A seasonal periodicity in relapses of multiple sclerosis? A single-center, population-based, preliminary study conducted in Bologna, Italy

Salvi, Fabriizio; Bartolomei, Ilaria; Smolensky, Michael H.; Lorusso, Anna Maria; Barbarossa, Elena; Malagoni, Anna Maria; Zamboni, Paolo; Manfredini, Roberto

doi:10.1186/1471-2377-10-105

Cited by 29 publications

(30 citation statements)

References 32 publications

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“…The relative humidity has one period with values below average, justified by the fact that the years 2013/2014 were the driest registered since 1995 in São Paulo 23 . It is observed that hospital admissions have a negative tendency in the studied period, just as the PM 10 . The seasonal component appears in all series; however, as expected, this component is more relevant to explain the temperature behavior.…”

Section: Resultsmentioning

confidence: 75%

“…There are no studies that report the cause of the decrease in hospitalizations; however, since hospitalizations and PM 10 have the same trend in the study period, it can be inferred that these two variables are related in some way. To investigate a possible relation between them, Table 2 presents the results obtained from the Pearson correlation test among the meteorological variables (Temp.= air temperature; Humid.= relative humidity), PM 10 , and the number of hospital admissions (total, by age and gender).…”

Section: Resultsmentioning

confidence: 96%

“…The exponential smoothing method of HoltWinters was used to smooth and eliminate any noise of the time series 13 . After the Kolmogorov-Smirnov test indicated normal distribution of data, the variables PM 10 , relative humidity, air temperature, and hospital admissions due to MS were correlated using Pearson's model 14,15 . Although many studies that correlate air pollution and meteorological variables with diseases use the Poisson family of generalized linear models (MLG), in this study we used multiple linear regression 3,16,17 .…”

Section: Materials and Methods O Meteorological Datamentioning

confidence: 99%

“…Studies show that there are possible relationships between air pollution and hospital admissions for MS relapses, because particulate materials present in the atmosphere can increase the systemic inflammatory response and neuro-inflammation 3,7,8 . Among the particulate pollutants, particulate matter (PM 10 ) is a pollutant classified as inhalable particles considered harmful to human health because they can be deposited in the upper respiratory tract 9 . Besides PM 10 , meteorological variables such as relative air humidity and temperature have also been considered possible factors contributing to relapses 10 .…”

Section: Introductionmentioning

confidence: 99%

“…Among the particulate pollutants, particulate matter (PM 10 ) is a pollutant classified as inhalable particles considered harmful to human health because they can be deposited in the upper respiratory tract 9 . Besides PM 10 , meteorological variables such as relative air humidity and temperature have also been considered possible factors contributing to relapses 10 .…”

Section: Introductionmentioning

confidence: 99%

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Influence of particulate matter and meteorological conditions on multiple sclerosis relapse: a preliminary study in São Paulo, Brazil

Diniz¹,

Frony-Macedo²,

Piacenti-Silva³

2017

Arch Health Invest

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Introduction: Multiple sclerosis (MS) is a chronic, inflammatory, and demyelinating disease of the central nervous system, which in some cases may be characterized by recurrent relapses of inflammation that cause mild to severe neurological disability. Some studies around the world have associated the increase of systemic inflammatory responses and neuro-inflammation of patients with exposure to high levels of particulate matter (PM 10 ) and certain conditions of temperature and humidity. Materials and methods: The objective of this study was to verify the influence of the concentration of PM 10 and meteorological variables (air temperature and relative humidity) on the number of hospitalizations for MS in the city of São Paulo. Data from 2008 to 2016, which passed through descriptive statistics and inferences, were used as multiple linear regression models. Results: The models obtained indicated a positive relation (p < 0.01) in the number of hospitalizations with the increase of PM 10 and relative humidity, showing that 31.23% of hospital admissions can be explained by these variables. Conclusion: These results are important, since there are no other studies from Brazil that correlate meteorological and air quality variables with MS. Descriptors: Air Pollution; Multiple Sclerosis; Linear Models. ResumoIntrodução: A Esclerose Múltipla (EM) é uma doença crônica, inflamatória e desmielinizante do sistema nervoso central, que em alguns casos pode ser caracterizada por surtos recorrentes de inflamação que causam leve a grave deficiência neurológica. Alguns estudos em todo o mundo têm associado o aumento de respostas inflamatórias sistêmicas e neuroinflamação de pacientes quando expostos a altos níveis de material particulado (MP 10 ) e certas condições de temperatura e umidade. Material e Método: O objetivo deste estudo foi verificar a influência da concentração de material particulado (MP 10 ) e das variáveis meteorológicas (temperatura do ar e umidade relativa) sobre o número de internações por EM na cidade de São Paulo. Para isso foram utilizados dados destas no período de 2008 a 2016, os quais passaram por estatísticas descritivas e inferencias, como modelos de regressão linear múltipla. Resultados: Os modelos obtidos indicaram relação positiva (p <0,01) no número de internações com o aumento do material particulado MP 10 e umidade relativa, demonstrando que 31,23% das internações hospitalares podem ser explicadas por essas variáveis. Conclusão: Esses resultados são importantes, pois até agora, em nosso conhecimento, no Brasil não existem estudos que correlacionem as variáveis meteorológicas e de qualidade do ar com a Esclerose Múltipla. Descritores: Poluição do Ar; Esclerose Múltipla; Modelos Lineares. ResumenIntroducción: La esclerosis múltiple (EM) es una enfermedad del sistema crónica, inflamatoria y desmielinizante nervioso central, que en algunos casos puede ser caracterizada mediante recaídas recurrentes de inflamación causando leve a déficit neurológico grave. Algunos estudios de todo el mundo q...

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Section: Resultsmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 96%

Section: Materials and Methods O Meteorological Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Influence of particulate matter and meteorological conditions on multiple sclerosis relapse: a preliminary study in São Paulo, Brazil

Diniz¹,

Frony-Macedo²,

Piacenti-Silva³

2017

Arch Health Invest

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Historical changes of seasonal differences in the frequency of multiple sclerosis clinical attacks: a multicenter study

Iuliano

Boz

Cristiano³

et al. 2012

J Neurol

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Previous papers show discordant patterns of monthly and seasonal differences in the frequency of multiple sclerosis relapses. Attacks are more often reported in spring and summer, but there are many variations, mainly as to summer peaks. This paper, an MSBase collaboration substudy, reports multiple series of relapses from 1980 to 2010, comparing ultradecennal trends of seasonal frequency of attacks in different countries. The MSBase international database was searched for relapses in series recording patient histories from 1980 up to 2010. The number of relapses by month was stratified by decade (1981-1990, 1991-2000, 2001-2010). Positive spring versus summer peaks were compared by odds ratios; different series were compared by weighted odds ratio (Peto OR). Decade comparison of the 1990s versus 2000s shows inversion of spring-summer peak (2000s = March; 1990s = July), significant in the whole group (Peto odds ratio = 1.31, CI = 1.10-1.56, p = 0.003) and in Salerno series (OR = 1.97, CI = 1.14-1.40). The global significance persisted also excluding Salerno series (Peto odds ratio = 1.25, CI = 1.04-1.50, p = 0.002). Multicentric data confirm a summer peak of relapses in the 1991-2000 decade, significantly different from the spring peak of 2001-2010. Seasonal frequency of relapses shows long-term variations, so that other factors such as viral epidemics might have more relevance than ultraviolet exposure.

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Seasonal variation in multiple sclerosis relapse

Harding

Tilling²,

MacIver

et al. 2017

J Neurol

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Relapses are a characteristic clinical feature of multiple sclerosis (MS), but an appreciation of factors that cause them remains elusive. In this study, we have examined seasonal variation of relapse in a large population-based MS cohort and correlated observed patterns with age, sex, disease course, and climatic factors. Relapse data were recorded prospectively in 2076 patients between 2005 and 2014. 3902 events were recorded in 1158 patients (range 0–24). There was significant seasonal variation in relapse rates (p < 0.0001) and this was associated with monthly hours of sunshine (odds ratio OR 1.08, p = 0.02). Relapse rates were highest in patients under the age of 30 (OR 1.42, p = 0.0005) and decreased with age. There was no evidence of different relapse rates for males compared to females (OR 0.90, p = 0.19). Identification of potentially modifiable environmental factors associated with temporal variation in relapse rates may allow alteration of risk on a population basis and alteration of outcome of established disease once established. Future epidemiological studies should examine dynamic environmental factors with serial prospective measurements and biological sampling. Significant seasonal differences in relapse rates highlight the importance of environmental factors in disease expression and should be taken into account when planning clinical trials in which relapse frequency is an outcome. In addition, identification of potentially modifiable factors associated with this variation may offer unique opportunities for alteration of risk of relapse and long-term outcome on a population level, and suggest putative biological mechanisms for relapse initiation.

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A seasonal periodicity in relapses of multiple sclerosis? A single-center, population-based, preliminary study conducted in Bologna, Italy

Cited by 29 publications

References 32 publications

Influence of particulate matter and meteorological conditions on multiple sclerosis relapse: a preliminary study in São Paulo, Brazil

Influence of particulate matter and meteorological conditions on multiple sclerosis relapse: a preliminary study in São Paulo, Brazil

Historical changes of seasonal differences in the frequency of multiple sclerosis clinical attacks: a multicenter study

Seasonal variation in multiple sclerosis relapse

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