Multiple sclerosis in the Levant: a regional consensus statement

Yamout, Bassem; El‐Salem, Khalid; Gebeily, Souheil; Khoury, Samia J.; Zeid, Nuhad Abu; Hamoulila, Khalid; Alhalabi, Mohammed Salem; Hasan, Zaki Noah; Hamadani, Hasan Al; Hamoodi, Hayder; Omar, Ammar Al; Dahdaleh, Maurice

doi:10.3109/00207454.2013.833198

Cited by 5 publications

(4 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of MS among the Jewish Israeli population who originated in Iraq is relatively low, similarly to the prevalence of MS in non-Jewish Iraqi population and the low MS prevalence is in Middle Eastern countries as compared to Northern Europe [ 9 , 10 ]. Despite the low prevalence for MS, we noticed in our day-to-day clinical work, that Jewish relapsing-remitting MS patients who originated in Iraq progress fast to disability.…”

Section: Discussionmentioning

confidence: 99%

Faster progression to multiple sclerosis disability is linked to neuronal pathways associated with neurodegeneration: An ethnicity study

et al. 2023

View full text Add to dashboard Cite

Although the causes of multiple sclerosis are largely unknown, genetic and environmental components play an important role. Geographic distribution, varying with latitude, reflects both genetic and environmental influences. We conducted a retrospective exploratory observational study to characterize the disability progression of 2396 Jewish patients with relapsing-remitting multiple sclerosis, followed at the Sheba Multiple Sclerosis Center, Tel-Aviv, Israel; 188 patients who originated in Iraq and 2207 patients who originated in northern Europe. Peripheral blood microarray gene expression analysis was performed in a subgroup of patients to identify molecular pathways associated with faster disability progression. During a follow-up period of 18.8 and 19.8 years, respectively, 51.6% of patients with an Iraqi origin progressed to moderate disability defined as expanded disability status scale (EDSS) score of 3.0 to 5.5, compared to 44.2% of patients with a northern European origin (odds ratio 1.347, 95% CI 1.0–1.815, p = 0.049). An Iraqi origin was associated with increased risk of progression to moderate disability adjusted for sex, disease duration, age at onset, and treatment with immunomodulatory drugs (hazard ratio 1.323; 95% CI, 1.049–1.668, p = 0.02), but not to severe disability defined as EDSS score > = 6.0 (i.e., walking aids are required for a distance of 100 meters, (hazard ratio 1.311; 95% CI, 0.918–1.874, p = 0.136). Gene expression analysis disclosed 98 differentially expressed genes (79 over-expressed and 19 under-expressed) between relapsing-remitting multiple sclerosis patients of Iraqi origin (N = 17) and northern European (N = 34) origin. Interestingly, this gene expression was enriched with genes related to neuronal pathways associated with morphology of axons, branching of neurites, proliferation of neocortical neurons, and formation of myelin sheath, suggesting an augmented process of neurodegeneration in relapsing-remitting multiple sclerosis patients with an Iraqi origin. The study results suggest that relapsing-remitting multiple sclerosis patients with an Iraqi origin progress faster to disability possibly due to an enhanced process of neurodegeneration.

show abstract

Section: Discussionmentioning

confidence: 99%

Faster progression to multiple sclerosis disability is linked to neuronal pathways associated with neurodegeneration: An ethnicity study

et al. 2023

View full text Add to dashboard Cite

show abstract

“…According to the Atlas of MS compiled by the Multiple Sclerosis International Federation and the World Health Organization [ 5 ], the Arabian Gulf, which is geographically defined as part of the Western Asia region, is a low-risk zone for MS. This low-risk status remains despite the recent affluence and rising tide of ‘diseases of affluence’ [ 6 ] including MS [ 7 – 9 ] in the region. However, there are emerging epidemiological surveys which are challenging this low risk hypothesis.…”

Section: Introductionmentioning

confidence: 99%

Magnitude and concurrence of anxiety and depression among attendees with multiple sclerosis at a tertiary care Hospital in Oman

et al. 2015

View full text Add to dashboard Cite

BackgroundAnxiety, depression and functional impairments are commonly reported by persons with multiple sclerosis (PwMS) but no data, to our knowledge, has emerged from an Arab Islamic population. The study aims to investigate the prevalence of anxiety, depression and related disabilities among PwMS attending tertiary care in Sultan Qaboos University Hospital (SQUH), one of the urban hospitals in Oman.MethodsConsecutive and consenting PwMS (n = 57) and healthy subjects (n = 53) completed the following measures: Hospital Anxiety and Depression Scale (HADS) which was used to measure anxiety (cut-point >7) and depression (>7); and Expanded Disability Status Scale (EDSS) to measure the level of disability (≥5). Characteristics such as socio-demographic and clinical variables were also explored.ResultsFifty seven subjects with multiple sclerosis (MS) met the inclusion criteria. The majority of them were females who were 40 years old or younger and the majority were employed and unmarried. Approximately 86 % of the participants were using beta interferon, 96 % scored ≥5 in EDSS. MS of the Relapsing-Remitting type constituted the majority of the cohort (94 %). Approximately 35 % and 51 % endorsed symptoms of anxiety and depression respectively. The MS group scored significantly higher than controls on HADS measurements of depression and anxiety.ConclusionDisability and symptoms of anxiety and depression are common among the PwMS attendees of tertiary care hospital in Oman. Such psychosocial variables have been largely unreported emerging from non-western populations. As these variables are strong indicators of the burden of MS, resolute effort is needed to address such psychosocial dysfunctions in the algorithms of care for PwMS in the Arab Islamic part of the world.

show abstract

“…Spinal cord involvement is the most common clinical manifestations of MS. 147 Compared to other continents, the advantage of the frequency of TM over that of visual disorders in Asia seems to be no significant. 142 , 148 – 151 A study comparing clinical characteristics between the Middle East and North Africa patients and Indian patients versus patients with European descent showed the frequency of spinal cord symptoms was not different between these groups. 151 A survey enrolled 142 MS patients in Pakistan showed that the most common initial symptoms were motor weakness (70%), followed by sensory symptoms (45%), while only 15% had bladder dysfunction.…”

Section: Clinical Featuresmentioning

confidence: 99%

Recent progress in epidemiology, clinical features, and therapy of multiple sclerosis in China

Wang,

Liu,

Zou

et al. 2023

Ther Adv Neurol Disord

View full text Add to dashboard Cite

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system characterized by inflammation, demyelination, and neurodegeneration. It mainly affects young adults, imposing a heavy burden on families and society. The epidemiology, clinical features, and management of MS are distinct among different countries. Although MS is a rare disease in China, there are 1.4 billion people in China, so the total number of MS patients is not small. Because of the lack of specific diagnostic biomarkers for MS, there is a high misdiagnosis rate in China, as in other regions. Due to different genetic backgrounds, the clinical manifestations of MS in Chinese are different from those in the West. Herein, this review aims to summarize the disease comprehensively, including clinical profile and the status of disease-modifying therapies in China based on published population-based observation and cohort studies, and also to compare with data from other countries and regions, thus providing help to develop diagnostic guideline and the novel therapeutic drugs. Meanwhile, we also discuss the problems and challenges we face, specifically for the diagnosis and treatment of MS in the middle- and low-income countries.

show abstract

Multiple sclerosis in the Levant: a regional consensus statement

Cited by 5 publications

References 19 publications

Faster progression to multiple sclerosis disability is linked to neuronal pathways associated with neurodegeneration: An ethnicity study

Faster progression to multiple sclerosis disability is linked to neuronal pathways associated with neurodegeneration: An ethnicity study

Magnitude and concurrence of anxiety and depression among attendees with multiple sclerosis at a tertiary care Hospital in Oman

Recent progress in epidemiology, clinical features, and therapy of multiple sclerosis in China

Contact Info

Product

Resources

About