Is it time for a new global classification of multiple sclerosis?

Area of Science:

• Epidemiology
• Neurology
• Public Health

Background:

• Classical multiple sclerosis (MS) geographic distribution zones, established in the 1970s, are outdated.
• Recent epidemiological studies indicate significantly rising MS prevalence and incidence rates globally.

Purpose of the Study:

• To systematically review and update the geographic distribution of MS.
• Incorporate the latest incidence, prevalence, and disease duration data from global epidemiology surveys.

Main Methods:

• Conducted a systematic literature review of MS epidemiology studies.
• Included articles published between January 1, 1990, and December 31, 2012.
• Grouped studies by continent: Americas, Europe, Asia, Australia/New Zealand, and Africa.

Main Results:

• Identified 101 relevant MS epidemiology studies; 58 provided incidence estimates.
• Global median MS incidence: 5.2 per 100,000 person-years (range: 0.5-20.6).
• Global median MS prevalence: 112.0 per 100,000 person-years (range: 5.2-335); average disease duration: 20.2 years.

Conclusions:

• Global MS prevalence and incidence patterns have significantly changed over the past few decades.
• The increasing rates highlight the need for a new classification system based on global MS disease burden.
• A revised system would enhance health policy planning and resource allocation for MS.