Increasing female preponderance of multiple sclerosis in Isfahan, Iran: a population-based study

2010 ◽  
Vol 16 (3) ◽  
pp. 359-361 ◽  
Author(s):  
AH Maghzi ◽  
H. Ghazavi ◽  
M. Ahsan ◽  
M. Etemadifar ◽  
SA Mousavi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sex Ratio ◽  
Rank Correlation ◽  
Population Based ◽  
Vitamin D Insufficiency ◽  
Lifestyle Changes ◽  
Isfahan Province ◽  
Male Ratio ◽  
Spearman’S Rank Correlation ◽  
Environmental Interactions

There is an overall increase in the worldwide prevalence and incidence of multiple sclerosis (MS). Studies from several countries also demonstrated an increase of female/male ratio over time denoting an increase in the incidence of MS particularly in women. In this study we sought to assess the trends in MS incidence and prevalence in males and females over recent decades in Isfahan, Iran, which differs from other regions in terms of environmental and lifestyle changes. We determined female/male ratio by year of birth (YOB) in 1584 patients with MS registered with Isfahan Multiple Sclerosis Society (IMSS) from April 2003 to August 2007. A comparison of sex ratio of MS patients by YOB showed a significant, progressive, gradual increase, with an apparent interruption in the late 1960s. In this study year of birth is a significant predictor for sex ratio ( p < 0.001, χ2 = 17.130, Spearman’s rank correlation r = 0.893). Our findings show that there is a significant increase in the incidence of MS among females for the the last decades in the Isfahan province of Iran. This rapid increase may be related to changes in environmental interactions rather than genetic factors, and among them vitamin D insufficiency, enhanced diagnosis, and lifestyle changes appear to be more plausible causative factors.

scholarly journals Epidemiological and clinical features of pediatric-onset multiple sclerosis: A population-based study in Isfahan, Iran, between 1997-2020

2022 ◽  
Author(s):  
Masoud Etemadifar ◽  
Amir Parsa Abhari ◽  
Ghasem Yadegarfar ◽  
Mehri Salari ◽  
Mohammadreza Ghazavi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Incidence Rate ◽  
Clinical Features ◽  
Relative Rate ◽  
Disease Diagnosis ◽  
Population Based ◽  
Isfahan Province ◽  
Male Ratio ◽  
The Central Nervous System ◽  
Pediatric Onset

Background: Pediatric-onset multiple sclerosis (POMS) is an autoimmune demyelinating disorder of the central nervous system (CNS), affecting individuals younger than 18 years of age. We sought to characterize the epidemiological and clinical features of patients with POMS in Isfahan, Iran, from April 1997 to March 2020. Methods: The medical records of patients with POMS in the databases of Isfahan Department of Public Health and Isfahan Multiple Sclerosis Society (IMSS) were retrospectively reviewed. The 2006 and 2016 Isfahan Province population censuses were used as reference values for assessing the temporal trend of POMS. Results: From April 1997 to March 2020, 509 individuals under18 years of age were diagnosed with POMS in Isfahan. 404 of these patients (79.4%) were girls, and 105 patients (20.6%) were boys (a female to male ratio of 3.85:1). Most of the patients (83%) were monosymptomatic at onset, with optic neuritis and brainstem-cerebellar disorders being the most frequent initial presentations. Mean ± standard deviation (SD) of age at disease diagnosis was 15.8 ± 2.5 years (ranging from 3 to 18, mode = 18).From April 2019 to March 2020, the crude prevalence and the crude incidence rate of the POMS were  5.42 per 100000 and 1.86 per 100000, respectively. Poisson regression analysis revealed a 3.4% increase in the incidence rate of POMS from April 1997 to March 2020 [relative rate:1.034, 95% confidence interval (CI): 1.021-1.048]. Conclusion: The female to male ratio in our cohort was significantly higher than any other studies conducted previously. The high female to male ratio and increasing incidence of the disease suggest increasing regionalization of care.

scholarly journals Inter-Regional Variability in the Incidence of Skin and Subcutaneous Tissue Diseases of Children Aged 0–14 Years in the Russian Federation (а Population-Based Study)

2018 ◽  
Vol 15 (4) ◽  
pp. 349-353
Author(s):  
Eleonora I. Pilguy ◽  
Leyla S. Namazova-Baranova ◽  
Igor A. Gundarov
Keyword(s):  
Russian Federation ◽  
Coefficient Of Variation ◽  
Subcutaneous Tissue ◽  
Rank Correlation ◽  
Population Based ◽  
Regional Variability ◽  
Spearman’S Rank Correlation ◽  
Risk Aggregation ◽  
The Russian Federation ◽  
Range Of Variation

Background. An effective system for management of pediatric dermatological care in Russia requires taking into account the peculiarities of regional morbidity. According to modern literature, this issue is not sufficiently developed. Our aim was to study the characteristics of variability in the incidence of skin and subcutaneous tissue diseases of children aged 0–14 years in the Russian Federation. Methods. The data of the state medical statistics on 83 territorial entities of the Russian Federation for 2009–2015 was used. The analysis implemented the risk aggregation method. The degree of variability in regional morbidity was assessed by the range of variation and the coefficient of variation. Region rankings were carried out by the annual incidence. The Spearman’s rank correlation coefficient was used to study the stability of regions belonging to a certain ranked place. Results. In 2009, the incidence of skin and subcutaneous tissue diseases of children aged 0–14 years in the Russian Federation had a pronounced variability: the range of variation was 7.7 times, the coefficient of variation was 28%. The annual region rankings were carried out. In 2010–2015, the annual variability indices remained high. The coefficients of rank correlation when distributing regions by morbidity were in the range of 0.75–0.94 compared to 2009. Quintiles of regions with different levels of pediatric dermatological morbidity were singled out. Conclusion. The incidence of skin and subcutaneous tissue diseases in children aged 0–14 years in the territorial entities of the Russian Federation during 2009–2015 had a pronounced variability. Regions had a stable preference for a certain ranking place. The division of territorial entities of the Russian Federation into groups of pediatric dermatological morbidity are presented.

Prediction of long-term disability in multiple sclerosis

2011 ◽  
Vol 18 (1) ◽  
pp. 31-38 ◽  
Author(s):  
R Schlaeger ◽  
M D’Souza ◽  
C Schindler ◽  
L Grize ◽  
S Dellas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Motor Evoked Potentials ◽  
Rank Correlation ◽  
Daily Practice ◽  
Z Score ◽  
Monitoring Methods ◽  
Spearman’S Rank Correlation ◽  
Mri Scans ◽  
Cranial Mri

Background: Little is known about the predictive value of neurophysiological measures for the long-term course of multiple sclerosis (MS). Objective: To prospectively investigate whether combined visual (VEP) and motor evoked potentials (MEP) allow prediction of disability over 14 years. Methods: A total of 30 patients with relapsing–remitting and secondary progressive MS were prospectively investigated with VEPs, MEPs and the Expanded Disability Status Scale (EDSS) at entry (T0) and after 6, 12 and 24 months, and with cranial MRI scans at entry (T2-weighted and gadolinium-enhanced T1-weighted images). EDSS was again assessed at year 14 (T4). The association between evoked potential (EP), magnetic resonance (MR) data and EDSS was measured using Spearman’s rank correlation. Multivariable linear regression was performed to predict EDSST4 as a function of z-transformed EP-latenciesT0. The model was validated using a jack-knife procedure and the potential for improving it by inclusion of additional baseline variables was examined. Results: EDSS valuesT4 correlated with the sum of z-transformed EP-latenciesT0 (rho = 0.68, p < 0.0001), but not with MR-parametersT0. EDSST4 as predicted by the formula EDSST4 = 4.194 + 0.088 * z-score P100T0 + 0.071 * z-score CMCTUE, T0 correlated with the observed values (rho = 0.69, p < 0.0001). Conclusion: Combined EPs allow prediction of long-term disability in small groups of patients with MS. This may have implications for the choice of monitoring methods in clinical trials and for daily practice decisions.

Multiple sclerosis and amyotrophic lateral sclerosis: is there a link?

2011 ◽  
Vol 18 (6) ◽  
pp. 902-904 ◽  
Author(s):  
Masoud Etemadifar ◽  
Seyed-Hossein Abtahi ◽  
Mojtaba Akbari ◽  
Amir-Hadi Maghzi
Keyword(s):  
Multiple Sclerosis ◽  
Amyotrophic Lateral Sclerosis ◽  
Fold Increase ◽  
Population Based ◽  
Isfahan Province ◽  
First Degree Relatives ◽  
The Family ◽  
Reverse Analysis ◽  
Als Patients ◽  
Lateral Sclerosis

To date, there are no reports studying the rate of amyotrophic lateral sclerosis (ALS) in relatives of multiple sclerosis (MS) patients and vice versa. This study was designed to look into this issue using two population-based databases of MS and ALS in Isfahan province of Iran. We have searched for any first, second or third degree familial kinship between the Isfahan MS Society database and Isfahan ALS population. We compared the rate of ALS among the population of first degree relatives of MS patients, with the crude prevalence of ALS in the general population of Isfahan. On the other hand, a reverse analysis was carried out to compare the prevalence of MS in Isfahan with its rate amongst the first degree relatives of ALS patients. We found 10 families among which five had first degree kinship. The rate of the diseases was significantly higher in both comparisons among the family members ( p < 0.00001) and an odds ratios of more than 67 in both calculations showed a several-fold increase of ALS occurrence in the first degree relatives of MS patients and vice versa. In our study relatives of MS patients were significantly more prone to ALS and vice versa. This could give clues about the common features that the two disease share. Both diseases have an environmental and genetic component and these results mostly point toward genetic similarities.

scholarly journals Correlation Between Disability Measure and Black Hole (T1 Hypointense Lesion) Lesion Load in Brain Magnetic Resonance Imaging (MRI) of Patients With Multiple Sclerosis (MS): Protocol for a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Amir Valizadeh ◽  
Elham Barati ◽  
Mohammad Ali Sahraian ◽  
Mohammad Reza Fattahi ◽  
Mana Moassefi
Keyword(s):  
Multiple Sclerosis ◽  
Meta Analysis ◽  
Rank Correlation ◽  
Brain Magnetic Resonance Imaging ◽  
Lesion Volume ◽  
Spearman’S Rank Correlation ◽  
Spearman’S Rank Correlation Coefficient ◽  
Disability Status ◽  
Formation And Evolution ◽  
Magnetic Resonance Imaging Mri

Abstract Introduction: As the role of neurodegeneration in the pathophysiology of multiple sclerosis (MS) has become more prominent, the formation and evolution of chronic or persistent T1-hypointense lesions (Black Holes) have been used as markers of axonal loss and neuronal destruction to measure disease activity. However, findings regarding this subject are controversial. In this study we aim to clarify the level of importance of T1 hypointense lesions for estimating the prognosis of patients.Methods: We will search MEDLINE (through PubMed), Embase and Web of Science for relevant studies. We will extract the Spearman's rank correlation coefficient (SRCC) between the T1 hypointense lesion volume and Extended Disability Status Scale (EDSS) in participants. All included studies will be evaluated for the risk of bias. We will also perform a meta-analysis on the data. The risk of publication bias will be evaluated using Funnel plots. Finally, we will assess the confidence in cumulative evidence using an adapted version of GRADE.

Sharp increase in the incidence and prevalence of multiple sclerosis in Isfahan, Iran

2011 ◽  
Vol 17 (8) ◽  
pp. 1022-1027 ◽  
Author(s):  
Masoud Etemadifar ◽  
Amir-Hadi Maghzi
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Environmental Factors ◽  
Sex Ratio ◽  
Vitamin D Deficiency ◽  
Sharp Increase ◽  
Isfahan Province ◽  
Study Population ◽  
Male Sex ◽  
Prevalence Figure

Background: The epidemiology of multiple sclerosis (MS) has changed in recent decades. Objectives: This study aimed to give an update on the prevalence and incidence of MS in Isfahan, Iran. Methods: The study population was all residents of Isfahan province during the period from April 2003 to July 2010. In April 2003, a registry of MS patients was created at the Isfahan MS Society (IMSS), which is the only referral center for MS patients in the province. Nearly all MS patients in Isfahan province are now registered with IMSS and were included in the analysis. Results: Among the 3522 registered patients, 2716 were female and 806 were male (sex ratio: 3.37 : 1), and 431 were diagnosed in 2009. This results in a prevalence figure of 73.3 (95% CI: 70.9–75.8) and an incidence of 9.1 (95% CI: 8.3–10.0) per 100,000. Conclusion: The reported prevalence and incidence figures in our study were higher than in our previous report of 2007, in which the prevalence and incidence of MS were reported to be 43.8 and 3.64 per 100,000, respectively. This dramatic increase in the prevalence of MS puts Isfahan amongst the regions with the highest prevalence of MS in Asia and Oceania and is mostly due to changing environmental factors, amongst which vitamin D deficiency seems an important factor in our population.

scholarly journals Is There Any Relationship between Upper and Lower Limb Impairments in People with Multiple Sclerosis? A Kinematic Quantitative Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Giancarlo Coghe ◽  
Federica Corona ◽  
Giuseppina Pilloni ◽  
Micaela Porta ◽  
Jessica Frau ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Rank Correlation ◽  
Correlation Coefficients ◽  
Motor Tasks ◽  
Motor Abilities ◽  
Spearman’S Rank Correlation ◽  
Gait Parameters ◽  
Disability Status ◽  
Spatiotemporal Parameters

Background. In people with multiple sclerosis (pwMS), disability is generally assessed on the basis of ambulation abilities, whereas upper limb motor dysfunctions are less frequently considered. Nevertheless, they can severely affect the quality of life of pwMS. To date, it remains mostly unknown whether a relationship exists between upper and lower limb impairments. Aim. To investigate the existence of a relationship between upper and lower limb impairments in pwMS based on two fundamental motor tasks, namely walking and hand-to-mouth (HTM) movement. Methods. Twenty-eight pwMS with Expanded Disability Status Scale (EDSS) scores in the range of 1–6, and 21 healthy controls (HC) underwent a kinematic analysis of gait and HTM movement performed with a motion capture system. The spatiotemporal parameters for the two tasks were calculated and correlated using Spearman’s rank correlation coefficients. Results. The pwMS performed worse than HC on both tasks. Small to large correlations were found between the total HTM movement duration and most of the gait parameters (rho, 0.35–0.68; p<0.05). Conclusions. Both upper and lower limb motor abilities in pwMS worsen as disability increases. Nevertheless, their relationship is only moderate. This finding emphasizes the need for specific tests to quantify disability considering the overall motor function in pwMS.

Temporal trends in multiple sclerosis prevalence and incidence in a large population

Neurology ◽  
2018 ◽  
Vol 90 (16) ◽  
pp. e1435-e1441 ◽  
Author(s):  
Dalia L. Rotstein ◽  
Hong Chen ◽  
Andrew S. Wilton ◽  
Jeffrey C. Kwong ◽  
Ruth Ann Marrie ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sex Ratio ◽  
Media Coverage ◽  
Latitudinal Gradient ◽  
Large Population ◽  
Temporal Trends ◽  
Delayed Diagnosis ◽  
Population Based ◽  
Incidence Rates ◽  
Health Administrative Data

ObjectiveWe sought to better understand the reasons for increasing prevalence of multiple sclerosis (MS) by studying prevalence in relation to incidence, mortality rates, sex ratio, and geographic distribution of cases.MethodsWe identified MS cases from 1996 to 2013 in Ontario, Canada, by applying a validated algorithm to health administrative data. We calculated age- and sex-standardized prevalence and incidence rates for the province and by census division. Incidence and prevalence sex ratios for women to men were computed.ResultsThe prevalence of MS increased by 69% from 1.57 (95% confidence interval [CI]: 1.54–1.59) per 1,000 in 1996 (n = 12,155) to 2.65 (95% CI: 2.62–2.68) in 2013 (n = 28,192). Incidence remained relatively stable except for a spike in 2010, followed by a subsequent decline in 2011–2013, particularly among young people and men. Mortality decreased by 33% from 26.7 (95% CI: 23.5–30.3) per 1,000 to 18.0 (95% CI: 16.4–19.8) per 1,000. The incidence sex ratio was stable from 1996 to 2009, then declined in 2010, with partial rebound by 2013. MS prevalence and incidence showed no consistent association with latitude.ConclusionIn this large, population-based MS cohort, we found stable incidence and increasing prevalence of MS; the latter largely reflected declining mortality. A spike in incidence in 2010 among younger patients and men at a time of widespread media coverage of MS suggests that these groups may be vulnerable to delayed diagnosis. We did not find a latitudinal gradient; however, most Ontarians live between the 42nd and 46th parallels, reducing our ability to detect an effect of latitude.

scholarly journals Evidence of an Increased Prevalence of Multiple Sclerosis: A Population-Based Study of Tehran Registry during 1999–2018

2020 ◽  
Author(s):  
Amir Almasi-Hashiani ◽  
Mohammad Ali Sahraian ◽  
Sharareh Eskandarieh
Keyword(s):  
Multiple Sclerosis ◽  
Age Groups ◽  
Population Data ◽  
Population Based ◽  
Population Based Study ◽  
Male Ratio ◽  
Registry System ◽  
Report Data ◽  
Tehran Province ◽  
Epidemiological Characteristics

Abstract Background: The epidemiological characteristics of multiple sclerosis (MS) have been investigated in various studies, which have revealed that the prevalence of MS varies across countries. The present study was conducted to investigate the longitudinal prevalence of MS in Tehran, Iran. Methods: The present population-based study was conducted in Tehran, the capital of Iran from 1999 to 2018 based on the annual report data provided by the Iranian MS Society (IMSS) registry system. The age-standardized and crude prevalence were estimated using population data presented by the Statistical Centre of Iran. Results: A total of 21,580 MS cases were registered and included in the analysis. Among the participant patients, 24.99% (5,393) and 75.01% (16,187) of cases were male and female, respectively. The mean age of MS onset was 28.8 years (S.D: 8.7). The age-standardized prevalence (ASP) of MS increased from 73.7 (95%CI: 72.1-75.2) per 100,000 people in 2006 to 137.6 (95% CI: 135.7-139.5) per 100,000 people in 2018. The ASP of MS in 2018 was estimated to be 67.9 (95%CI: 66.0-69.8) and 207.3 (95%CI: 204.0-210.7) per 100,000 people among males and females, respectively. The age-standardized female-to-male ratio of MS ranged from 3.7 (in 2010) to 2.06 (in 2017). Conclusion: The findings of this study suggested that the prevalence of MS in Tehran province is relatively high, and the occurrence of the disease is more common in the age groups under 40 years as compared with older-aged groups. In line with reports provided for various regions of the world, the prevalence of MS was higher among women. Similarly, the findings of this study revealed that the female-to-male ratio was 2.14 in 2018.

Age, Gender, Comorbidity, and the MDS-UPDRS: Results from a Population-Based Study

2016 ◽  
Vol 46 (3) ◽  
pp. 222-227 ◽  
Author(s):  
Mark R. Keezer ◽  
Christina Wolfson ◽  
Ronald B. Postuma
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Age Groups ◽  
Rank Correlation ◽  
Correlation Coefficients ◽  
Population Based ◽  
Neurodegenerative Process ◽  
Spearman’S Rank Correlation ◽  
Sources Of Variation

Background: Understanding sources of variation in International Parkinson and Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores is essential for planning clinical trials in Parkinson's disease and interpreting studies of mild parkinsonian signs. Methods: We describe the characteristics of the MDS-UPDRS in a population-based sample of individuals without parkinsonism. Multiple linear regression and Spearman's rank correlation coefficients were used to examine potential associations. Results: Among 194 consecutive individuals without parkinsonism, the mean total MDS-UPDRS score was 12.5 (SD 9.8). Sixty-nine percent (134/193) had motor examination (Part III) scores of 2 or more, 16% (30/194) had scores of 10 or more. Female sex, arthritis or spondylosis, diabetes mellitus, and essential tremor were found to be associated with statistically significant increases in MDS-UPDRS Part III scores. For every 10-year increase in age, the Part III score was greater on average by 2.2 (1.5-2.8). Conclusions: Elevated MDS-UPDRS scores are common in the general population. The overall burden of motor signs of parkinsonism is especially high in older age groups, in women, and in those with particular comorbidities. Whether this represents evidence of a subclinical neurodegenerative process or the effect of comorbid conditions requires further examination.

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