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    You are here : Home » MS Research News » Ethnic Groups and MS Research

    Ethnic Groups and MS Research

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    More news can be found in New Pathways Magazine, our bi-monthly publication, and also check daily at MSRC: Latest MS News.

    Rapid disease course in African Americans with Multiple Sclerosis
    MS MRIAbstract
    OBJECTIVE: To investigate utility of a Multiple Sclerosis Severity Scale (MSSS)-based classification system for comparing African American (AA) and white American (WA) multiple sclerosis (MS) subpopulations in the New York State Multiple Sclerosis Consortium (NYSMSC) database.

    MSSS is a frequency-rank algorithm relating MS disability to disease duration in a large, untreated reference population.

    METHODS: Distributions of patients in 6 MSSS-based severity grades were calculated for AA and WA registrants.

    RESULTS: There were 419 AA and 5,809 WA patients in the NYSMSC, who had EDSS recorded during years 1-30 since symptom onset. Median EDSS was not different in AA and WA (3.5 vs 3.0, p = 0.60), whereas median MSSS in AA was higher than in WA (6.0 vs 4.8, p = 0.001). AA patients were overrepresented in the 2 most severe grades (41.5% vs 29.3% for WA) and underrepresented in the 2 lowest grades (23.4% vs 35.4%; p < 0.001).

    In multivariable analysis (ordered logistic and median regression), MSSS for AA remained significantly higher than in WA after adjusting for age, gender, disease duration, disease type distribution, and treatment with disease-modifying therapies.

    CONCLUSIONS: The 6-tiered MSSS grading system is a powerful tool for comparing rate of disease progression in subpopulations of interest. MSSS-based analysis demonstrates that African ancestry is a risk factor for a more rapidly disabling disease course.

    Kister I, Chamot E, Bacon JH, Niewczyk PM, De Guzman RA, Apatoff B, Coyle P, Goodman AD, Gottesman M, Granger C, Jubelt B, Krupp L, Lenihan M, Lublin F, Mihai C, Miller A, Munschauer FE 3rd, Perel AB, Teter BE, Weinstock-Guttman B, Zivadinov R, Herbert J.

    Department of Neurology, NYU School of Medicine, Multiple Sclerosis Care Center, New York, NY 10003-3804, USA.

    Source: Neurology. 2010 Jul 20;75(3):217-23. & PMID: 20644149 (28/07/10)

    MS cases on the rise in Hispanic community
    MS MRIAbout 400,000 Americans suffer from the vision and mobility robbing condition multiple sclerosis.

    While the disease is more likely to afflict Caucasians, it's showing up more and more in minorities. USC researchers hope discovering why minority cases are on the rise will eventually lead to a cure for everyone.

    Three years ago, doctors told 34-year-old Jessica Parra she had a pinched nerve. Her right side went numb. She was extremely exhausted and that's not all.

    "I had extreme skin sensitivity," said Parra. "Everything that touched me hurt."

    She went two years without treatment. Finally when she collapsed and went to an ER, she got the diagnosis: multiple sclerosis.

    "I didn't know," said Parra. "I didn't know to think it was MS. I didn't know what MS was."

    Multiple sclerosis occurs when the body's own immune system destroys something called the myelin sheath that encases nerve cells. The breakdown can happen in the brain and spinal cord.

    USC's Dr. Lilyana Amezcua says MS cases are rising in minority populations. She is following patients in the Hispanic population to find clues toward a potential cure.

    "When the disease happens in the minorities it commonly has different features," said Dr. Amezcua.

    African-Americans are more likely to have more destruction and a rapid escalation of symptoms. In Asians, the disease tends to affect the optical nerve and motor function.. And Latinos appear to experience a mix of the two.

    If MS affects various ethnicities differently, USC researchers say it is possible patients of colour will have different needs overall and will need different treatments.

    "We don't know if the current available treatments would have the same results in the Hispanic," said Dr. Amezcua.

    Researchers hope to find answers. Parra is getting daily shots of Copaxone. Her disease is in remission.

    Dr. Amezcua says the cause of MS is a complex interplay of genes and environmental factors such as diet, vitamin D deficiency, and infectious diseases such as Epstein-Barr virus.

    If researchers can trace the environmental causes in the Latino population it could lead to some answers about why MS is on the rise.

    Source: KABC Los Angeles ©2010 KABC-TV/DT (14/05/10)

    African/Americans with MS have more severe symptoms, decline faster than whites
    MS MRIFewer African Americans than Caucasians develop multiple sclerosis (MS), statistics show, but their disease progresses more rapidly, and they don't respond as well to therapies, a new study by neurology researchers at the University at Buffalo has found.

    Magnetic resonance images (MRI) of a cohort of 567 consecutive MS patients showed that blacks with MS had more damage to brain tissue and had less normal white and grey matter compared to whites with the disease.

    Results of the study appear in the Feb. 16 issue of the journal Neurology.

    Bianca Weinstock-Guttman, MD, UB associate professor of neurology in the UB School of Medicine and Biomedical Sciences, is first author on the study. Weinstock-Guttman directs the Baird Multiple Sclerosis Center in Kaleida Health's Buffalo General Hospital.

    "Black patients showed more brain tissue damage and accumulated brain lesions faster than whites, along with rapid clinical deterioration," confirms Weinstock-Guttman. "The results provide further support that black patients experience a more severe disease, calling for individualised therapeutic interventions for this group of MS patients."

    "White matter" refers to the parts of the brain that contain nerve fibers sheathed in a white fatty insulating protein called myelin. The white matter is responsible for communication between the various grey matter regions, where nerve cells are concentrated and where cognitive processing occurs.

    "Initially, multiple sclerosis was considered primary a white-matter disease," says Weinstock-Guttman, "but today we know that the grey matter may be more affected than white matter."

    In general, black MS patients tend to have more severe and more frequent attacks, followed by an incomplete recovery even after the first episode. Studies on signs and symptoms of MS among populations have shown that blacks experience gait problems sooner after their diagnosis, show faster cognitive decline than whites with MS, and become dependent on a wheelchair sooner, she notes.

    The study's MRI scans were conducted at the Buffalo Neuroimaging Analysis Center (BNAC), part of the Jacobs Neurological Institute/UB Department of Neurology. Robert Zivadinov, MD, PhD, a UB associate professor of neurology, is director of the center.

    Seventy-nine black patients and 488 white patients were entered in the study. Participants were older than 18 and had been scanned within 90 days of their most recent clinical visit. Black participants were significantly younger, and their disease was more severe than white patients, despite having MS for a shorter amount of time.

    "Results of the MRI scans showed that the aggressive disease process in blacks appears to be associated with increased macroscopic and microscopic tissue damage, as measured by specific MRI parameters," says Weinstock-Guttman.

    "Based on our MRI findings, a plausible hypothesis that would explain the more aggressive disease in blacks compared to whites with MS may be that blacks have a reduced capacity for remyelination, the brain's ability to repair the protective myelin sheath. However, to confirm this hypothesis, we will need to conduct more longitudinal studies."

    Murali Ramanathan, PhD, associate professor in the departments of Pharmaceutical Sciences and Neurology in the UB School of Pharmacy and Pharmaceutical Sciences and School of Medicine and Biomedical Sciences, respectively, also contributed significantly to the study.

    Additional contributors were David Hojnacki, MD, Michael G. Dwyer, Sara M. Hussein, MD, Niels P. Bergsland and Frederick E. Munschauer, MD, former chair of the UB Neurology department, now vice president of U.S. medical affairs for Biogen Idec in Boston, Mass.

    The study was supported by grants from the National Multiple Sclerosis Society and the UB Pediatric MS Center of Excellence.

    The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.

    Source: University of Buffalo © 2010 University at Buffalo.(08/02/10)

    AKU experts publish new data on multiple sclerosis
    Experts at the Aga Khan University Hospital have published what is believed to be the first in-depth study into multiple sclerosis (MS) in Pakistan.

    MS varies considerably in Asian countries, but, in general, occurs less than in Caucasians. In their report, the AKU experts describe their analysis of 142 cases of MS from five centers in the cities of Karachi, Islamabad, and Peshawar. Wasay and colleagues published their study in Multiple Sclerosis (Multiple sclerosis in Pakistan. Multiple Sclerosis 2007;13(5):668-9).

    All 142 patients underwent brain magnetic resonance imaging (MRI), which was abnormal, and consistent with diagnosis of MS in 137 (95 percent) patients. Spinal MRI was performed in 37 (26 percent) patients, and abnormalities consistent with MS were seen in 22 (15 percent) patients. Of 56 (40 percent) patients given contrast, enhancing lesions occurred in 25 (18 percent) patients. The disease course was relapsing-remitting (RR)

    “We describe retrospective data from the largest series of patients with multiple sclerosis from Pakistan. Mean age at onset was 27 years, with a female to male ratio of 1.45:1,” the scientists reported.

    “The disease onset was polysymptomatic in 75 percent patients. Motor weakness was the most common onset symptom (70 percent), followed by sensory symptoms (45 percent). Optico-spinal type of MS was seen in only 3 percent of patients The course was relapsing-remitting (RR) in 81 percent, primary progressive (PP) in 21 percent, and secondary progressive (SP) in 4 percent of patients. Almost three-fourths of the patients were moderately (45 percent) or severely (31 percent) disabled at the time of evaluation. Two-thirds of patients with severe disability had a mean disease duration of only 5.2 years,” wrote M. Wasay and colleagues of the AKU. The researchers concluded: “MS is not uncommon in Pakistan, and many patients were found to have severe disability despite short disease duration.”.

    Source: Daily Times (20/07/07)

    Clue seen to why MS disability worse for blacks
    The abnormal immune response that leads to multiple sclerosis, or MS, is stronger in African Americans than in whites with the disease, new research indicates. This may partly explain why blacks often experience greater disability.

    MS develops when myelin, the insulating tissue around neurons in the brain, is attacked by the body's own immune system. "The findings show that ethnic differences in multiple sclerosis extend to the immune response system, which plays a central role in multiple sclerosis," Dr. John R. Rinker, from Washington University School of Medicine in St. Louis, said in a statement.

    The results, which appear in the medical journal Neurology, stem from a comparison of the immune responses seen in 66 African Americans with multiple sclerosis and in 132 whites with the disease.

    The researchers found that levels of antibodies responsible for anti-myelin activity in the cerebrospinal fluid are higher in blacks than whites.

    While this finding might help explain some of the racial differences seen with multiple sclerosis, it remains unclear why African Americans typically require help with walking earlier in the course of the disease.

    Consistent with previous reports, the African American patients in the current study required assistance with walking sooner than did their white counterparts. However, the cerebrospinal antibody level was not related to earlier ambulatory assistance.

    "It remains possible that genes are unevenly distributed between ethnic groups to account for different susceptibility to some diseases," Rinker noted. "In multiple sclerosis, recent genetic studies have begun to identify certain genes which may explain why African Americans experience more disability." However, exactly what these genes do remains unknown.

    SOURCE: Neurology, July 3, 2007.

    US Ethnic MS Study

    A study, supported in part by the National MS Society, comparing the clinical characteristics of MS in African Americans and Caucasian Americans found significant differences between these two groups.

    This study found that blacks with MS are more likely to experience a more aggressive course of disease, more likely to develop mobility impairments, and more likely to develop opticospinal MS and transverse myelitis.

    The authors note that as this study was a retrospective review of medical records, it did not evaluate aspects such as environmental or socioeconomic factors that might affect the results.

    A prospective study – in which people would be followed for a certain period of time – is being planned to validate and expand on these findings.

    This group and other Society-supported scientists also are using a new and powerful genetics technique known as “admixture mapping” to determine if differences in MS between African and Caucasian Americans stem from genetic factors.

    Many Hispanics Believe Myths About Multiple Sclerosis, In Part Because of Lack of Information
    Many Hispanics believe that multiple sclerosis is a disease that primarily affects non-Hispanic whites, in part because of a lack of good information about the disease's prevalence among Hispanics, the San Jose Mercury News reports.

    An estimated 20,000 to 30,000 of the 400,000 U.S. residents with MS are Hispanic, according the Mercury News. However, the misconception that the disease does not affect minorities is a "very common notion among the public and even for the medical establishment," according to Janet Sutton, a University of Chicago research scientist who has studied the state of MS treatment in blacks and Hispanics. "There's so little information about MS and Latinos, it's amazing," Sutton added.

    MS patients commonly have some loss of vision, memory, hearing, balance and comprehension skills and are easily tired and can lose control of bladder and bowel movements, among other symptoms. There also is a possibility that MS is more aggressive in blacks and Hispanics, even though it is less prevalent in the groups, Sutton said. In addition, some Hispanic immigrants do not follow the proper medical treatments for MS and depend on Hispanic customs or advice from relatives to relieve symptoms, according to the Mercury News.

    Nicholas LaRocca, director of health care delivery and policy research for the National Multiple Sclerosis Society, said support groups can address myths and issues that affect Hispanic MS patients. "What makes a group work is cohesiveness. When you add sociocultural values, you add more to the feeling of one-ness," LaRocca said.

    Source: San Jose Mercury News.

    © Multiple Sclerosis Resource Centre (MSRC)

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