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Related Concept Videos

Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
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Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...
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Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...

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Injury preceding the classical recognition of multiple sclerosis: A population-based study.

Fardowsa L A Yusuf1, Mohammad Ehsanul Karim2, Jason M Sutherland3

  • 1School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Medicine (Neurology), University of British Columbia and The Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada.

Annals of Epidemiology
|December 7, 2025
PubMed
Summary
This summary is machine-generated.

Injuries like fractures, dislocations, and burns were more common in individuals who later developed multiple sclerosis (MS). This suggests potential early indicators for MS diagnosis before formal recognition.

Keywords:
Health-care utilizationMultiple sclerosis

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Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Investigated the link between injuries and multiple sclerosis (MS) preceding diagnosis.
  • Examined fractures, dislocations/sprains/strains, and burns as potential early indicators.

Purpose of the Study:

  • To determine if specific injuries occur more frequently before MS is clinically recognized.
  • To explore the potential for earlier MS detection through pre-diagnostic injury patterns.

Main Methods:

  • Conducted a cohort study in British Columbia, Canada (1991-2020) using health administrative data.
  • Compared injury risk in the six years before MS diagnosis (demyelinating claim or symptom onset) to matched controls.
  • Employed modified Poisson regression, high-dimensional propensity scores (hdPS), and targeted maximum likelihood estimation (TMLE) for analysis.

Main Results:

  • MS cases showed a higher risk of fractures (adjRR=1.28), dislocations/sprains/strains (adjRR=1.20), and burns (adjRR=1.40) before their first demyelinating claim.
  • Sensitivity analyses using hdPS and TMLE confirmed these associations, with slightly reduced relative risks.
  • Similar, though weaker, associations were observed before MS symptom onset in the clinical cohort.

Conclusions:

  • Injuries including fractures, dislocations, and burns are more prevalent in the period before MS diagnosis.
  • These findings suggest that certain injuries may serve as early warning signs for multiple sclerosis.
  • Earlier recognition of MS could be facilitated by considering these pre-diagnostic injury patterns.