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Epidemiology of multiple sclerosis

B G Weinshenker1

  • 1Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.

Neurologic Clinics
|May 1, 1996
PubMed
Summary

Multiple Sclerosis (MS) distribution suggests both genetic and environmental factors. While family history increases risk, twin studies indicate environmental influences are crucial for MS susceptibility.

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Area of Science:

  • Epidemiology
  • Genetics
  • Environmental Health

Background:

  • Multiple Sclerosis (MS) exhibits inhomogeneous geographical distribution, with higher prevalence in populations of Northern European descent.
  • MS prevalence appears to be increasing globally, though this may be influenced by improved ascertainment over the past 50 years.
  • Familial aggregation is evident, with a 10- to 50-fold increased risk in relatives of MS patients, suggesting a genetic component.

Purpose of the Study:

  • To explore the distribution and potential causes of Multiple Sclerosis (MS).
  • To investigate the interplay of genetic and environmental factors in MS etiology.
  • To review analytical approaches for studying MS risk factors.

Main Methods:

  • Review of epidemiological data on MS prevalence and distribution.
  • Analysis of familial aggregation, twin studies, and migration studies.
  • Discussion of ecologic, case-control, and cohort study designs for risk factor identification.

Main Results:

  • MS is most common in Northern European populations and their descendants.
  • First-degree relatives have a 2% to 5% absolute risk of developing MS.
  • While genetic factors play a role (multigenic pattern suggested), a majority of monozygotic twins are discordant, highlighting significant environmental contributions.
  • Migration studies suggest altered risk, supporting both genetic and environmental influences.

Conclusions:

  • The etiology of MS is complex, involving both genetic predisposition and environmental determinants.
  • Further research using advanced methodologies and informative populations (e.g., discordant twins) is needed to refine understanding of MS risk factors.
  • Epidemiological studies are essential for elucidating the population-level and individual-level factors contributing to MS.

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