Increase In Incidence Of Multiple Sclerosis Research Articles

Age-period-cohort analysis of the incidence of multiple sclerosis over twenty years in Lorraine, France

Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system. An increase in MS incidence over time is reported in several regions of the world. We aimed to describe the evolution of the annual MS incidence in the Lorraine region, France, from 1996 to 2015 and to analyze potential components of a possible change by a temporal effect of age at MS onset, MS onset period, and birth cohort, overall and for each sex. Cases were identified from ReLSEP, a population-based registry of MS cases living in Lorraine, northeastern France, with MS onset between 1996 and 2015. Age-period-cohort modeling was used to describe trends in MS incidence. Annual age- and sex-standardized incidences were relatively stable: 6.76/100 000 population (95%CI [5.76–7.91]) in 1996 and 6.78/100 000 (95%CI [5.72–7.97]) in 2015. The incidence ratio between women and men was 2.4. For all time periods, the peak incidence occurred between ages 25 and 35 years. Age-period–adjusted cohort and age-cohort–adjusted period analyses did not reveal a period or cohort effect. The incidence of MS remained stable over the study period in Lorraine, and we could not identify any particular effect of disease onset period or birth period on this evolution.

How to Heal Patient with Multiple Sclerosis

Multiple Sclerosis (MS) has been defined as an inflammatory demyelinating condition afflicting more than 2.8 million people worldwide. Meta-regression analyses of studies on MS epidemiology since 1965 revealed an almost universal increase in prevalence and incidence of MS over time; and suggest a general increase in incidence of MS in females.

Prevalence and Incidence of Multiple Sclerosis in Russian Federation: 30 Years of Studies.

In the Russian Federation, multiple sclerosis prevalence rates vary from 10 to 80 cases per 100,000, depending on region and the nationality of the population. The main characteristics of multiple sclerosis epidemiology in the XX century in this big territory are: (1) steady increase in multiple sclerosis prevalence and incidence rates, maybe because of better diagnosis and treatment, but also changes in environmental/epigenetic risk profile and/or lifestyle factors; (2) increase of the female to male ratio, increase in multiple sclerosis incidence mainly in females; (3) appearance and increasing frequency of multiple sclerosis in ethnic groups, previously free of multiple sclerosis (Northern Tribes, Yakuts and others). The latest data show that in European Russia, the multiple sclerosis prevalence varies from 30 to 80 cases, in Siberia—from 20 to 70 cases, with steady increases, especially in women.

Modifiable environmental factors – Role and impact of (including evidence for intervention)

It is now generally accepted that multiple sclerosis (MS) is a multifactorial disease occurring in genetically susceptible individuals upon exposure to environmental factors. The importance of environmental factors in MS is supported by discordance in monozygotic twins, geographical distribution of MS prevalence, migration studies, increase in MS incidence and changes of gender ratio over time, among others. Robust evidence supports the role of EBV, smoking, UV radiation/vitamin D and obesity during adolescence as environmental factors. Some evidence also suggests the involvement of other factors such as night shift work, organic solvents, concussions, salt intake, melatonin, parasites, coffee and alcohol consumption as well as dysbiosis of the gut microbiome. Environmental factors play a role not only in the susceptibility to develop MS but also in disease activity and disability progression. Furthermore, it has been shown that environmental factors interact among one another and with genetic factors. Whether there is a critical time period during which exposure to these factors is most important is still not fully understood. However, modifying these factors once MS is established might still have an impact in the disease course, as is the case of smoking cessation. Overall, this suggests that interventions directed towards modifying environmental and lifestyle factors could prevent some MS cases and improve the prognosis in MS patients. However, our understanding of the underlying pathogenic mechanisms of these factors and the impact of their modification is still limited. Future research to identify other environmental factors and to investigate the impact of intervention over known environmental factors is necessary.

The changing course of multiple sclerosis: rising incidence, change in geographic distribution, disease course, and prognosis.

This review provides a brief update of new research findings on the changing epidemiology, disease course, and prognosis of multiple sclerosis (MS). Evidence not only continues to support the female predominance in incidence and prevalence of the disease but also supports an increase in incidence of MS in geographic areas that were previously considered to be low incidence for the disease. An increased interest in population-based registries and databases will provide more valid epidemiological measures and observational studies conducted in well-defined study populations. Such studies are crucial for an accurate description of both changing prognosis of MS and differential characteristics of the various MS phenotypes.

Multiple Sclerosis Female to Male Ratio Trend from 1999 to 2017 in Tehran, Iran

Background: Multiple sclerosis (MS) affects more than 2.5 million people worldwide. Several studies in asia revealed an almost regional and national increase in prevalence and incidence of MS over time; and suggest a general increase in incidence of MS in females. Our goal is to evaluate overall trend and patterns of MS and sex-specific changes of incidence and prevalence.

Blood Concentrations of Cadmium and Lead in Multiple Sclerosis Patients from Iran.

Since industrial revolution heavy metals such as lead (Pb) and cadmium (Cd) have been extensively dispersed in environment which, unknown biological effects and prolong biological half-life make them as a major hazard to human health. In addition, the sharp increase in Multiple sclerosis incidence rateshas been recorded in Iran. The propose of this study was to measuring blood lead and cadmium concentration and their correlation with smoking habit in a group of 69 RRMS patients and 74 age/gender-matched healthy individuals resident in Tehran as most polluted city in Iran. All subjects were interviewed regarding age, medical history, possible chemical exposure, acute or chronic diseases, smoking and dietary habits. Blood Pb and Cd levels were measured by double beam GBC plus 932 atomic absorption spectrometer. Our result indicated a significant difference in Cd level (p = 0.006) in which, MS patients had higher blood concentration (1.82 ± 0.13 μg/L) in comparison with healthy individuals (1.47 ± 0.11 μg/L). A comparable blood Cd level to similar recent study (1.78 µg/L vs.1.82 µg/L) was observed. With respect to Pb there was no significant difference between cases and controls, however the geometric means of blood Pb concentration were considerably higher in males than in females in MS patients (57.1 ± 33.7 μg/L vs. 36.7 ± 21.9 μg/L. P = 0.02). Taking into consideration tobacco smoking, an elevated contents of each metal were observed in smoker subjects (p<0.0001). A significant correlation between cigarette smoking and risk of multiple sclerosis was shown before. Thus, high level of Cd in smokers might affect the susceptibility to multiple sclerosis and could increase the risk of disease development.

Качество жизни у больных рассеянным склерозом проживающих в северном регионе в зависимости от когнитивного статуса

Multiple sclerosis is the most frequent disease of the central nervous system. An increase in multiple sclerosis frequency was registered in several countries including Russia. This may be associated with better multiple sclerosis diagnosis and treatment, better data collection and real increase in multiple sclerosis incidence. Early disability and its rapid progression emphasize the medico-social importance of multiple sclerosis. Neuropsychological disturbances are often observed in multiple sclerosis, being one of the important components in the formation of clinical disease. 43 patients living in the North region with definite multiple sclerosis and mild or moderate disability were tested with expended neuropsychological, neurological and study of quality of life. The purpose of the study was to analyze the role of cognitive, emotional and personal peculiarities at multiple sclerosis on quality of life. To assess quality of life the authors used SF-36. The results of this study of quality of life revealed significant differences in the physical, role and social components depending on the cognitive peculiarities.

Incidence of multiple sclerosis among European Economic Area populations, 1985-2009: the framework for monitoring

BackgroundA debate surrounding multiple sclerosis epidemiology has centred on time-related incidence increases and the need of monitoring. The purpose of this study is to reassess multiple sclerosis incidence in the European Economic Area.MethodsWe conducted a systematic review of literature from 1965 onwards and integrated elements of original research, including requested or completed data by surveys authors and specific analyses.ResultsThe review of 5323 documents yielded ten studies for age- and sex-specific analyses, and 21 studies for time-trend analysis of single data sets. After 1985, the incidence of multiple sclerosis ranged from 1.12 to 6.96 per 100,000 population, was higher in females, tripled with latitude, and doubled with study midpoint year. The north registered increasing trends from the 1960s and 1970s, with a historic drop in the Faroe Islands, and fairly stable data in the period 1980-2000; incidence rose in Italian and French populations in the period 1970-2000, in Evros (Greece) in the 1980s, and in the French West Indies in around 2000.ConclusionsWe conclude that the increase in multiple sclerosis incidence is only apparent, and that it is not specific to women. Monitoring of multiple sclerosis incidence might be appropriate for the European Economic Area.

Situación epidemiológica actual de la esclerosis múltiple: pertinencia y puesta en marcha de un registro poblacional de nuevos casos en Cataluña

The first epidemiological studies on multiple sclerosis (MS) around the world pictured a north to south latitudinal gradient that led to the first genetic and environmental pathogenic hypothesis. MS incidence seems to be increasing during the past 20 years based on recent data from prospective studies performed in Europe, America and Asia. This phenomenon could be explained by a better case ascertainment as well as a change in causal factors. The few prospective studies in our area together with the increase in the disease in other regions, justifies an epidemiological MS project in order to describe the incidence and temporal trends of MS. A prospective multicenter MS registry has been established according to the actual requirements of an epidemiological surveillance system. Case definition is based on the fulfillment of the McDonald diagnostic criteria. The registry setting is the geographical area of Cataluna (northeastern Spain), using a wide network of hospitals specialized in MS management. Recent epidemiological studies have described an increase in MS incidence. In order to contrast this finding in our area, we consider appropriate to set up a population based registry.

Gender as a prognostic factor and its impact on the incidence of multiple sclerosis in Lorraine, France

We sought to identify (a) the change of incidence rates among gender from 1990 to 2002 from the LORSEP (Lorraine Multiple Sclerosis) population-based cohort, and (b) the role of gender as a predictive demographic factor of disability during the initial course of the disease among multiple sclerosis (MS) patients. The incidence rates of multiple sclerosis (MS) in Lorraine, France, have significantly increased in women, but not in men, from 1990 to 2002 but this increase in incidence of MS was not related to a better ascertainment of patients with mild disability. A total of 2871 MS patients were analyzed. For relapsing–remitting (RR) patients, a multivariate analysis showed that a shorter time to the assignment of an EDSS score of 3 and 4 was associated with the late onset MS, incomplete recovery from the first relapse and a high number of relapses during the first 5 years after the MS onset. Median times were not influenced by gender or by time between the first two relapses. The data were very different for the time between the assignment of scores of 4 and 6, since the median times were not influenced by any of the predicting variables.

Concordance and heritability of multiple sclerosis in Finland: study on a nationwide series of twins

To evaluate the changes in the multiple sclerosis (MS) concordance in twins, and the contribution of genetic and environmental factors to the aetiology of MS in Finland. Both genes and the environment contribute to the development of MS. A well-conducted twin study is an excellent means to assess the relative contribution of heritability and environmental factors. Multiple sclerosis concordance was assessed for 10 Monozygotic and 14 dizygotic twin pairs using pairwise and probandwise concordance rates. The tetrachoric correlations in liability to disease for twin pairs were computed and a polygenic multifactorial model was used to estimate heritability. The pairwise concordance for MZ twins was 30% and for the DZ twins 14.3%, compared with 30% for MZ and 0% for DZ 20 years ago. The corresponding probandwise concordance rates were 46.2% and 25%. The genetic variance (heritability) was 15.3% (95% Cl 0.0-77.6), the common environmental variance 73.7% (95% Cl 14.1-93.9) and the unique environmental variance 11.1% (95% Cl 2.3-30.0). As the concordance of MS in DZ twins has increased during the past two decades and the heritability estimate is low, it seems that the reported increase in MS incidence in Finland is mainly caused by environmental factors.

Estudio epidemiológico analítico sobre la esclerosis múltiple en Alcoi

Multiple sclerosis (MS) is a disease of controversial epidemiology, which has frequently been studied. The results of an epidemiological descriptive study in the Alcoi area led to a first case-control study to give information about the factors associated with the illness in this area. It was seen from this that migration, contact with dogs and with cloth might be related to it. To carry out a second analytical study, maintaining the migration factor stable to avoid the possible confounding effect with other associated factors. For this case-control study we grouped one case with four controls from the population according to age, sex and place of birth. All cases fulfilled criteria defined for MS and the controls were randomly selected from the census. We also classified the cases and controls into three groups, according to whether or not migration was involved (group A: Autochthonous; group B: Immigrants who arrived before the age of 13, and group C: Immigrants who arrived after the age of 13). We analyzed 40 patients and 160 controls. We obtained significant values for 'social group'. The cases belonged to the less favored social group both on overall analysis and in the autochthonous group. Pneumonia was the only infection with significant figures in patients over 15. Contact with dogs gave new statistically significant figures, together with cloth and cloth products. Persistence of positive correlation of MS with contact with dogs and cloth suggest the possible influence of these two factors in the increase in incidence of MS in this area.