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Seasonal variation in multiple sclerosis relapse
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 cours...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486559/ https://www.ncbi.nlm.nih.gov/pubmed/28424900 http://dx.doi.org/10.1007/s00415-017-8485-0 |
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author | Harding, Katharine Tilling, Kate MacIver, Claire Willis, Mark Joseph, Fady Ingram, Gillian Hirst, Claire Wardle, Mark Pickersgill, Trevor Ben-Shlomo, Yoav Robertson, Neil |
author_facet | Harding, Katharine Tilling, Kate MacIver, Claire Willis, Mark Joseph, Fady Ingram, Gillian Hirst, Claire Wardle, Mark Pickersgill, Trevor Ben-Shlomo, Yoav Robertson, Neil |
author_sort | Harding, Katharine |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5486559 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-54865592017-07-17 Seasonal variation in multiple sclerosis relapse Harding, Katharine Tilling, Kate MacIver, Claire Willis, Mark Joseph, Fady Ingram, Gillian Hirst, Claire Wardle, Mark Pickersgill, Trevor Ben-Shlomo, Yoav Robertson, Neil J Neurol Original Communication 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. Springer Berlin Heidelberg 2017-04-19 2017 /pmc/articles/PMC5486559/ /pubmed/28424900 http://dx.doi.org/10.1007/s00415-017-8485-0 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Communication Harding, Katharine Tilling, Kate MacIver, Claire Willis, Mark Joseph, Fady Ingram, Gillian Hirst, Claire Wardle, Mark Pickersgill, Trevor Ben-Shlomo, Yoav Robertson, Neil Seasonal variation in multiple sclerosis relapse |
title | Seasonal variation in multiple sclerosis relapse |
title_full | Seasonal variation in multiple sclerosis relapse |
title_fullStr | Seasonal variation in multiple sclerosis relapse |
title_full_unstemmed | Seasonal variation in multiple sclerosis relapse |
title_short | Seasonal variation in multiple sclerosis relapse |
title_sort | seasonal variation in multiple sclerosis relapse |
topic | Original Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486559/ https://www.ncbi.nlm.nih.gov/pubmed/28424900 http://dx.doi.org/10.1007/s00415-017-8485-0 |
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