Multiple sclerosis in Somali Americans: Nature or nurture?

Area of Science:

• Neurology
• Immunology
• Epidemiology

Background:

• Multiple Sclerosis (MS) course varies significantly across different racial and ethnic populations.
• The Somali immigrant population in Minnesota presents a unique opportunity to study MS in native Africans.
• Understanding these differences is crucial for personalized MS care.

Purpose of the Study:

• To compare clinical features and disease-modifying therapy (DMT) use in Somali American (SA), African American (AA), and White American (WA) persons with MS (pwMS).
• To investigate potential disparities in MS progression and treatment among these diverse groups.

Main Methods:

• A retrospective cohort study was conducted at a single center (Mayo Clinic) including pwMS residing within 250 miles of Rochester, MN.
• Data collected included age at immigration, age at MS onset, DMT use and type, MS phase, age at progressive MS (PMS) onset, and severe MS (EDSS ≥6).

Main Results:

• Somali American pwMS (SApwMS) were younger at MS onset compared to African American (AApwMS) and White American pwMS (WApwMS).
• SApwMS were treated with DMTs earlier than AApwMS and WApwMS, but less frequently received natalizumab or anti-CD20 therapies.
• The frequency of progressive MS (PMS) was similar across groups, but age at PMS onset was older in SApwMS compared to AApwMS.

Conclusions:

• Recently immigrated Somali American pwMS exhibit a similar disease course to WApwMS.
• The MS disease course in SApwMS appears more favorable than in AApwMS from the same geographical region.
• These findings highlight the importance of considering ethnic and immigration factors in MS management.