Temporal trends in the incidence of multiple sclerosis

Alonso, Álvaro; Hernán, Miguel A.

doi:10.1212/01.wnl.0000316802.35974.34

Cited by 633 publications

(431 citation statements)

References 50 publications

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“…This is consistent with published data reporting the prevalence range TN in multiple sclerosis from 1.6% to 18% [3,8,19,11,24]. The age of onset of multiple sclerosis-associated TN in patients has been noted to be about 10 years younger than in patients without multiple sclerosis [25][26][27].…”

Section: Characteristics Of Types Of Central Painsupporting

confidence: 91%

“…Regarding proportional representation by age our set of patients is consistent with epidemiological data on multiple sclerosis [18]. Regarding proportional representation by gender, it correlates with epidemiological data concerning multiple sclerosis [15,19]. Finally, from the viewpoint of proportional representation of patients stratified by multiple sclerosis forms, we found our sample to be just as consistent with epidemiological data [18].…”

Section: Representativeness Of Samplesupporting

confidence: 84%

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Central Pain in Patients with Multiple sclerosis

Feketova¹,

Waczulíková²,

Valkovič³

et al. 2017

J Mult Scler

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Central pain (CP) is little recognized and diagnosed type of pain in multiple sclerosis.Objective: This second part of our work related to pain in multiple sclerosis is concentrated on occurrence of CP and defined its characteristics.Methods: Questionnaires on pain were sent to 307 patients with definitive multiple sclerosis diagnose. Patients admitting to CP were examined with aim to diagnose CP. The dates were statistically processed.Results: Out of 220 responders 92% reported pain during the course of their multiple sclerosis. CP was found in 57.72%, including 40.91% with central neuropathic extremity and trunk pain (CNEP), 5.91% with trigeminal neuralgia (TN), and 33.18% with Lhermitte's sign (LS). In 28.8% of all patients, CP was an initial multiple sclerosis symptom. The prevalence of CP does not increase with age, disease duration, or the Expanded Disability Status Scale (EDSS). Lower extremities were the commonest location of CNEP (74.5%) and burning was the commonest painful sensation. Three and more concurrent unpleasant painful sensations experienced 68.9% of patients, which were in 46.7% located in the lower extremities. Three and more concurrent CP locations (including TN and LS) were reported by 89% of patients. Number of locations in CP increases significantly with age and EDSS, in contrast to group with nociceptive and peripheral neuropathic pain (n=113), where does not increase with age, EDSS and multiple sclerosis duration. The group with nociceptive and peripheral neuropathic pain featured significantly less patients with only one pain location (p=0.0269) and only one pain quality. In contrast to the other group, In CP increases significantly the number of patients with increase the number of concurrent pain qualities (p<0.0001). Conclusion:CP is not only a frequent complaint among persons with multiple sclerosis, but is a distinctive type of pain requiring special attention and their identification remains still the major challenge.

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Section: Characteristics Of Types Of Central Painsupporting

confidence: 91%

Section: Representativeness Of Samplesupporting

confidence: 84%

Central Pain in Patients with Multiple sclerosis

Feketova¹,

Waczulíková²,

Valkovič³

et al. 2017

J Mult Scler

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“…Therefore, our data cannot at present be generalized beyond the current population, requiring further evaluation of our methods in participants with MS and other diagnoses with multiple comorbidities that might generate white matter abnormalities. Although epidemiological data suggest that both MS and migraine are more common in women and in approximately similar proportions,34, 35, 36, 37, 38 only one man was included in the study due to recruitment challenges, and this may limit the generalizability of our results. It is interesting to note that several participants with migraine had a high number of CVs, perhaps suggesting that the pathophysiology of these lesions may be more heterogeneous than presumed.…”

Section: Discussionmentioning

confidence: 97%

“Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine

Solomon

Schindler

Howard³

et al. 2015

Ann Clin Transl Neurol

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ObjectiveThe diagnosis of multiple sclerosis (MS) presently relies on radiographic assessments of imperfect specificity. Recent data using T2* methodology for the detection of the “central vessel sign” (CVS) in MS lesions suggests this novel MRI technique may distinguish MS from other disorders. Our aim was to determine if evaluation for CVS on 3T FLAIR* MRI differentiates MS from migraine.MethodsPatients with MS or migraine and a prior brain MRI demonstrating at least two hyperintense lesions ≥3 mm were recruited. Exclusion criteria included any additional comorbidity known to cause brain MRI abnormalities. 3T MRI was performed in each participant with administration of gadopentetate dimeglumine, and FLAIR* images were generated in postprocessing. The total number of discrete ovoid lesions ≥3 mm were counted on FLAIR, per participant, and subsequently evaluated for presence of CVS on FLAIR*. An exploratory method evaluating for CVS in a maximum of 12 lesions per subject was also completed.ResultsTen participants with MS and 10 with migraine completed the study. The median percentage (quartiles) of lesions in MS participants with CVS was 84 (79, 94) compared to 22 (15, 54) in migraine (P = 0.008). In a subanalysis by brain region, in the subcortical and deep white matter, the median percentage (quartiles) of lesions in MS participants with CVS was 88 (81, 100) compared to 19 (11, 54) in migraine (P = 0.004). This difference was not identified in juxtacortical, periventricular, or infratentorial regions.InterpretationIdentification of CVS using FLAIR* on 3T MRI helps differentiate MS from migraine, particularly in the subcortical and deep white matter.

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“…Overall, the prevalence of MS appears to be increasing, particularly in Europe and the Mediterranean Basin 16, 17. Prevalence in Spain does appear to be on the increase, with a recent study by Fernandez et al.…”

Section: Discussionmentioning

confidence: 84%

Long‐term epidemiology of multiple sclerosis in the N orthern S eville D istrict

et al. 2015

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ObjectivesComprehensive epidemiologic data for multiple sclerosis (MS) in Spain are limited. The aim of this study was to collect epidemiologic data on MS in the Northern Seville District of Spain.Materials and methodsThis longitudinal study identified possible MS cases every year from nine centres between 1 January 1991 and 31 December 2011. Patients with a confirmed diagnosis of MS were included. MS data prior to enrolment were collected retrospectively from clinical records and prospectively during quarterly follow‐up clinic visits. Variables included age at onset, age at diagnosis, treatment, follow‐up duration, number of visits, number of relapses, change in the number of relapses over time and Expanded Disability Status Scale score. The incidence and prevalence of MS rate were calculated.ResultsOverall, 156 patients with MS were identified (111 females; mean follow‐up 7.5 years). Most patients had relapsing‐remitting MS (73.7%); primary progressive disease was less frequent than secondary disease (10.9% vs 15.4%). The yearly incidence of MS was 4.6 per 100,000, and the prevalence at 31 December 2011 was 90.2 per 100,000.ConclusionsThe annual MS incidence rate in this southern region of Spain was higher than previously reported rates in Spanish studies.

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Temporal trends in the incidence of multiple sclerosis

Abstract: Background: Multiple sclerosis (MS) has been traditionally considered to be more frequent in

Cited by 633 publications

References 50 publications

Central Pain in Patients with Multiple sclerosis

Central Pain in Patients with Multiple sclerosis

“Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine

Long‐term epidemiology of multiple sclerosis in the N orthern S eville D istrict

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