Latitudinal prevalence gradient of multiple sclerosis in Latin America

Risco, J; Maldonado, Holger; Luna, Lisbel Valido; Osada, Jorge; Ruiz, P.; Juárez, Alan; Vizcarra, Darwin

doi:10.1177/1352458511405562

Cited by 53 publications

(43 citation statements)

References 28 publications

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“…First, the low prevalence of multiple sclerosis in our series (0.3%) contrast with that reported from Europe, where this condition has a prevalence higher than 8% [5,10]. This confirms the previously reported very low prevalence of multiple sclerosis in regions near to the equator [25]. Second, we had an important number of patients with neurocysticercosis, a disease that – with only one exception [17] – has not even been mentioned in the existing published series of neurologic outpatients.…”

Section: Discussioncontrasting

confidence: 55%

Changing Profile of 7,519 Neurologic Outpatients Evaluated over 20 Years

2012

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Introduction: There is scarce information on the demographic profile and diseases affecting neurologic outpatients. Methods: We evaluated 7,519 neurologic outpatients over 20 years at the outpatient clinic of the Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador. Results: Mean age was 48 ± 19.4 years, and 57.8% were women. Common reasons for consultation included headache (33.2%), focal deficits (10.7%), and seizures (9%). The most common categories of neurologic diseases were cerebrovascular (10.6%), degenerative (7.6%), and traumatic (7.1%). Diseases of uncertain/unknown etiology accounted for 50.2% of cases. Young patients were most often evaluated for headache and seizures, while elderly patients usually presented with focal deficits, movement disorders, or cognitive decline. We also found significant variations in the prevalence of neurologic diseases over the study years. While the prevalence of degenerative diseases increased from 5.7% in 1990–1994 to 10.2% in 2005–2009, that of infectious diseases steadily decreased from 3.7 to 2.1% over the study years. Conclusion: There was a dynamic pattern of neurologic diseases over the years. Nowadays, distribution of neurologic symptoms and diseases in our population is more similar to that reported from the developed world than it was 20 years ago.

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Section: Discussioncontrasting

confidence: 55%

Changing Profile of 7,519 Neurologic Outpatients Evaluated over 20 Years

2012

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“…Despite the low reported prevalence of MS in South America in comparison with the industrialized northern countries [28,29], our data do not seem to reflect the benign MS profile previously suggested for South American patients [11,28,30,31]. …”

Section: Discussioncontrasting

confidence: 45%

Quantitative MRI and Cerebrospinal Fluid Inflammatory Mediators in Brazilian Patients with Relapsing-Remitting Multiple Sclerosis before and after Treatment with Immunomodulators: A Longitudinal Study

Ruocco

Brandão

Farias

et al. 2012

Neuroimmunomodulation

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Objective: The pathological hallmarks of multiple sclerosis (MS) lesions are inflammation, demyelination, axon loss and gliosis. The aim of this study was to verify the relation of brain lesion load and volume of the cerebral hemisphere determined by brain MRI with intrathecal antibody synthesis. Methods: A longitudinal study of 54 Brazilian patients with the relapsing-remitting form of MS was undertaken after an average of 6.3 ± 2.7 years of treatment. MRI scans were performed, and cerebrospinal fluid samples were collected both during the diagnostic process and after treatment with β-interferon or glatiramer acetate. Results: A positive correlation between the IgG index and total lesion volume was identified. Intrathecal IgG against Epstein-Barr virus (EBV) was observed in 21 patients. The number of contrast-enhanced lesions observed in these patients was correlated with intrathecal IgM synthesis. Brain atrophy was observed early in the disease, with the number of relapses inversely correlated with brain volume. Conclusion: The high intrathecal IgG synthesis observed in these relapsing-remitting MS patients is associated with the brain lesion burden and the presence of antibodies to EBV, whereas intrathecal IgM synthesis is associated with the activity of the disease, as revealed by MRI.

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“…First recognized in the early 1920s by Charles Davenport [18], it is now widely accepted that there is geographical variation in the incidence and prevalence of MS. While many studies have demonstrated an increased incidence and prevalence in regions at higher latitudes [19,20,21], other studies have found no such association [4,22,23]. A recent meta-analysis evaluating prevalence estimates from 59 countries found a statistically significant latitudinal gradient for prevalence even after age standardization and adjustment for prevalence year [24].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Prevalence of Multiple Sclerosis in the Americas: A Systematic Review

et al. 2013

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Background: The incidence and prevalence of multiple sclerosis (MS) varies considerably around the world. No previous study has performed a comprehensive review examining the incidence and prevalence of MS across the Americas. The purpose of this study was to systematically review and assess the quality of studies estimating the incidence and/or prevalence of MS in North, Central and South American regions. Methods: A comprehensive literature search was performed using MEDLINE and EMBASE from January 1985 to January 2011. Search terms included ‘multiple sclerosis’, ‘incidence’, ‘prevalence’ and ‘epidemiology’. Only full-text articles published in English or French were included. Study quality was assessed using an assessment tool based on recognized guidelines and designed specifically for this study. Results: A total of 3,925 studies were initially identified, with 31 meeting the inclusion criteria. The majority of studies examined North American regions (n = 25). Heterogeneity was high among all studies, even when stratified by country. Only half of the studies reported standardized rates, making comparisons difficult. Quality scores ranged from 3/8 to 8/8. Conclusion: This review highlights the gaps that still exist in the epidemiological knowledge of MS in the Americas, and the inconsistencies in methodologies and quality among the published studies. There is a need for future studies of MS prevalence and incidence to include uniform case definitions, employ comparable methods of ascertainment, report standardized results, and be performed on a national level. Other factors such as sex distribution, ethnic make-up and population lifestyle habits should also be considered.

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Latitudinal prevalence gradient of multiple sclerosis in Latin America

Abstract: Our findings suggest a latitudinal prevalence gradient of MS in Latin American countries between Panama and Argentina.

Cited by 53 publications

References 28 publications

Changing Profile of 7,519 Neurologic Outpatients Evaluated over 20 Years

Changing Profile of 7,519 Neurologic Outpatients Evaluated over 20 Years

Quantitative MRI and Cerebrospinal Fluid Inflammatory Mediators in Brazilian Patients with Relapsing-Remitting Multiple Sclerosis before and after Treatment with Immunomodulators: A Longitudinal Study

Incidence and Prevalence of Multiple Sclerosis in the Americas: A Systematic Review

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