Examining the environmental risk factors of progressive-onset and relapsing-onset multiple sclerosis: recruitment challenges, potential bias, and statistical strategies.
Journal: Journal of neurology
Volume: 271
Issue: 1
Year of Publication: 2024
Affiliated Institutions:
Menzies Institute of Medical Research, University of Tasmania, Liverpool Street, Hobart, TAS, , Australia.
Florey Institute for Neuroscience, University of Melbourne, Melbourne, VIC, Australia.
School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia.
Hunter Medical Research Institute, University of Newcastle, Callaghan, Australia.
Hacettepe University, Ankara, Turkey.
Department of Medical and Surgical Sciences and Advanced Technologies, GF Ingrassia, Catania, Italy.
Hospital Universitario Virgen Macarena, Seville, Spain.
University G. d'Annunzio, Chieti, Italy.
Dokuz Eylul University, Konak, Izmir, Turkey.
Charles University in Prague and General University Hospital, Prague, Czech Republic.
Neuro Rive-Sud, Quebec, Canada.
Amiri Hospital, Sharq, Kuwait.
Zuyderland Medical Center, Sittard-Geleen, The Netherlands.
University of Florence, Florence, Italy.
Department of Neurology and Koc University Research Center for Translational Medicine (KUTTAM), Koc University, School of Medicine, Istanbul, Turkey.
CHUM and Universite de Montreal, Montreal, Canada.
Hospital Clinic de Barcelona, Barcelona, Spain.
Hospital Germans Trias i Pujol, Badalona, Spain.
Universitary Hospital Ghent, Ghent, Belgium.
Department of Neurology, Neroimmunology Centre, Royal Melbourne Hospital, Melbourne, Australia.
American University of Beirut Medical Center, Beirut, Lebanon.
Isfahan University of Medical Sciences, Isfahan, Iran.
Al Zahra Hospital, Isfahan, Iran.
Bombay Hospital Institute of Medical Sciences, Mumbai, India.
Department of Neurology, LR SP, Clinical Investigation Centre Neurosciences and Mental Health, University Hospital Razi-Manouba, Tunis, Tunisia.
S. Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy.
University Hospital Center Zagreb, Zagreb, Croatia.
Monash Medical Centre, Melbourne, Australia.
Royal Victoria Hospital, Belfast, UK.
Royal Brisbane and Women's Hospital, Brisbane, Australia.
Nemocnice Jihlava, Jihlava, Czech Republic.
The Alfred Hospital, Melbourne, Australia.
Monash University, Melbourne, Australia.
Groene Hart Ziekenhuis, Gouda, Netherlands.
St Vincent's University Hospital, Dublin, Ireland.
Hospital Clinico San Carlos, Madrid, Spain.
Centro Hospitalar Universitario de Sao Joao, Porto, Portugal.
Aarhus University Hospital, Aarhus, Denmark.
King Fahad Specialist Hospital-Dammam, Khobar, Saudi Arabia.
Hospital General Universitario de Alicante, Alicante, Spain.
Pelt and Hasselt University, Hasselt, Belgium.
AHEPA University Hospital, Thessaloniki, Greece.
CSSS Saint-Jérôme, Saint-Jerome, Canada.
South Eastern HSC Trust, Belfast, UK.
Hospital Universitario Donostia and IIS Biodonostia, San Sebastián, Spain.
Austin Health, Melbourne, Australia.
IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Golestan University of Medical Sciences, Gogan, Iran.
Menzies Institute of Medical Research, University of Tasmania, Liverpool Street, Hobart, TAS, , Australia. ingrid.vandermei@utas.edu.au.
Abstract summary
It is unknown whether the currently known risk factors of multiple sclerosis reflect the etiology of progressive-onset multiple sclerosis (POMS) as observational studies rarely included analysis by type of onset. We designed a case-control study to examine associations between environmental factors and POMS and compared effect sizes to relapse-onset MS (ROMS), which will offer insights into the etiology of POMS and potentially contribute to prevention and intervention practice. This study utilizes data from the Primary Progressive Multiple Sclerosis (PPMS) Study and the Australian Multi-center Study of Environment and Immune Function (the AusImmune Study). This report outlines the conduct of the PPMS Study, whether the POMS sample is representative, and the planned analysis methods. The study includes 155 POMS, 204 ROMS, and 558 controls. The distributions of the POMS were largely similar to Australian POMS patients in the MSBase Study, with 54.8% female, 85.8% POMS born before 1970, mean age of onset of 41.44 ± 8.38 years old, and 67.1% living between 28.9 and 39.4° S. The POMS were representative of the Australian POMS population. There are some differences between POMS and ROMS/controls (mean age at interview: POMS 55 years vs. controls 40 years; sex: POMS 53% female vs. controls 78% female; location of residence: 14.3% of POMS at a latitude ≤ 28.9°S vs. 32.8% in controls), which will be taken into account in the analysis. We discuss the methodological issues considered in the study design, including prevalence-incidence bias, cohort effects, interview bias and recall bias, and present strategies to account for it. Associations between exposures of interest and POMS/ROMS will be presented in subsequent publications.
Authors & Co-authors:
Li Ying Y
Saul Alice A
Taylor Bruce B
Ponsonby Anne-Louise AL
Simpson-Yap Steve S
Blizzard Leigh L
Broadley Simon S
Lechner-Scott Jeannette J
Karabudak Rana R
Patti Francesco F
Eichau Sara S
Onofrj Marco M
Ozakbas Serkan S
Horakova Dana D
Kubala Havrdova Eva E
Grand'Maison Francois F
Alroughani Raed R
Gerlach Oliver O
Amato Maria Pia MP
Altintas Ayse A
Girard Marc M
Duquette Pierre P
Blanco Yolanda Y
Ramo-Tello Cristina C
Laureys Guy G
Kalincik Tomas T
Khoury Samia J SJ
Shaygannejad Vahid V
Etemadifar Masoud M
Singhal Bhim B
Mrabet Saloua S
Foschi Matteo M
Habek Mario M
John Nevin N
Hughes Stella S
McCombe Pamela P
Ampapa Radek R
van der Walt Anneke A
Butzkueven Helmut H
de Gans Koen K
McGuigan Chris C
Oreja-Guevara Celia C
Sa Maria Jose MJ
Petersen Thor T
Al-Harbi Talal T
Sempere Angel Perez AP
Van Wijmeersch Bart B
Grigoriadis Nikolaos N
Prevost Julie J
Gray Orla O
Castillo-Triviño Tamara T
Macdonell Richard R
Lugaresi Alessandra A
Sajedi Seyed Aidin SA
van der Mei Ingrid I
Study Outcome
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