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Decrease in multiple sclerosis with acute transverse myelitis in Japan.

I Nakashima1, K Fujihara, S Takase

  • 1Department of Neurology, Tohoku University School of Medicine, Sendai, Japan. ichiro@mail.cc.tohoku.ac.jp

The Tohoku Journal of Experimental Medicine
|September 24, 1999
PubMed
Summary
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Acute transverse myelitis (ATM) in multiple sclerosis (MS) decreased significantly in Japan over 30 years. The conventional form of MS (C-MS) increased, suggesting environmental factors may influence MS clinical presentations.

Area of Science:

  • Neurology
  • Epidemiology

Background:

  • Acute transverse myelitis (ATM) is a potential manifestation of multiple sclerosis (MS).
  • ATM has been reported to be more prevalent in Japanese MS patients compared to Caucasian MS patients.
  • Recent discussions question whether MS clinical manifestations have evolved over time.

Purpose of the Study:

  • To investigate the changing frequency of ATM in MS patients.
  • To analyze trends in clinical subtypes of MS, specifically conventional MS (C-MS) and optic-spinal/spinal MS (OSS-MS).
  • To explore potential factors influencing these observed changes in MS presentation.

Main Methods:

  • Retrospective analysis of 86 clinically definite MS patients in Sendai, Japan.
  • Patients were categorized by disease onset decade: 1970-1979, 1980-1989, and 1990-1998.

Related Experiment Videos

  • Frequencies of ATM, C-MS, and OSS-MS were compared across these time periods.

    • Main Results:

    • ATM was exclusively observed in the OSS-MS subtype and not in C-MS.
    • The frequency of OSS-MS with ATM significantly decreased from 60.0% (1970-1979) to 5.3% (1990-1998).
    • Conversely, the frequency of C-MS increased from 20.0% (1970-1979) to 63.2% (1990-1998).

    Conclusions:

    • The incidence of ATM in MS patients has markedly decreased in Sendai, Japan, over the past three decades.
    • The prevalence of C-MS has concurrently increased during the same period.
    • Environmental factors, rather than genetic changes, are hypothesized to be responsible for the observed shifts in MS clinical subtypes.