Above is a map giving the geographical prevalence of Multiple Sclerosis (MS) world-wide. It has long been established that MS is more likely to occur in communities in the further Northern and Southern Lattitudes, possibly due to less sunlight, environmental factors or dietary reasons.

We report below on news stories and scientific articles from around the world which look into this apparent "geographical phenomenon".

Abstract
The uneven distribution of multiple sclerosis (MS) across populations can be attributed to differences in genes and the environment and their interaction.

Prevalence and incidence surveys could be affected by inaccuracy of diagnosis and ascertainment, and prevalence also depends on survival.

These sources of error might play a part in the geographical and temporal variations.

Our literature search and meta-regression analyses indicated an almost universal increase in prevalence and incidence of MS over time; they challenge the well accepted theory of a latitudinal gradient of incidence of MS in Europe and North America, while this gradient is still apparent for Australia and New Zealand; and suggest a general, although not ubiquitous, increase in incidence of MS in females.

The latter observation should prompt epidemiological studies to focus on changes in lifestyle in females.

New insights into gene-environment and gene-gene interactions complicate interpretations of demographic epidemiology and have made obsolete the idea of simple causative associations between genes or the environment and MS.

Lancet Neurol. 2010 May;9(5):520-32. Copyright 2010 Elsevier Ltd. All rights reserved.

Koch-Henriksen N, Sørensen PS.

Department of Neurology, Aarhus University Hospital in Aalborg, Aalborg, Denmark.

Source: Pubmed PMID: 20398859

The epidemiology of multiple sclerosis (MS) is undergoing dramatic changes; MS is occurring with increased frequency in many parts of the world. In this retrospective study, we examined the changes in incidence and prevalence of MS in Kuwait in the period between 1993 and 2000.

We analyzed the records of patients with clinically defined and laboratory supported MS.

The total incidence rate increased from 1.05/100,000 population in 1993 to 2.62/100,000 in 2000.

The increased incidence of MS was most pronounced among Kuwaiti women (from 2.26/100,000 in 1993 to 7.79/100,000 in 2000. The total prevalence rate increased from 6.68/100,000 in 1993 to 14.77/100,000 in 2000.

It was much higher for Kuwaitis (31.15/100,000), as compared to non-Kuwaitis (5.55/ 100,000), in a complete reversal of the pattern observed before 1990.

The prevalence was also higher among Kuwaiti women (35.54/100,000), as compared with Kuwaiti men (26.65/100,000).

In conclusion, the incidence and prevalence of MS in Kuwait has increased between the early and late 1990s with no signs of leveling off. In a geographic area that was previously associated with low prevalence, local environmental factors may be responsible for these dramatic changes.

Source: Department of Neurology, Ibn Sina Hospital, Safat, Kuwait. (23/04/10)

Summary
Several studies suggest an increasing prevalence of multiple sclerosis (MS) in Canada. Canadian MS neurologist and researcher Dr. Marrie and colleagues aimed to validate a case definition for MS using administrative health insurance data, and to describe the incidence and prevalence of MS in Manitoba, Canada. Neurology. 2010 Jan 13. [Epub ahead of print]

Details
Provincial administrative claims data were reviewed to identify persons with demyelinating disease using International Classification of Diseases 9/10 codes and prescription claims. Questionnaires were mailed to 2,000 randomly selected persons with an encounter for demyelinating disease, requesting permission for medical records review. Diagnoses abstracted from medical records were used as the gold standard to evaluate candidate case definitions using administrative data.

From 1984 to 1997, cases of MS using claims data were defined as persons with seven or more  medical contacts for MS. From 1998 onward, cases were defined as persons with three or more medical contacts. As compared to medical records, this definition had a positive predictive value of 80.5% and negative predictive value of 75.5%. From 1998 to 2006, the average age- and sex-adjusted annual incidence of MS per 100,000 population was 11.4 (95% confidence interval [CI] 10.7-12.0). The age-adjusted prevalence of MS per 100,000 population increased from 32.6 (95% CI 29.4-35.8) in 1984 to 226.7 (95% CI 218.1-235.3) in 2006, with the peak prevalence shifting to older age groups.

Authors conclude that the prevalence of multiple sclerosis (MS) in Manitoba is among the highest in the world. The rising prevalence with minimally changing incidence suggests improving survival. This study supports the use of administrative data to develop case definitions and further define the epidemiology of MS.

Source: MS Society of Canada National Research and Programs (03/02/10)

Joensen P.

Multiple sclerosis incidence in the Faroe Islands 1986 - 2007.

Objective - Epidemiological studies of the isolated Faroese population in 1945 identified a high annual incidence of multiple sclerosis (MS) of 10/100,000. At the time, there was speculation that the disease was brought to the country by British occupation forces resident in the islands from 1940 to 1945. The objective of the current study is to determine the incidence of diagnosis of MS in the Faroe Islands during the period 1986 - 2007.

Methods -All patients in the Faroe Islands diagnosed with MS from July 1, 1986 to July 1, 2007 are documented in the current longitudinal, prospective study. The diagnosis is based on clinical observation, magnetic resonance imaging scanning, cerebrospinal fluid tests, and visual evoked potential response testing.

Results -The incidence of MS during the period 1986 - 2007 is 4.5/100,000 annually. This is generally of the same order of magnitude as other research findings in Scandinavia and Iceland. The incidence of MS from 1986 to 2007 is about double the incidence in the Faroe Islands for the period from 1940 to 1986, calculated to be 2.7/100,000 annually.

Conclusion -The observed incidence of MS in the Faroe Islands, where the population is genetically homogeneous and where the diet exposes the population to neuro-toxic contamination, is at the same level as found in other high-risk regions. The former detected epidemics of MS in Faroe Islands seems apparently to have leveled out and could not be recognized in the recent period covered by the present survey.

Source:  Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2009.01252.x.© 2009 The Author Journal compilation © 2009 Blackwell Munksgaard.(17/12/09)

BACKGROUND: The ratio of female to male (F:M) MS cases varies geographically, generally being greater in areas of high prevalence. In many regions, including Canada, rising MS incidence in women has been implied by the marked increase in F:M ratio.

METHODS: We examined the F:M ratio over time in MS patients in the Canadian Collaborative Study born outside of Canada, with onset post-migration (n=2531). We compared the (y.o.b.) was a significant predictor of sex ratio in immigrants (chi 2 = 21.4, p<0.001 correlation r= 0.61). The rate of change of sex ratio was increasing in all migrant subgroups (by a factor of 1.16 per 10y period, p<0.001), with the steepest increase observed in those from Southern Europe trends to native-born Canadians, by region of origin and age at migration.

RESULTS: Regression analysis showed that year of birth (1.27/10y, p<0.001). The overall immigrant F:M ratio was 2.17, but varied by country of origin. It was significantly lower in migrants from Southern Europe compared to Northern Europe or USA (1.89 vs 2.14 and 2.86, p=0.023 and p=0.0003, respectively). Increasing age at immigration was associated with decreasing sex ratio (p=0.041). The sex ratio of individuals migrating <21 was significantly higher than those migrating >/=21 (2.79 vs 1.96, p=0.004).

CONCLUSIONS: MS Sex ratio in immigrants to Canada is increasing but variable by region of origin and influenced by age at migration. The findings highlight the importance of environmental effect(s) in MS risk, which are likely gender-specific.

Source: Pubmed PMID: 19710047 (02/09/09)

Scientists working on a major study into the causes of multiple sclerosis (MS) are appealing for volunteers from Shetland to take part in the second phase of their work.

Funded by the MS Society and led by Dr Jim Wilson of the Uni­versity of Edinburgh and Dr Eliza­beth Visser of the University of Aberdeen, the research aims to find a correlation between MS and genes and, specifically, whether an “MS gene” exists. The first phase of the study was launched last year and is progressing well, according to Dr Wilson.

Clinical research fellow on the project Dr Visser, a neurologist, has been in Shetland a number of times dealing with volunteers who came forward for the first phase and will be here every month for a week at a time until the autumn to conduct the next stage of the work.

Currently around one in every 250 people in Shetland and Orkney suffers from the condition. This figure is around double that of the Scottish mainland average, putting Shetland and Orkney in the unfor­tunate position of having the highest rates in the world.

Dr Wilson, originally from Ork­ney, said: “It’s not unlikely that there may be undiscovered genes in Ork­ney and Shetland as [the prevalence of MS] is so high.”

The link between genes and medical conditions can be extremely important. Dr Wilson explained: “Finding the genes which increase the risk of developing the disease is the first step to finding new treatments.”

The second phase of the research requires comparison with non MS patients. To do this, the study is recruiting volunteers to act as “controls”, so that their DNA can be related to the genes carried by people with MS.

Dr Wilson said: “By this I mean a group of people who share certain characteristics with the MS patients – for example being the same age and sex, and coming from Shetland, so we can compare the DNA of the patients with that of the matched comparison group.”

To do this they are looking for people who are from Shetland, born between 1930 and 1990 and have no family members with MS. If you would like to help with the study, call 0131 651 1643 or email Shetland@ed.ac.uk.

An appointment to meet Dr Visser will be made, where she will go through a short questionnaire and take a blood test.

Dr Visser explained what a volunteer can expect: “We’ll have a bit of a chat about their medical history and do the questionnaire which we’ve created, basically to make sure they don’t have MS,” she said. “The first 10 or so controls will be examined and then we’ll take a small blood test. This can be done at their GP or at home.”

MS is a chronic auto-immune disease caused by damage to myelin, the protective sheath which sur­rounds the spinal cord and central nervous system. This leads to dis­ruption to the nerve signals that control muscle co-ordination, strength, sensation and vision.

It is the most common debilitating neurological disease in the UK, affecting around 100,000 people.

Despite the frequency of cases, the range and complexity of symp­toms which can occur means there is no single diagnostic test for the disease.

Other conditions with similar symptoms often have to be ruled out, however some of the tests which can lead to diagnosis include MRI scans, neurological examinations and lumbar puncture, in which spinal fluid is examined for abnormalities.

The variety in symptoms and their severity often means different experiences for each person, how­ever it usually means life is unpredictable.

The study has been welcomed by the members of the community.

Ann MacLellan, 66, from Lerwick, was diagnosed with MS 24 years ago. She said: “A lot of folk have wondered why something’s not been done before as there are so many people affected by it.”

Despite the length of time she has suffered, Mrs MacLellan’s symp­toms have been manageable. “Really I’ve kept very well, I’ve been lucky, other than if I overdo it my legs get weak. That and the tiredness. But a lot of folk wouldn’t know I had it.”

However for Ian Richardson, 52, from Unst, MS has had a huge impact on day to day life.

“It’s affected everything. It defines how you live, whether you want it or not,” he said.

Diagnosed five years ago, his symptoms vary from time to time, with the worst periods preventing him from getting up the stairs.

However while mobility is a huge issue, there are other sides to the disease.

Mr Richardson explained: “The major problem that develops is your ability to deal with it. The mental attack is often worse than the physical, the drain of knowing you can’t do simple tasks.”

He continued: “I don’t like having to ask for things, but I have to. The little things become more important; it’s the frustration of that.”

However Mr Richardson said he is “very impressed” with the standard of service provided in Shetland.

He said: “Not just for MS, with anything of this type, it’s one of the best places to be. The entire house was fitted out with grab-bars and the MS Society locally has assisted me a great deal.”

Speaking about the study itself, Mr Richardson said: “Anything that develops a better knowledge of it and lead to the golden aim of destroying it is a great thing. It all helps.”

Dr Wilson and his team are, at the moment, primarily looking for people who do not have any cases of MS in their family, but he advised that anyone who does and would like to help should encourage their friends or neighbours to get involved.

Dr Visser continued: “The study is very important as the disease is very common in Orkney and Shetland, so it will be interesting to see if there is anything special [which would] make people more prone to it in the area.

“I’d just like to say a big thank you to everyone who’s been involved so far. We’re very grateful, we’ve had a remarkable response. If anyone would like to be involved or help, now is the time to say. We’re very excited about this study and we’re really hoping it will reveal a bit more about MS.”

Source: The Shetland Times © 1996–2008 The Shetland Times (23/01/09)

Epidemiological studies of multiple sclerosis suggest a trend of increasing disease prevalence in susceptible populations. The reasons for this are unclear and may be the results of methodological differences between studies, incomplete ascertainment or advances in technologies that allow the increased identification of early or mild disease. In addition, direct comparison of cross-sectional prevalence estimates performed in different epochs in ethnically and geographically distinct populations may be inappropriate.

Using detailed phenotypic information and standardised methodology we have resurveyed a geographically defined Welsh population after a significant interval, establishing contemporary prevalence rates and examining demographic and clinical data to determine causes of changing disease frequency.

Disease prevalence rose 45% from 101 to 146 per 100,000 population over 20 years. The greatest increase was observed in females between the ages of 45 and 54. No significant increase in disease frequency was observed in the male population overall, or within specific age groups. There was no demographic evidence for a pattern of earlier age at onset or diagnosis to explain increased disease frequency or decrease in mean age of the prevalent population. In addition we failed to identify a pattern of recognition of patients with less severe disability. Although there was a modest 13% increase of 2.2 years in mean disease duration, and 8 new previously prevalent patients were identified, the main cause of rising disease frequency was related to a 2.8 fold increase in disease incidence for females over 23 years from 2.65 to 7.30/100,000/year increasing sex ratio of incident patients from 1.8 to 4.3 F:M.

Recent change in disease incidence and prevalence in this population is likely to be the result of environmental factors that have been operative in the last few decades in females alone and infers avoidable risk factors. Modelling of current overall incidence suggests a further increase in prevalence to 260 per 100,000 population within the next 20-40 years. Further studies are needed in order to identify recent changes in sex specific environment and lifestyle that confer susceptibility.

Claire L Hirst ¹, Gillian Ingram 1, Trevor P Pickersgill ¹, Robert J Swingler ², D A S Compston ³ and Neil P Robertson ¹

¹ University Hospital of Wales, United Kingdom
² Ninewells Hospital & Medical School, United Kingdom
³ Addenbrooke's Hospital, United Kingdom

Source: JNNP Online © 2008 by the BMJ Publishing Group Ltd. (20/10/08)

The number of people suffering from the neurological disease multiple sclerosis (MS) worldwide could be far more than the estimated 1.3m, researchers say.

A major new study into the disease has been launched by the Multiple Sclerosis International Federation (MSIF) and the World Health Organization (WHO).

They hope to answer key questions about MS, the cause of which is unclear.

Governments are being urged to invest more in education and services to improve sufferers' quality of life.

Specialist equipment

MS is a degenerative disease of the central nervous system. It typically emerges in young adults and can lead to severe disability.

Symptoms often include aching, loss of balance, muscle spasm and paralysis and general fatigue.

But there are still many mysteries surrounding MS.

It is not clear what causes it or why women are twice as likely as men to develop it. Or why it is so much more common in colder countries than warmer ones.

The study has found that although most cases occur in the developed world, every country that took part in the survey, rich or poor, had some instances.

Peer Baneke, the chief executive of the MSIF, says the rough estimate of 1.3m cases worldwide is probably a big underestimation.

"The diagnosis of multiple sclerosis is very difficult," he said. "You really need neurologists who have the knowledge to distinguish it from other things."

It also needs specialist equipment which poorer health systems simply cannot access. MRI scanners, for example, are in short supply in the developing world.

"There must be many people out there who we just don't know about," said Mr Baneke.

Stigma

The survey also looks at the experiences of people with MS, the BBC's Jill McGivering reports.

In many countries, sufferers face stigma and misunderstanding.

Kanya Puspokusumo, a 36-year-old Indonesian, was diagnosed in 2001.

She said that some people thought MS was similar to Aids. Even though she explained it was not transmitted from one person to another, many still excluded her socially.

Dr Hithaishi Weerakoon is a doctor in Sri Lanka who was diagnosed with MS more than a decade ago.

Many families do not acknowledge MS, she says, and keep affected family members hidden away.

Others say, wrongly, that it has developed as a condition because of sins in a past life.

Those associated with the study say this is an important start - but that far more research needs to be done, especially in developing countries where the process of identifying cases systematically and collecting data is still at a very early stage.

Source: BBC News © BBC 2008 (18/09/08)

Canada has one of the highest rates of multiple sclerosis in the world and the country fails in providing adequate services for sufferers, a new study suggests.

The global survey by the World Health Organization and the Multiple Sclerosis International Federation focuses on the prevalence of the disease in more than 100 countries representing almost 88 per cent of the world's population.

The Atlas of Multiple Sclerosis was launched on Wednesday at the beginning of a four-day conference on the disease.

The study said MS strikes 133 people out of every 100,000 in Canada, the fifth-highest rate among the nations surveyed between 2004 and 2007.

Only in the United States, Germany, Norway and Hungary was the disease more prevalent.

Allan Thompson, a top official with the MS International Federation, says Canada has always been a model in terms of the treatment of MS and in addressing quality of life for sufferers.

"But I think even in Canada the services could be better," Thompson said in an interview, noting that support for employment is a big issue for Canadians with MS.

"Staying in employment is so important for quality of life and self-esteem and we just simply ignore it in most countries and Canada would probably fall into that group as well."

Stewart Wong, a spokesman for the Multiple Sclerosis Society of Canada, agreed.

"You can't easily earn income without reducing the benefits that are given to you by the government in a seamless way," he said.

"It means that in many cases people will choose not to work even if they are able to so they can afford their treatments and that's a very unfortunate thing."

Still, the study also highlights where Canada succeeds, Wong said.

"If someone has a first symptom of MS, they can go to a doctor, they can go to a neurologist, they can go to a support group and that's all within a couple of phone calls," he said.

"That stands out for us."

But Thompson believes the overall results highlight the lack of services, expertise and training in the area of MS worldwide.

"We're failing miserably and we're failing in even the most affluent countries," he said. "That's something that needs to be addressed urgently for which there's really no excuse."

Multiple sclerosis is a chronic disease that attacks the central nervous system, causing inflammation and damage. It has also been linked to environmental and genetic factors.

Wong said 2.5 million people worldwide have MS.

The MS Society of Canada says 55,000 Canadians have the disease.

Source: The Canadian Press © 2008 The Canadian Press.(18/09/08)

New Zealand has become the first country in the world to fully research the incidence of multiple sclerosis (MS) over an entire country.

A jointly funded report by the Multiple Sclerosis Society and the Health Research Council, released today, says that close to 3000 people have been clinically identified as having MS (or 71.9 per 100,000 people), with a further 1200 potentially with the condition.

The $500,000 report, which took nearly two years to compile, shows that the prevalence of MS is significantly related to regions of the country -- increasing from 50.8 people per 100,000 in Northland to 134.6 people per 100,000 in Southland.

Worldwide, MS becomes more common the further away from the equator you are.

MS is an auto-immune disease where the body produces a misdirected immune system attack on the central nervous system. There is no known cure.

The symptoms of MS usually appear and disappear unpredictably and they vary from person to person. Common symptoms include: weak or uncoordinated limbs, impaired balance, urinary dysfunction and vision problems as well as fatigue.

MS affects women at a rate three times that of men and is most often diagnosed in the late 20s to early 30s.

MSNZ national director Graham Billings said New Zealand's geographic spread, small population and consistent health services meant the study was possible.

It would become the ground work for a number of other studies into MS and trying to understand the disease, he said.

The cause of MS is still not known. However, researchers are closer to finding the answer and think that both the genetic and environmental factors are important.

"The real problem is there doesn't appear to be a single silver bullet. It's clearly possible that geographic location has something to do with it, and possibly a link to exposure to sunlight and vitamin D. And clearly there is some element of genetic background. Scotland has the highest incidence in the world," Mr Billings said.

Aspects of the results will be presented to the International MS Federation conference in Canada later this year.

Regional data of people with MS (followed by per 100,000):
Northland 82 (50.8)
Auckland 732 (59)
Waikato 177 (46.4)
Bay of Plenty 132 (50)
Gisborne 20 (46.7)
Hawkes Bay 82 (54.3)
Taranaki 72 (66.8)
Manawatu-Wanganui 120 (54)
Wellington 383 (86.2)
Nelson-Tasman 75 (77.7)
Marlborough 42 (86.8)
Canterbury 557 (103)
West Coast 40 (119.2)
Otago 234 (119.3)
Southland 148 (134.6).

People in NZ with MS:
male 720 or 24.86 percent, female 2176 or 75.14 percent.

Source: stuff.co.nz © Fairfax New Zealand Limited 2008 (01/09/08)

As a journalist it's my job to ask questions and try to find out answers, so when I heard that Scotland has the highest rate of Multiple Sclerosis in the world I obviously wanted to know why.

And that's exactly what BBC Radio Scotland's Investigation is all about.

But for me this investigation is more than just out of professional interest.

I have a very personal interest in discovering why there is this curious connection between the country I was born and grew up in and MS - more than seven years ago I was told I had MS.

Scotland has a very special place in the world of MS.

It is generally accepted this country has the highest rate in the world and there are an estimated 10,500 people coping with MS in Scotland.

It's the most common disabling neurological disease among young adults in Britain.

So what is it exactly?

Well here's the science bit ... something called myelin covers the nerve fibres of the central nervous system - but in MS it's damaged and that means messages between the brain and other parts of the body are disrupted.

That can cause a range of possible symptoms - fatigue, balance and mobility problems, weakness, numbness and speech problems - the only thing that's certain about MS is it's unpredictability.

Latitude link

But why is it so prevalent here in Scotland? Well the simple answer is - no-one knows.

Across the UK about one in every 800 people has MS.

But in Scotland about one person in every 500 has MS.

It's far more common here and in countries like Canada, Scandinavia and Ireland than it is in countries nearer the equator.

MS can often quite literally be mapped along lines of latitude.

Another thing we don't know is exactly how many people have MS in Scotland

It's more common in higher latitudes but confusingly that's not the only factor in explaining why and where MS occurs.

You can't catch MS - it's not contagious - and you can't directly inherit MS, but genetic factors do seem to play some kind of role.

Another theory is that it could be down to a virus that triggers the onset of MS.

Diet and climate could have something to do with it but basically no-one has a definitive answer.

Another thing we don't know is exactly how many people have MS in Scotland. But that looks set to change with the development of a register of everyone who has the condition.

New centre

The MS Society in Scotland has begun setting up just such a database along with the NHS in Scotland.

An MS register has already been established in Canada.

For a quarter of a century clinicians there have been gathering details of just about everyone diagnosed with MS - and keeping a national register.

Keeping a register of who has MS could be crucial in solving the puzzle of the condition - as could a brand new centre in Edinburgh - the MS Society Edinburgh University Translational Research centre.

It'll be the UK's first ever major research centre into the condition - and it's been funded thanks largely to a substantial donation from the author J K Rowling, whose mother had MS.

We know where MS occurs in the world, we know what it is but the answer to the question why is still elusive.

Source: BBC Scotland © BBC 2007 (05/11/07)

The French West Indies (FWI), i.e., the islands of Martinique and Guadeloupe, have recently experienced the emergence of multiple sclerosis (MS).

This epidemiological upheaval followed a return migration of the FWI population that had previously migrated to continental France.

The prevalence MS was 14.8/10(5) (95% CI: 11.9-17.7) on Dec. 31, 1999 and its mean annual incidence was 1.4/10(5) (95% CI: 1.0-1.8) for the period July 1997 to June 2002.

The prevalence of MS in Martinique, that received more return migration, is higher than that of Guadeloupe (21.0/10(5)vs. 8.5/10(5)).

This emergence of MS has been accompanied also by an inversion of its clinical spectrum, with recurrent neuromyelitis optica accounting for only 17.8% of cases.

The standardized ratio of the incidence of MS among migrants is 1.71 (95% CI: 1.19-2.38; P<0.01) and if migration to continental France occurred before the age of 15 it is 4.05 (95% CI: 2.17-6.83; P<0.0001).

According to recent data, a drastic reduction in exposure to sunlight and to intestinal parasites during childhood, found preferentially among migrants, are possible environmental factors responsible for this emergence.

Cabre P. Service de Neurologie, CHU Fort de France, Hôpital Pierre Zobda Quitman, BP 97261, Fort de France, Martinique, France.

Source: J Neurol Sci. 2007 Nov 15;262(1-2):117-21. (30/10/07

Existing data on the incidence of multiple sclerosis (MS) in the UK have some limitations.

Few studies have reported age- and sex-specific incidence rates of MS, and none of those is based on a large sample of the general population. Further, no published reports have provided age- and sex-specific incidence rates of MS by clinical course from onset.

To estimate the age- and sex-specific incidence rate and lifetime risk of multiple sclerosis, we identified all new cases of MS during the period 1993-2000 in the General Practice Research Database, which includes health information on over three million Britons.

Based on 642 incident cases, incidence rates of MS adjusted to the world population were 7.2 (95 % CI 6.5, 7.8) in women and 3.1 (95 % CI 2.6, 3.5) in men. The incidence of MS with relapsing-remitting onset was higher in women than in men (incidence rate ratio 2.5, 95% CI 2.1, 3.1), but there were no sex differences for primary-progressive MS (incidence rate ratio 1.1, 95% CI 0.7, 1.8). The estimated lifetime risk from birth of receiving an MS diagnosis was 5.3 per 1,000 in women and 2.3 per 1,000 in men.

These results confirm the relatively high incidence of MS in the UK and show marked differences in the sex-specific pattern of MS incidence by clinical course from onset.

Alonso A, Jick SS, Olek MJ, Hernán MA. Dept. of Epidemiology, Harvard School of Public Health

Source: Journal of Neurology October 2007 (03/10/07)

Methods: A population-based registry was established in 1969, and identification of cases continued to 2005, from medical records, physicians, neurologists, community and provincial resources. A modified classification of Allison and Millar and the Schumacher diagnostic criteria were originally applied, and patients with definite and probable MS were included. The rates were age- and sex-adjusted to the US, European, and world 2000 populations.

Results: From 1970 to 2004, there were 558 incidence cases identified, 402 women and 156 men, for a sex ratio of 2.6:1 The average annual incidence rate was 9.5 in 100,000 (95% CI 8.8 to 10.4) and was stable over the three decades. The innate risk or residence at onset rate was 197 in 100,000 (95% CI 170 to 226). The crude prevalence rate for the living 587 cases on January 1, 2005, was 298.3 in 100,000 (95% CI 274.7 to 323.6).

Conclusions: The incidence and prevalence rates adjusted to the standardised populations were statistically higher than the longitudinal European studies and similar to North American studies. Our incidence study confirms the high risk of multiple sclerosis (MS) in Saskatoon, and these rates seem to be stable over the past 35 years. The high crude prevalence rate results from an accumulation of incidence and nonresident cases over time. Long-term follow-up studies and comparison with standardised populations are recommended to estimate reliable incidence and the true risk of MS in the world.

Walter J. Hader, MD, FRCPC and Irene M.L. Yee, MSc

From the Department of Physical Medicine and Rehabilitation (W.J.H.), University of Saskatchewan, Saskatoon, Saskatchewan, Canada; and the Faculty of Medicine (I.M.L.Y.), Department of Medical Genetics, University of British Columbia, Vancouver, Canada.

Source: Neurology Copyright © 2007 by AAN Enterprises, Inc. (19/09/07)

The Palouse area of eastern Washington is one of the nation's hot spots in terms of reported cases of MS.

These hot spots are located all over the country: New York, Missouri, Kansas, and, as it turns out, eastern Washington.

Brett Parmenter is an assistant professor in the Department of Psychology at Washington State University:

Brett Parmenter: "In eastern Washington there are about 200 people diagnosed with MS for every 100,000 people living in the area. What's been documented on the west side‚ that‚ about 65 people with MS for every 100,000 people."

Parmenter is conducting research into this debilitating neurological disorder but says scientists don't yet know why, for example, the numbers would be so much higher in eastern Washington than western Washington.

Brett Parmenter: "There are various hot spots throughout the country, and no one is really sure as to why some places you just see more MS than others."

Another research team from the Oregon Health and Sciences University is collecting data on the actual number of cases of MS by age and by gender for each county in eastern Washington.

M.S. affects 400,000 in the United States and 2 and half million people around the world. Its cause isn't known.

Source: OPB News © 2007 Northwest News Network (18/09/07)

Almost one in 1,000 people in the U.S. have MS, according to the review.

"Our estimate of MS prevalence is about 50% higher than a comprehensive review from 1982," says researcher Deborah Hirtz, MD, in an American Academy of Neurology news release.

"Whether this reflects improvement in diagnosis or whether incidence is actually increasing deserves further study," says Hirtz, who works at the National Institute of Neurological Disorders and Stroke.

Hirtz and colleagues analysed about 500 studies published from 1990 to 2005 to track 12 neurological disorders.

Their findings appear in the Jan. 30 issue of Neurology.

Source: WebMD ©2005-2006 WebMD, Inc. All rights reserved.(28/06/07)

A chronic, often disabling disease hits more people in New Hampshire than nearly any other state, health officials said.

Joyce Nelson of the National Multiple Sclerosis Society said that the state has one of the highest rates of multiple sclerosis in the country, with 3,000 cases.

There is no cure for the autoimmune disease and no known exact cause, but experts said they believe a combination of factors seems to be responsible. One possible factor for the number of cases in the Granite State may have to do with its location.

"We have found that the incidence of MS increases the further that we get from the equator," Nelson said.

The disease also strikes twice as many women as men. It can cause a wide range of symptoms and severity in patients, including loss of mobility.

Source: WMUR 9 New Hampshire Copyright 2007 by WMUR. All rights reserved (02/02/07)

Overall, the frequency of MS in the UK is on the increase. In 1985, the prevalence in Wales was 117 per 100,000. In 1988 it was 120 per 100,000.

In Scotland, there is 137 per cent more MS than in England and Wales. MS is more prevalent in northern Great Britain and northern Ireland than in England and Wales.

However, this increase is not necessarily due to more people actually getting MS. The figures can be explained by:

• a steady reduction in mortality from MS.
• changes in definition, classification, and laboratory methods of diagnosis.

Ref: Epidemiology And Current Treatment of Multiple Sclerosis in Europe Today, Journal of Rehabilitation Research and Development, Vol. 39 No. 2, March/April 2002. Pages 175–186Jul 3, 2002. Carlo Pozzilli, MD, PhD; Silvia Romano, MD; Stefania Cannoni, MD Department of Neurological Science, University of Rome, “La Sapienza,” Italy. (05/06/04)

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