Home Recommended Publications International publications Latitudinal variation in incidence and type of first central nervous system demyelinating events.

Latitudinal variation in incidence and type of first central nervous system demyelinating events.

Taylor BVLucas RMDear KKilpatrick TJPender MPvan der Mei IAChapman CCoulthard ADwyer TMcMichael AJValery PCWilliams DPonsonby AL.

Menzies Research Institute, University of Tasmania, Hobart, Australia. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Abstract

Increasing prevalence and variable geographic patterns of occurrence of multiple sclerosis suggest an environmental role in causation. There are few descriptive, population-level, data on whether such variability applies to first demyelinating events (FDEs). We recruited 216 adults (18-59 years), with a FDE between 1 November 2003 and 31 December 2006 in a multi-center incident case-control study in four locations on the south-eastern and eastern seaboard of Australia, spanning latitudes 27 degrees south to 43 degrees south. Population denominators were obtained from the Australian Bureau of Statistics censuses of 2001 and 2006. Age and sex adjusted FDE incidence rates increased by 9.55% (95% confidence interval (CI) 7.37-11.78, p < 0.001) per higher degree of latitude. The incidence rate gradient per higher degree of latitude varied by gender (male: 14.69% (95% CI 9.68-19.94, p < 0.001); female 8.13% (95% CI 5.69-10.62, p < 0.001)); and also by the presenting FDE type: optic neuritis 11.39% (95% CI 7.15-15.80, p < 0.001); brainstem/cerebellar syndrome 9.47% (95% CI 5.18-13.93, p < 0.001); and spinal cord syndrome 5.36% (95% CI 1.78-9.06, p = 0.003). Differences in incidence rate gradients were statistically significant between males and females (p = 0.02) and between optic neuritis and spinal cord syndrome (p = 0.04). The male to female ratio varied from 1 : 6.7 at 27 degrees south to 1 : 2.5 at 43 degrees south. The study establishes a positive latitudinal gradient of FDE incidence in Australia. The latitude-related factor(s) influences FDE incidence variably according to subtype and gender, with the strongest influence on optic neuritis presentations and for males. These descriptive case analyses show intriguing patterns that could be important for understanding the etiology of multiple sclerosis.

Mult Scler. 2010 Apr;16(4):398-405. Epub 2010 Feb 18.

 

Epidemiology


Highlights

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Desde el pasado 20 de marzo el Registro EPIDEMCAT permite introducir pacientes prevalentes, es decir, aquellos con inicio de los síntomas antes de 2009 para las formas en brotes y antes del 2006 para las fomas de inicio progresivo. De esta forma, el Registro será completo, permitiendo conocer el impacto global de la enfermedad en Catalunya. Para facilitar la identificación de los pacientes, se ha sustituído la calve identificativa DNI por el CIP.

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