS Society. Declaration of Interest: Mr. Olesen has nothing to disclose; Dr. Soelberg has nothing to disclose; Dr. Debrabant has nothing to disclose; Dr. Nilsson has nothing to disclose; Dr. Grauslund has nothing to disclose; Dr. Brandslund has nothing to disclose; Dr. Madsen has nothing to disclose; Dr. Paul Friedemann reports non-financial support from Novartis, non-financial support and other from Bayer, non-financial support and other from Sanofi Genzyme, non-financial support and other from Merck, non-financial support and other from Roche, outside the submitted work; Terry Smith is scientific advisor to Guthy-Jackson Charitable Foundation; Sven Jarius has nothing to disclose; Dr. Asgari has nothing to disclose. Ethical Approval: The research was carried out in compliance with Danish ethical regulations for clinical research and was approved by The Regional Health Research Ethics Committee for the Region of Southern Denmark (ref. no. S-20130137). All patients provided written informed consent.

Self-Care Activities among People with Multiple Sclerosis in Denmark: Use and User Characteristics

Background: People with multiple sclerosis (PwMS) are known to use a wide range of medical and non-medical treatments. This study aims at investigating the use of self-care activities within this patient group. Material and Methods: The study follows a descriptive cross-sectional design based on an online survey among members of the Danish Multiple Sclerosis Society's permanent respondent panel. Results: The results of the study indicate that the respondents carry out a wide variety of self-care activities. These activities comprise conventional activities as well as complementary and alternative medicine (CAM)-based activities. The self-care activities are mainly kept up for non-specific and preventive purposes, with primarily personal or non-specific issues as the primary source of inspiration. Comparative analyses indicate that respondents with a low level of self-care more often are men, belong to the young age group and have a low level of education, a low level of self-assessed state of health, a low level of self-assessed quality of life (QoL), and an unknown subdiagnosis. Respondents with a high level of self-care are more often women and have a high level of self-assessed QoL. Conclusions: A wide variety of self-care activities are carried out by PwMS, comprising conventional as well as CAM-based activities. The purposes of such activities are manifold, but they are mainly of non-specific and preventive nature. Differences in background characteristics exist between groups of low and high levels of self-care.

Use of bodily sensations as a risk assessment tool: exploring people with Multiple Sclerosis’ views on risks of negative interactions between herbal medicine and conventional drug therapies

BackgroundMost users of complementary and alternative medicine (CAM) combine it with conventional medicine. Recent risk assessment studies have shown risks of negative interactions between CAM and conventional medicine, particularly when combining herbal medicine and conventional drug therapies (CDT). Little is known about the way users consider such risks. The present paper aims to gain knowledge about this issue by exploring views on risks of negative interactions when combining herbal medicine and CDT among people with multiple sclerosis (MS).MethodsThis paper draws on a qualitative follow-up study on a survey among members of the Danish MS Society. Semi-structured, in-depth qualitative interviews were conducted with a strategic selection from the survey respondents. The study was inspired by a phenomenological approach and emerging themes were extracted from the data through meaning condensation.ResultsFour themes characterized the informants’ views on risks of negative interactions when combining herbal medicine and CDT: 1) ‘naturalness’ in herbal medicine; 2) ‘bodily sensations’ as guidelines; 3) trust in the CAM practitioner; 4) lack of dialogue with medical doctor.ConclusionsGenerally, the combination of herbal medicine and CDT was considered by the informants to be safe. In particular, they emphasized the ‘non-chemical’ nature of herbal medicine and of their own bodily sensations as warrants of safety. A trustful relation to the CAM practitioner furthermore made some of them feel safe in their use of herbal medicine and CDT in combination. The informants’ use of bodily sensations as a non-discursive risk assessment may be a relevant element in understanding these issues.

An investigation of multidisciplinary complex health care interventions – steps towards an integrative treatment model in the rehabilitation of People with Multiple Sclerosis

BackgroundThe Danish Multiple Sclerosis Society initiated a large-scale bridge building and integrative treatment project to take place from 2004–2010 at a specialized Multiple Sclerosis (MS) hospital. In this project, a team of five conventional health care practitioners and five alternative practitioners was set up to work together in developing and offering individualized treatments to 200 people with MS. The purpose of this paper is to present results from the six year treatment collaboration process regarding the development of an integrative treatment model.DiscussionThe collaborative work towards an integrative treatment model for people with MS, involved six steps: 1) Working with an initial model 2) Unfolding the different treatment philosophies 3) Discussing the elements of the Intervention-Mechanism-Context-Outcome-scheme (the IMCO-scheme) 4) Phrasing the common assumptions for an integrative MS program theory 5) Developing the integrative MS program theory 6) Building the integrative MS treatment model. The model includes important elements of the different treatment philosophies represented in the team and thereby describes a common understanding of the complexity of the courses of treatment.SummaryAn integrative team of practitioners has developed an integrative model for combined treatments of People with Multiple Sclerosis. The model unites different treatment philosophies and focuses on process-oriented factors and the strengthening of the patients’ resources and competences on a physical, an emotional and a cognitive level.

Clinical Efficacy of Laquinimod for the Treatment of Multiple Sclerosis; Pooled Analyses from the ALLEGRO and BRAVO Phase III Trials (S01.007)

Clinical Efficacy of Laquinimod for the Treatment of Multiple Sclerosis; Pooled Analyses from the ALLEGRO and BRAVO Phase III Trials (S01.007)

Potentials and barriers in cooperation between conventional and complementary practitioners at a Danish Multiple Sclerosis Hospital

Introduction: More than 50% of the People with Multiple Sclerosis (PwMS) in Denmark have used complementary and alternative medicine (CAM). The majority of these combine CAM and conventional treatment, and from 2004 to 2010 the Danish Multiple Sclerosis Society conducted a research project with the purpose of investigating and testing models for cooperation between conventional and complementary practitioners. Theory: Five health care providers and five CAM practitioners were set up to work together from 2004 to 2010 in developing and offering integrated treatment to 200 PwMS at a Danish MS Hospital. The investigation of the collaborative process between practitioners has been based on theories of epistemic cultures as well as learning theories, focusing on interdisciplinary development. Methods: Empirical material consists of individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish MS Hospital, interviews with patients as well as written responses from the practitioners. Results and conclusions: The six-year cooperation among the practitioners documented mutual inspiration and learning within the team, as well as numerous basic challenges involved in developing interdisciplinary treatment for PwMS. Cooperation between researchers and the treatment team resulted in the development of four interdisciplinary models, which describe the potentials and barriers in relation to various types of collaboration. Discussions: In many cases, integrating CAM and conventional treatment providers is seen as an ideal. This paper points out the importance of not overlooking the opportunities, values and the potential inherent in a pluralistic ideal in terms of the patients’ own active efforts and the dynamism that can arise when the patient becomes a co-informant, co-coordinator and/or co-integrator.

Types of treatment collaboration between conventional and alternative practitioners – results from a research project at a Danish MS hospital

More than 50% of People with Multiple Sclerosis (PwMS) in Denmark use alternative treatment. Most of them combine alternative and conventional treatment, but PwMS often find that they engage in parallel courses of treatment between which there is no dialogue, coordination or synergy. For this reason the Danish Multiple Sclerosis Society conducted a research project to develop and examine different models for collaboration between conventional and alternative treatment providers. The empirical material consisted of 10 individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish Multiple Sclerosis hospital that provided the organisational framework for the project, interviews with 59 patients and written responses from participating treatment providers in connection with 29 practitioner-researcher seminars held during the period 2004-2010. Collaboration between researchers and the treatment team resulted in the development and examination of several models which describe the strengths and weaknesses of various types of collaboration. The models show that the various types of collaboration place different requirements on the degree of 1) mutual acknowledgement and understanding among practitioners and 2) flexibility and resources in the organizational framework. The analyses also point to the fact that the degree of patient activity must be considered in relation to a given type of collaboration. The relationship between integration and pluralism can contribute to a fruitful discussion in regards to the value of treatment collaboration. In addition to the many positive perspectives that characterise integration of different treatment modalities the project points to the importance of not overlooking the opportunities, values and potential inherent in a pluralistic ideal in the form of patients' own active efforts and the dynamism that can arise when the patient becomes a co-informant, co-coordinator and/or co-integrator.

VITAMIN B12 IN THE SERUM AND CEREBROSPINAL FLUID IN NEUROLOGICAL DISEASES

Acta Neurologica ScandinavicaVolume 38, Issue 4 p. 241-255 VITAMIN B12 IN THE SERUM AND CEREBROSPINAL FLUID IN NEUROLOGICAL DISEASES J. Worm-Petersen, Corresponding Author J. Worm-Petersen The Department of Biochemistry, University of Copenhagen (Former head: Professor Rich. Ege, present head: Professor Frank Lundquist) and the Department of Neurology, Kommunehospitalet, Copenhagen (Torben Fog, M.D.)J. Worm-Petersen, M.D. Universitetes Biokemiske Institut, Juliane Mariesvej 30, Copenhagen.Search for more papers by this author J. Worm-Petersen, Corresponding Author J. Worm-Petersen The Department of Biochemistry, University of Copenhagen (Former head: Professor Rich. Ege, present head: Professor Frank Lundquist) and the Department of Neurology, Kommunehospitalet, Copenhagen (Torben Fog, M.D.)J. Worm-Petersen, M.D. Universitetes Biokemiske Institut, Juliane Mariesvej 30, Copenhagen.Search for more papers by this author First published: December 1962 https://doi.org/10.1111/j.1600-0404.1962.tb01098.xCitations: 12 Aided by a grant from the Danish Multiple Sclerosis Society. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume38, Issue4December 1962Pages 241-255 RelatedInformation

Researching bridge building between conventional health care providers and alternative therapists at a specialized MS hospital

The Danish Multiple Sclerosis Society (a patient organization) has initiated a research-based bridge-building and treatment project to take place from 2004 to 2010 at a specialized MS hospital. The background for initiating the project was the recognition of the facts that Persons with Multiple Sclerosis (PwMS) like other persons with chronic diseases increasingly use both alternative and conventional treatment and that the role of the patient is changing and challenging the role of the health care provider. The modern PwMS are expanding their universe of knowledge and are moving towards a manager position in their choice of treatment and self care that improve their living with MS. The PwMS continuously assess the treatment processes and results in the context of their daily life and demand more comprehensive treatment/care approaches taking into account their goals and changes in their goals. The purposes of the project are: (1) to evaluate the bridge-building process developing between five conventional health care providers and five alternative therapists involved in order to develop a model in practice for bridge building between conventional and alternative practitioners and (2) to evaluate the health-related change processes initiated by the team-based treatment. In previous research, little attention has been paid to the bridge-building process between conventional health care providers and alternative therapists in developing patient-centred treatment approaches. To promote a constructive dialogue between the health care providers and alternative therapists on the differences and similarities in their thoughts and actions related to the treatment of PwMS and their goals, we developed a tool to facilitate confrontation and to make conflicts visible, explicit and legitimate. The tool is called the IMCO scheme which is an abbreviation of Intervention, Mechanism, Context and Outcomes. In the paper we will outline the use of the tool as well as the experience and knowledge gathered when building the tool facilitates. We will give examples from IMCO schemas filled in by the neurologist, the occupational therapist, the physical therapist, the psychologist, the nurse, the acupuncturist, the nutritional therapist, the classical homeopath, the craniosacral therapist and the reflexologist. The potential for developing a dynamic program theory on the significance for patients of the combined efforts by the team will be explored.

The IMCO Scheme as a Tool in Developing Team-Based Treatment for People with Multiple Sclerosis

The Danish Multiple Sclerosis Society (a patient organization) has initiated a research-based bridge-building and integrative treatment project to take place from 2004 to 2010 at a specialized MS hospital. The background for initiating the project was an increasing use of alternative treatment documented among persons with multiple sclerosis (PwMS). From PwMS there has been an increasing demand upon The Danish Multiple Sclerosis Society to initiate the project. The overall purpose of the project is to examine whether collaboration between 5 conventional and 5 alternative practitioners may optimize treatment results for people who have multiple sclerosis (MS). The specific aim of this paper is to present tools used in developing collaboration between the conventional and alternative practitioners. Two main tools in developing collaboration between the practitioners are described: (1) the planning and conduction of 4 practitioner-researcher seminars in the prephase of the project before recruiting patients with MS; and (2) the IMCO scheme (which is an abbreviation of Intervention, Mechanism, Context, and Outcomes). This tool was developed and used at practitioner-researcher seminars to make visible the different practitioners' treatment models and the patient-related treatment courses. Examples of IMCO schemes filled in by the medical doctor and the classical homeopath illustrate significant differences in interventions, assumptions concerning effect mechanisms, and awareness of contexts facilitating and inhibiting the intervention to generate the outcomes expected and obtained. The IMCO schemes have been an important tool in developing the team-based treatment approaches and to facilitate self-reflection on the professional role as a health care provider. We assume that the IMCO scheme will be of real value in the development of effective treatment based on collaboration between conventional and alternative practitioners.

Bridge Building and Integrative Treatment of People with Multiple Sclerosis. Research-based Evaluation of a Team-building Process

Background: The Danish Multiple Sclerosis Society has initiated a research project dealing with bridge building and integrative treatment. Little attention has been paid to research on the experience of conventional and alternative practitioners with bridge building and integrative treatment through teamwork. Objective: The objective of this article is to describe essential features of the preparatory phase of the research project focusing on the process of initiating and developing a team of conventional and alternative practitioners before treating people with Multiple Sclerosis at a specialized MS hospital in Denmark. The team consists of five conventional and five alternative practitioners. Materials and Methods: The preparatory phase took place from August 2004 to May 2005. In-depth, semi-structured interviews were conducted with the ten team practitioners. Each practitioner was interviewed before and eight months after joining the team, and after participating in four practitioner-researcher seminars. Written materials and participatory observations of practitioner-researcher seminars have been used in addition. Results: The team-building process involved motivation, emotions, challenges, professional and personal competences, and the development of a professional team identity. The practitioners assessed the preparatory phase based on researcher-practitioner seminars as an essential basis for moving on to provide treatments to people with MS.

Preliminary Initiatives in a Bridge Building Project between Conventional and Alternative Practitioners in Denmark

A growing number of the approximately7,400 persons with multiple sclerosis (MS) in Denmarkuse alternative treatments. The Danish Multiple SclerosisSociety has been experiencing an increasing demand forresearch on the effects of combined conventional and alternativetreatments. For this reason, the Society has initiateda bridge building project to be implemented from2004-2011 at a specialized MS hospital. In that project, ateam of five conventional and five alternative practitionersworks together and offers integrative treatments to atotal of 400 MS patients. Objective: The overall purposeof the project is to examine if integrative treatments mayoptimize treatment results for people suffering from MS,and to develop a model for a bridge building cooperationof conventional and alternative practitioners in the future.Material and Methods: In this article we give anoverview of the steps taken before establishing the hospital-based team of practitioners: (1) a public hearing attendedby conventional and alternative practitioners experiencedin treating MS patients; (2) qualitative interviewsamong conventional practitioners at a specializedMS hospital; (3) a literature study on the use and effectsof alternative treatments and integrative treatments relatedto MS. Results: The knowledge gained in the preliminarysteps of the project showed that we had to adda preparatory phase to the project focusing on the developmentof the team before it would start treating MS patients.

The Danish Multiple Sclerosis Registry: a 50-year follow-up.

The Danish Multiple Sclerosis Registry was established in 1948 in continuation with a nationwide survey of the prevalence of Multiple Sclerosis (MS) in Denmark. The register has since collected information on MS patients from all Danish departments of neurology, practising neurologists, MS rehabilitation centres, the National Patient Registry, the Danish MS Society, and departments of neuropathology. The registry is linked with the Danish Central Population Registry. The completeness has been estimated at more than 90%. All cases are reclassified by two neurologists as to diagnosis and year of onset. 12 070 cases with a confirmed diagnosis of MS are kept in the databases. They were prevalent in 1949 or have had onset in the period 1948 - 1993. The registry is continuously updated with new information on registered cases and new cases. The crude average annual incidence rate 1980 - 89 was 4.99/105; the prevalence rate was 112/105 by 1 January 1990. Cross-linking with other registers have enabled analytical prospective epidemiological studies, and the registry has provided population based unbiased samples of patients for a number of clinical studies.

The Danish Multiple Sclerosis Registry: a 50-year follow-up

The Danish Multiple Sclerosis Registry was established in 1948 in continuation with a nationwide survey of the prevalence of Multiple Sclerosis (MS) in Denmark The register has since collected information on MS patients from all Danish departments of neurology, practising neurologists, MS rehabilitation centres, the Notional Patient Registry, the Danish MS Society, and departments of neuropathology. The registry is linked with the Danish Central Population Registry. The completeness has been estimated at more than 90%. All cases are reclassified by two neurologists as to diagnosis and year of onset 12 070 cases with a confirmed diagnosis of MS are kept in the databases. They were prevalent in 1949 or have had onset in the period 1948 - 1993. The registry is continuously updated with new information on registered cases and new cases. The crude average annual incidence rate 1980-89 was 4.99/10 5 ; the prevalence rate was 112/10 5 by I January 1990. Cross-linking with other registers have enabled analytical prospective epidemiological studies, and the registry has provided population based unbiassed samples of patients for a number of clinical studies.

Social remedial measures for multiple sclerosis patients in Denmark.

A total of 57 patients admitted to the Danish Multiple Sclerosis Society's treatment and nursing home in Haslev have been interviewed about their socio-medical situation concerning their course of disease, physical, psychic and economic status, family relationships, and different assistance needs. Sixty per cent lived together, and of the solitary only 9 were unmarried. None were employed fulltime and as a whole they received higher allowances than other disabled persons. All suffered from walking impairment. 17 had no wheelchair, 21 had a wheelchair and limited walking ability, 19 could move around only by wheelchair. None were bedridden. The distribution of housing corresponded to that of other disabled persons but was inferior to that of the population as a whole. 54 per cent had got modifications to housing paid for by the public authorities and 42 per cent had a car for the disabled. 47 per cent alleged that their need for transportation remained uncared for. None of the patients were lonely to a severe degree. Expenses for medicine and transportation varied greatly, showing inequality of grant administration. The results of the investigation are discussed.

Allergic encephalomyelitis induced by brain antigen after deficiency in polyunsaturated fatty acids during myelination. Is multiple sclerosis a nutritive disorder?

Acta Neurologica ScandinavicaVolume 43, Issue 3 p. 375-388 ALLERGIC ENCEPHALOMYELITIS INDUCED BY BRAIN ANTIGEN AFTER DEFICIENCY IN POLYUNSATURATED FATTY ACIDS DURING MYELINATION Is Multiple Sclerosis a Nutritive Disorder? Jørgen Clausen, Corresponding Author Jørgen Clausen Neurochemical Institute, National Danish Multiple Sclerosis Society and the Laboratory of Psychiatry (Neuropathology), University of Copenhagen, Denmark.J. Clausen and J. Møller, Pindehuggervang 25, Holte, Denmark.Search for more papers by this authorJørn MØLLER, Corresponding Author Jørn MØLLER Neurochemical Institute, National Danish Multiple Sclerosis Society and the Laboratory of Psychiatry (Neuropathology), University of Copenhagen, Denmark.J. Clausen and J. Møller, Pindehuggervang 25, Holte, Denmark.Search for more papers by this author Jørgen Clausen, Corresponding Author Jørgen Clausen Neurochemical Institute, National Danish Multiple Sclerosis Society and the Laboratory of Psychiatry (Neuropathology), University of Copenhagen, Denmark.J. Clausen and J. Møller, Pindehuggervang 25, Holte, Denmark.Search for more papers by this authorJørn MØLLER, Corresponding Author Jørn MØLLER Neurochemical Institute, National Danish Multiple Sclerosis Society and the Laboratory of Psychiatry (Neuropathology), University of Copenhagen, Denmark.J. Clausen and J. Møller, Pindehuggervang 25, Holte, Denmark.Search for more papers by this author First published: July 1967 https://doi.org/10.1111/j.1600-0404.1967.tb05740.xCitations: 77 The gas-chromatographic equipment used was purchased from a research grant from The MIFU organization, Copenhagen, Denmark. These investigations have been supported by grant No. NB 05216–02, National Institute of Health, Education, and Welfare, Bethesda, U.S.A. A part of these studies have been presented on the “Nordforsk” meeting, Trondheim, Norway, April 1966. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume43, Issue3July 1967Pages 375-388 RelatedInformation

Phospholipid and glycolipid patterns of infant and foetal brain. Thin-layer chromatographic studies.

Journal of NeurochemistryVolume 12, Issue 7 p. 599-606 PHOSPHOLIPID AND GLYCOLIPID PATTERNS OF INFANT AND FOETAL BRAIN THIN-LAYER CHROMATOGRAPHIC STUDIES J. Clausen, J. Clausen From the Biochemical Department, University of Copenhagen and The Perinatal Research Laboratory, supported by the Association for the Aid for Crippled Children, New York.Search for more papers by this authorH. O. christensen Lou, H. O. christensen Lou From the Biochemical Department, University of Copenhagen and The Perinatal Research Laboratory, supported by the Association for the Aid for Crippled Children, New York. H. O. C. L. is a Research Fellow under the auspices of The Danish Multiple Sclerosis Society, Copenhagen, Denmark.Search for more papers by this authorH. Andersen, H. Andersen From the Biochemical Department, University of Copenhagen and The Perinatal Research Laboratory, supported by the Association for the Aid for Crippled Children, New York.Search for more papers by this author J. Clausen, J. Clausen From the Biochemical Department, University of Copenhagen and The Perinatal Research Laboratory, supported by the Association for the Aid for Crippled Children, New York.Search for more papers by this authorH. O. christensen Lou, H. O. christensen Lou From the Biochemical Department, University of Copenhagen and The Perinatal Research Laboratory, supported by the Association for the Aid for Crippled Children, New York. H. O. C. L. is a Research Fellow under the auspices of The Danish Multiple Sclerosis Society, Copenhagen, Denmark.Search for more papers by this authorH. Andersen, H. Andersen From the Biochemical Department, University of Copenhagen and The Perinatal Research Laboratory, supported by the Association for the Aid for Crippled Children, New York.Search for more papers by this author First published: July 1965 https://doi.org/10.1111/j.1471-4159.1965.tb04252.xCitations: 29 These investigations have been supported by grants from the Danish Multiple Sclerosis Society, The Fund for Promotion of Medical Science in Denmark and from the Technical Research Fund in Denmark, Copenhagen, Denmark. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume12, Issue7July 1965Pages 599-606 RelatedInformation