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The Gulf War era multiple sclerosis cohort: 3. Early clinical features
M T Wallin1,2,3, W J Culpepper1,3, H Maloni1
1Department of Veterans Affairs Multiple Sclerosis Center of Excellence - East, Washington, DC, USA.
Acta Neurologica Scandinavica
|August 24, 2017
Summary
This study on Gulf War era military personnel found that males and Black individuals had higher rates of primary progressive multiple sclerosis (MS). Early diagnosis showed more severe disability in Black individuals and men.
Area of Science:
- Neurology
- Epidemiology
- Military Health
Background:
- Multiple Sclerosis (MS) affects numerous individuals, with varied clinical presentations.
- Understanding early disease characteristics is crucial for effective management and prognosis.
- Military personnel during the Gulf War era (GWE) represent a unique cohort for MS research.
Purpose of the Study:
- To detail the clinical features at diagnosis for a large, nationwide incident cohort of multiple sclerosis (MS).
- Focus on US military personnel serving during the Gulf War era (GWE).
- Analyze demographic and neurological involvement at the time of diagnosis.
Main Methods:
- Reviewed medical records and VA databases for MS cases with onset from 1990 onwards.
- Included active duty personnel between 1990-2007 with VA service connection.
- Assessed neurological involvement using Kurtzke Disability Status Scale (DSS) and Multiple Sclerosis Severity Score (MSSS).
Main Results:
- Among 1919 clinically definite MS cases, 94% had a relapsing-remitting course, 6% primary progressive.
- Males and Black individuals showed higher rates of primary progressive MS.
- Functional system involvement included pyramidal (69%), cerebellar (58%), and sensory (55%) systems.
Conclusions:
- Males and Black individuals exhibited significantly higher proportions of primary progressive MS.
- Black individuals presented with more severe DSS at diagnosis; whites and women had less severe DSS.
- Early morbidity assessment provides essential population-based data for MS diagnosis, management, and prognosis.
