Statistics of Multiple Sclerosis

Abstract

This study is based on the records of 1,970 cases of multiple sclerosis. Of the total, 1,773 represent cases culled from literature and 197 those whose records I have personally studied. Of the latter, fifty-five are from the Vanderbilt Clinic, ninety-three from the Mount Sinai Hospital and forty-nine from the Montefiore Hospital. The object of the investigation was to determine the comparative incidence of the disease in the United States and Europe, the ages (including the ages of onset), average duration, sex, civil status, occupation and nativity. Special study was made of cases reported as hereditary, congenital, familial and infantile. Although the matter of personality (psychic and mental manifestations) does not come within the purview of a statistical study, attention was paid to this aspect of the symptomatology of the disease. With the exception of a few recent reports in the literature, most of the statistical records date back many years, especially those which have appeared in this country. The diagnosis of multiple sclerosis was more rigidly dependent on the Charcot triad in the earlier days and many reports date back to the time when the Babinski phenomenon was unknown and when the significance of absent abdominals in multiple sclerosis was not appreciated. The more elastic conception of the disease on the part of European (more especially German) neurologists may account for some of the differences in the reported comparative incidence of the disease. It may be said, too, that critical study of case reports frequently leads one to doubt the diagnosis. This is especially true of cases recorded as infaotile, congenital, hereditary and familial. I have therefore taken special pains to study, as far as was possible, the histories of many of the cases of multiple sclerosis recorded in the literature, which bore on statistics, especially those of the last mentioned group. I reviewed each of the 197 records of the cases which make up my own study. Another point of importance *Read before the Association for Research in Nervous and Mental Diseases,

The Causal Cascade to Multiple Sclerosis: A Model for MS Pathogenesis

“…Despite this, however, men have a lower threshold of actual environmental exposure for the disease to develop than women. Such a circumstance might explain why the earliest reports of MS were often in men [2] , [93] and why a 1922 study reported that of 363 MS patients from the United States and of 1,142 cases from Europe, approximately 58% (in both regions separately) were men [94] . Moreover, it can be shown that, at a minimum, there must have been a 32% increase in the prevalence of MS in Canada over the 35 year interval of study.…”

The change in the sex ratio in multiple sclerosis is driven by birth cohort effects

“…At the beginning of the 20th century, however, the sex ratio was estimated to be equal or even reversed [5]. Some earlier data series [1,[6][7][8][9][10][11][12][13] that illustrate the evidence of pioneer scholars are depicted in Table 1. Counterevidence first arose from two epidemiological prevalence studies in the 1920s, one of them by Bing in Switzerland [1,6,14] and the other by Allison in North Wales [13].…”

Multiple Sclerosis: Exploring the Limits of Genetic and Environmental Susceptibility

“…Moreover, to achieve ( F:M ) sex ratios of the magnitudes observed, requires that the difference in threshold be small ( Figure 3 ). By contrast, the circumstances of Figures 1D, 2D & 4A–4D (i.e., c < d ≤ 1), result in a continuously increasing ( F:M ) sex ratio with increasing exposure over most (or all) of the response curves, it easily accounts for the magnitudes of the observed ( F:M ) sex ratios and, in Figures 1D & 4A–D , it could also account for the observation [39], at an earlier point in the history of MS, that: …”

“…Therefore, the only circumstances for which it is possible that: ( Zw 2 ≤ Zm 2 ), are also those for which: ( p ≥ p ′ 2 ≥ 0.74). In addition, again considering the implications of Equation 1a , the only circumstances in which the ( F:M ) sex ratio can increase over time, is for the ratio ( Zw / Zm ) also to increase over time, which, in turn, requires that: ( Zw < Zm ) during any Time Period for which { p ≥ p ′ } – a circumstance that would pertain to every Time Period represented by the Canadian data [7] and, in fact, would pertain to all observations throughout the history of MS, including a time when the proportion of men among MS patients was reported to exceed that of women [39]. Thus, in the circumstance that: { p ≥ p ′ }, throughout the history of MS, including currently, susceptible men would be envisioned to have a greater penetrance for MS than susceptible women .…”