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MS research update - How common is MS across Europe? - 30 September 2013

Summary

This study was a review which pooled all previously published European population-based studies of MS that had been published in English or French between 1985 and 2011.

They found that there was a lot of variation in the incidence (the number of new cases within a set period of time, usually a year) and the prevalence (the number of people with a condition, usually measured as the number of cases out of 100,000 people) figures reported even within particular regions or countries.

The United Kingdom was one of the two most studied areas. Prevalence ranged from 96 cases in 100,000 people in Guernsey to over 200 cases in 100,000 people in Scotland and Northern Ireland. These two countries also had the highest annual incidence rates (7.2 to 12.2 per 100,000).

The researchers concluded that despite there being so many studies on the incidence and prevalence of MS in Europe, it is difficult to compare the different studies with each other because the studies are carried out in different ways. This makes it difficult to come to definite conclusions about how one region or country compares with another.

Background

MS occurs across the world. However, the incidence (the number of new cases within a set period of time, usually a year) and the prevalence (the number of people with a condition, usually measured as the number of cases out of 100,000 people) varies considerably in different regions and different populations. This is probably due to the different genetic and environmental factors that affect the risk of getting MS.

How this study was carried out

This study was a review which pooled all previously published European population-based studies of MS that had been published in English or French between 1985 and 2011. 1985 was chosen as the start date because MRI scans were introduced around that time and so diagnosis of MS became much more reliable. 123 studies met the criteria and were included in the analysis.

What was found

There was a lot of variation in the prevalence and incidence figures reported even within particular regions or countries. However, large areas of Europe had not been studied but other areas had multiple studies.

In general, both prevalence and incidence were higher in the more recent studies and also in the Nordic countries and the more northerly regions of the UK. Prevalence could be as low as 20 cases of MS in 100,000 people in some of the early studies, in recent studies from Malta and in ethnic minority populations of Norway and Bulgaria. However, prevalence could be over 200 cases in 100,000 people in parts of Scotland and Northern Ireland and in specific populations in Scandinavia and Sicily.

Incidence varied from one to over ten new cases in every 100,000 people every year.

Almost without exception, prevalence and incidence were higher in women than men and could be as much as three times higher although the average was twice as high.

The United Kingdom was one of the two most studied areas. Prevalence ranged from 96 cases in 100,000 people in Guernsey to over 200 cases in 100,000 people in Scotland and Northern Ireland. These two countries also had the highest annual incidence rates (7.2 to 12.2 per 100,000).

What does it mean?

The researchers concluded that despite there being so many studies on the incidence and prevalence of MS in Europe, it is difficult to compare the different studies with each other because the studies are carried out in different ways. This makes it difficult to come to definite conclusions about how one region or country compares with another.

They suggest that future research should focus on regions that have not been studied so far and on any ethnic differences in the prevalence and incidence of MS.

Kingwell E, Marriott JJ, Jetté N, et al.
Incidence and prevalence of multiple sclerosis in Europe: a systematic review. .
BMC Neurol. 2013 Sep 26;13(1):128. [Epub ahead of print]
abstract
Read the full text of this paper (PDF)

More about incidence and prevalence of MS

You can read more about the incidence and prevalence of MS and what is known about the genetic and environmental factors that may add up to increase the risk of MS in a particular person or a whole population.

Another scientific paper published this week looked at the incidence and prevalence of MS in the UK from 1990-2010. It used information from the General Practice Research Database (GPRD) which holds anonymised records of patients from around 400 GP practices throughout the UK. They estimated that about 127,000 people were living with MS in the UK in 2010 which is a prevalence of 203 per 100,000 people. This is higher than previous estimates of about 100,000 people.

There were other differences in results compared with previous studies. This highlights again that it is difficult to get an accurate figure for how many people are living with MS. Also, it is difficult to work out whether the differences between studies represent real changes in prevalence and incidence or are due, in part or completely, to differences in the way the research was carried out. 

The Multiple Sclerosis International Federation maintains an Atlas of MS, which has just been updated. It is an online source of information on the worldwide distribution of MS and the global availability and accessibility of resources for people with MS. For example, you can ask the database questions like the percentage of people who receive disease modifying treatments across Europe or the number of neurologists in a particular area of the world.

Research by topic areas...

Symptoms and symptom management

Newland PK, Flick LH, Thomas FP, et al.
Identifying symptom co-occurrence in persons with multiple sclerosis.
Clin Nurs Res. 2013 Sep 17. [Epub ahead of print]
abstract

Disease modifying treatments

Castrop F, Haslinger B, Hemmer B, et al.
Review of the pharmacoeconomics of early treatment of multiple sclerosis using interferon beta.
Neuropsychiatr Dis Treat. 2013;9:1339-1349.
abstract
Read the full text of this paper

Outteryck O, Zéphir H, Salleron J, et al.
JC-virus seroconversion in multiple sclerosis patients receiving natalizumab.
Mult Scler. 2013 Sep 26. [Epub ahead of print]
abstract

Comi G.
Disease-modifying treatments for progressive multiple sclerosis.
Mult Scler. 2013 Oct;19(11):1428-36.
abstract

Other treatments

Ginsberg D, Cruz F, Herschorn S, et al.
OnabotulinumtoxinA is effective in patients with urinary incontinence due to neurogenic detrusor activity regardless of concomitant anticholinergic use or neurologic etiology.
Adv Ther. 2013 Sep 27. [Epub ahead of print]
abstract

Epidemiology

Mackenzie IS, Morant SV, Bloomfield GA, et al.
Incidence and prevalence of multiple sclerosis in the UK 1990-2010: a descriptive study in the General Practice Research Database.
J Neurol Neurosurg Psychiatry. 2013 Sep 19. [Epub ahead of print]
abstract
Read the full text of this paper

Co-existing conditions

Sun LM, Lin CL, Chung CJ, et al.
Increased breast cancer risk for patients with multiple sclerosis: a nationwide population-based cohort study.
Eur J Neurol. 2013 Sep 19. [Epub ahead of print]
abstract

Nielsen NM, Pasternak B, Stenager E, et al.
Multiple sclerosis and risk of Parkinson's disease: a Danish nationwide cohort study.
Eur J Neurol. 2013 Sep 19. [Epub ahead of print]
abstract

Wens I, Dalgas U, Stenager E, et al.
Risk factors related to cardiovascular diseases and the metabolic syndrome in multiple sclerosis - a systematic review.
Mult Scler. 2013 Sep 18. [Epub ahead of print]
abstract

Causes of MS

Lossius A, Riise T, Pugliatti M, et al.
Season of infectious mononucleosis and risk of multiple sclerosis at different latitudes; the EnvIMS Study.
Mult Scler. 2013 Sep 26. [Epub ahead of print]
abstract

Paediatric MS

Weisbrot D, Charvet L, Serafin D, et al.
Psychiatric diagnoses and cognitive impairment in pediatric multiple sclerosis.
Mult Scler. 2013 Sep 26. [Epub ahead of print]
abstract

Carbonell CF, Benson L, Rintell D, et al.
Functional Relapses in Pediatric Multiple Sclerosis.
J Child Neurol. 2013 Sep 23. [Epub ahead of print]
abstract

Psychological aspects

Goretti B, Viterbo RG, Portaccio E, et al.
Anxiety state affects information processing speed in patients with multiple sclerosis.
Neurol Sci. 2013 Sep 27. [Epub ahead of print]
abstract

Ensari I, Motl RW, McAuley E, et al.
Patterns and predictors of naturally occurring change in depressive symptoms over a 30-month period in multiple sclerosis.
Mult Scler. 2013 Sep 25. [Epub ahead of print]
abstract

Kollndorfer K, Krajnik J, Woitek R, et al.
Altered likelihood of brain activation in attention and working memory networks in patients with multiple sclerosis: An ALE meta-analysis.
Neurosci Biobehav Rev. 2013 Sep 19. [Epub ahead of print]
abstract

Karadayi H, Arisoy O, Altunrende B, et al.
The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients.
Int J Psychiatry Clin Pract. 2013 Sep 19. [Epub ahead of print]
abstract

Physical activity

Dixon J, Hatton AL, Robinson J, et al.
Effect of textured insoles on balance and gait in people with multiple sclerosis: an exploratory trial.
Physiotherapy. 2013 Sep 23. [Epub ahead of print]
abstract

Skjerbæk A, Næsby M, Lützen K, et al.
Endurance training is feasible in severely disabled patients with progressive multiple sclerosis.
Mult Scler. 2013 Sep 20. [Epub ahead of print]
abstract

Zackowski KM, Cameron M, Wagner JM.
2nd International Symposium on Gait and Balance in Multiple Sclerosis: interventions for gait and balance in MS.
Disabil Rehabil. 2013 Sep 16. [Epub ahead of print]
abstract

Self-management

Rezapour-Firouzi S, Arefhosseini SR, Mehdi F, et al.
Immunomodulatory and therapeutic effects of Hot-nature diet and co-supplemented hemp seed, evening primrose oils intervention in multiple sclerosis patients.
Complement Ther Med. 2013 Oct;21(5):473-80.
abstract

Falls

Gunn H, Creanor S, Haas B, et al.
Frequency, characteristics and consequences of falls in multiple sclerosis: findings from a cohort study.
Arch Phys Med Rehabil. 2013 Sep 18. [Epub ahead of print]
abstract

Conference

Fernandez O, Arnal-Garcia C, Arroyo-Gonzalez R, et al.
Review of the novelties presented at the 28th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) (III).
Rev Neurol. 2013 Oct 1;57(7):317-329.
abstract

Other

Ward-Abel N, Köhler W, Matthews V, et al.
Moving towards the pan-European unification of Multiple Sclerosis Nurses: a consensus paper.
Mult Scler. 2013 Sep 18. [Epub ahead of print]
abstract

von Pückler A.
A patient's perspective of partnership in the treatment of multiple sclerosis: MS regimes-An orchestrated approach.
J Neurol Sci. 2013 Aug 30. [Epub ahead of print]
abstract

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