Epidemiologic characteristics of multiple sclerosis

Kurland, Leonard T.

doi:10.1016/0002-9343(52)90236-2

Cited by 45 publications

(17 citation statements)

References 21 publications

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“…Men, being the primary breadwinners in the late nineteenth and early twentieth centuries, were more likely to have sought medical attention if symptoms interfered with work (Murray 2005). However, since the middle of the twentieth century, reports have described MS to be more frequent in women (Kurland 1952;Schumacher 1960;McAlpine 1961), and by 1980, the female to male ratio of MS was reported to be 2:1 (Confavreux et al 1980). More recently, a number of systematic reviews have conducted an evaluation of the sex ratio and the incidence of MS in well-characterized cohorts who were followed longitudinally (Alonso and Hernan 2008;Koch-Henriksen and Sorensen 2010).…”

Section: Rise In the Female Preponderance Of Ms: Role For Environmentmentioning

confidence: 99%

Sex-Based Differences in Multiple Sclerosis (MS): Part II: Rising Incidence of Multiple Sclerosis in Women and the Vulnerability of Men to Progression of this Disease

Dunn

Gunde

Lee

2015

Emerging and Evolving Topics in Multiple Sclerosis Pathogenesis and Treatments

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It is well known that a number of autoimmune diseases including multiple sclerosis (MS) predominantly affect women and there has been much attention directed toward understanding why this is the case. Past research has revealed a number of sex differences in autoimmune responses that can account for the female bias in MS. However, much less is known about why the incidence of MS has increased exclusively in women over the past half century. The recency of this increase suggests that changing environmental or lifestyle factors are interacting with biological sex to increase MS risk predominantly in females. Indeed, a number of recent studies have identified sex-specific differences in the effect of environmental factors on MS incidence. The first part of this chapter will overview this evidence and will discuss the possible scenarios of how the environment may be interacting with autoimmune mechanisms to contribute to the preferential rise in MS incidence in women. Despite the strong female bias in MS incidence, culminating evidence from natural history studies, and imaging and pathology studies suggests that males who develop MS may exhibit a more rapid decline in disability and cognitive functioning than women. Very little is known about the biological basis of this more rapid deterioration, but some insights have been provided by studies in rodent models of demyelination/remyelination. The second part of this chapter will overview the evidence that males with relapsing-onset MS undergo a more rapid progression of disease than females and will discuss potential biological mechanisms that account for this sex difference.

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Section: Rise In the Female Preponderance Of Ms: Role For Environmentmentioning

confidence: 99%

Sex-Based Differences in Multiple Sclerosis (MS): Part II: Rising Incidence of Multiple Sclerosis in Women and the Vulnerability of Men to Progression of this Disease

Dunn

Gunde

Lee

2015

Emerging and Evolving Topics in Multiple Sclerosis Pathogenesis and Treatments

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“…The month of birth effect on increasing trend in female to male ratio of MS risk is consistent with relatively recent reports of similar findings in other countries [3,18] . Females' increased vulnerability to MS remained unrecognized for quite some time [6,31] . But later on, a disproportionate increased number of female than male MS patients (female:male ratio of 1.4) was suggested by a review of cross-sectional studies [32] .…”

Section: Discussionmentioning

confidence: 99%

“…For quite some time, MS was regarded as a disease of men, possibly due to substantial under-diagnosis of this condition among women [5,6] . However, this elusive notion gradually started waning, when an increase in sex ratio (female:male) from 1.9 to 3.2 was observed in birth cohorts of MS patients born during 1936-1940 and 1976-1980 in Canada [3] .…”

Section: Introductionmentioning

confidence: 99%

Retrospective Cohort Study of Gender Differential in Risk of Multiple Sclerosis in Kuwait

et al. 2016

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Background: Despite an increase in the incidence of multiple sclerosis (MS) in the Middle-East, there is a paucity of published data on sex ratio among MS patients in the region. Therefore, this retrospective cohort study determined sex ratio by year of birth of MS patients born from January 1, 1950, to December 31, 2000, who were diagnosed and registered in the Kuwait National MS Registry till April 30, 2013. Methods: Patients were classified into 5-year periods according to their year of birth. Sex ratio (female:male) and its 95% CI for each period were computed. Using binomial logistic regression, sex ratio in MS patients was modeled with respect to year of birth and nationality. Results: Of 1,035 patients with MS, 675 (65.2%) were women and 798 (77.1%) Kuwaiti. Sex ratio (female:male) of MS cases for entire study period was 1.9 (range 0.4-3.0). Multivariable logistic regression model showed that with each passing year of birth, there was statistically significant 8% increase in sex ratio (female:male) for vulnerability to MS risk (adjusted OR 1.08; 95% CI 1.06-1.09; p < 0.001). Conclusions: There was a statistically significant steady increase on logarithmic scale in the gender disparity for MS risk over the study period. This study from the Middle-East adds to the existing persuasive evidence of enhanced MS risk in women. Further insight in the context of differential risk factors including the role of sex hormones and vitamin D deficiency in MS pathogenesis may help designing preventive strategies.

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“…Globally it is the more probable for people to acquire the disease, the farther from the equator they have grown up (Kurland 1975). …”

Section: (B) Epidemiological and Clinical Findingsmentioning

confidence: 99%

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2017

JTAVR

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Epidemiologic characteristics of multiple sclerosis

Cited by 45 publications

References 21 publications

Sex-Based Differences in Multiple Sclerosis (MS): Part II: Rising Incidence of Multiple Sclerosis in Women and the Vulnerability of Men to Progression of this Disease

Sex-Based Differences in Multiple Sclerosis (MS): Part II: Rising Incidence of Multiple Sclerosis in Women and the Vulnerability of Men to Progression of this Disease

Retrospective Cohort Study of Gender Differential in Risk of Multiple Sclerosis in Kuwait

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