Relapses In multiple sclerosis.

Authors

  • O. O. Nikolenko
  • O. D. Shulga
  • V. V. Kozliuk
  • O. M. Zheshko
  • O. A. Yurko
  • M. I. Dubinets

DOI:

https://doi.org/10.26641/2307-0404.2019.3.181888

Keywords:

relapse, exacerbartion, multiple sclerosis, gender, age, seasonal factors

Abstract

Exact causes of contradictions in the understanding of relapsing course as characteristic phenomenon of multiple sclerosis (MS) and primarily relapsing-remitting type are still considered to be “sub rosa”. We tried to determine connection and correlation between seasonal dynamic factors, chronometric parameters of disease progression (age, disease duration) and frequency of relapses and the role of gender differences as well. A four-year prospective study included complete registration of all cases of MS exacerbations in resident patients with a relapsing-remmiting course of the disease according to McDonald criteria in Volyn region of Ukraine in 2010. Each patient had neurological score based on EDSS scale to ensure compliance with inclusion criteria. 128 patients (44 males and 84 females) with a remitting-recurring course of the disease were involved in this study. Statistical analysis was performed using SPSS 18, MedCalc and Microsoft Excel software using standard descriptive statistics, correlation and regression analysis. In total, 197 cases of MS relapses were registered. Episodes of relapses prevailed in winter-spring period. Multiple regression model including suggested climate factors showed multiple correlation coefficient – 0.55 (p<0.01). The prevalence of MS was higher in females, while general incidence of recurrences was similar to males. However, relapse rate in different age groups differs: the rate of recurrence increases in women aged after 50 years (mean annualized relapse rate (ARR)=0.66), while it slowly decreases in men with aging. The duration of the disease did not have significant effect on the course of MS in women, whereas weak negative relationship (0.24, p<0.001) between the duration of the disease and the frequency of MS in men was showed. Correspondingly, the average negative correlation (-0.37, p<0.001) was detected between the age of disease onset and the incidence of MS recurrence in males, while this connection was not observed in females. We established that the recurrence of MS is a result of multifactorial influence of external and internal factors. Individual seasonal climate variability did not have sufficient force of influence. Therefore, combined effect of corresponding climate changes played a significant role. Furthermore, it is quite probable that interactions of MS with external factors influencing the human body can be mutually integrated.

Author Biographies

O. O. Nikolenko

Volyn Regional Clinical Hospital
Department of Neurology
Hrushevskoho av., 21, Lutsk, 43005, Ukraine

O. D. Shulga

Volyn Regional Clinical Hospital
Department of Neurology
Hrushevskoho av., 21, Lutsk, 43005, Ukraine

V. V. Kozliuk

Volyn Regional Clinical Hospital
Department of Neurology
Hrushevskoho av., 21, Lutsk, 43005, Ukraine

O. M. Zheshko

Volyn Regional Clinical Hospital
Department of Neurology
Hrushevskoho av., 21, Lutsk, 43005, Ukraine

O. A. Yurko

Volyn Regional Clinical Hospital
Department of Neurology
Hrushevskoho av., 21, Lutsk, 43005, Ukraine

M. I. Dubinets

Volyn Regional Clinical Hospital
Department of Neurology
Hrushevskoho av., 21, Lutsk, 43005, Ukraine

References

Nikolenko ОО, Shulga ОD, Kozliuk VV, Valets­ka UV, Tenderiak OV Zheshko ОМ, Dubinets МІ, Yur­ko ОА. [Influence of seasonal climatic factors on the frequency of exacerbations of multiple sclerosis]. Ukrayinskyi medychnyi chasopys. 2019;2(2):130. doi: https://doi.org/10.32471/umj.1680-3051.130.140263

Halik OI, Basyuk TO. Method instructions. Ukrainian Climate Reference. Available from: http://ep3.nuwm.edu.ua/591/1/01-03-16.pdf

Zheshko ОМ, Shulga ОD, Dubinets МІ, Yur­ko ОА, Lopachak ОR. [Exacerbation of multiple sclero­sis: a clinical and paraclinic paradox]. Prykarpatskyi visnyk NTSH. Puls. 2019;5(57):65-69. doi: https://doi.org/10.21802/2304-7437-2019-5(57)-65-69

Nefodov ОО, Mamchur VY. [Experimental aller­gic encephalomyelitis: features of analgesic therapy and the place of anticonvulsants as analgesics]. Medicnі perspektivi. 2015;(20)4:4-9 doi: https://doi.org/10.26641/2307-0404.2015.4.56125.

Central geophysical observatory named after Bo­ris Sreznevsky. Available from: http://cgo-sreznevskyi.kiev.ua/

Bouman A, Heineman MJ, Faas MM. Sex hormo­nes and the immune response in humans. Human Repro­duction 2005;11(4):411-23. doi: https://doi.org/10.1093/humupd/dmi008

Bove R., Gilmore W. Hormones and MS: Risk factors, biomarkers, and therapeutic targets. Multiple Sclerosis Journal. 2018;24(1):17-21. doi: https://doi.org/10.1177/1352458517737396

Chitnis T. The role of testosterone in MS risk and course. Multiple Sclerosis Journal. 2018;24(1):36-41. doi: https://doi.org/10.1177/1352458517737395

Damasceno A, Glehn FV, de Deus-Silva L, Da­masceno BP. Monthly variation of multiple sclerosis activity in the southern hemisphere: analysis from 996 relapses in Brazil. Eur J Neurol. 2012;19(4):660-2. doi: https://doi.org/10.1111/j.1468-1331.2011.03543.x

Vojinovic Slobodan, Savic Dejan, Lukic Stevo, Savic Ljiljana, Vojinovic Jelena. Disease relapses in mul­tiple sclerosis can be influenced by air pollution and climate seasonal conditions. Vojnosanitetski pregled. 2014;72:30-30. doi: https://doi.org/10.2298/VSP140121030V

Dunn SE, Lee H, Pavri FR, Zhang MA. Sex-Based Differences in Multiple Sclerosis (Part I): Biology of Disease Incidence. Current Topics in Beha­vioral Neurosciences. Springer. 2015;26:29-56.

Gomez FP, Steelman AJ, Young CR, Welsh CJ. Hormone and immune system interactions in demyeli­nating disease. Hormones and Behavior. 2013;63(2):315-21. doi: https://doi.org/10.1016/j.yhbeh.2012.10.014

Hartl C, Obermeier V, Gerdes LA, Brügel M, von Kries R, Kümpfel T. Seasonal variations of 25-OH vita­min D serum levels are associated with clinical disease activity in multiple sclerosis patients. Journal of the Neurological Sciences. 2017;375:160-4. doi: https://doi.org/10.1016/j.jns.2017.01.059

Tomassini Valentina, Onesti Emanuela, Mainero Caterina, Giugni E, Paolillo Andrea, Salvetti Massimo, Nicoletti Ferdinando, Pozzilli C. Sex hormones modulate brain damage in multiple sclerosis: MRI evidence. Journal of neurology, neurosurgery, and psychiatry. 2005;76:272-5. doi: https://doi.org/10.1136/jnnp.2003.033324

Sicotte NL, Giesser BS, Tandon V, et al. Testo­sterone treatment in multiple sclerosis: A pilot study. Arch Neurol 2007;64:683-8. doi: https://doi.org/10.1001/archneur.64.5.683

Downloads

How to Cite

1.
Nikolenko OO, Shulga OD, Kozliuk VV, Zheshko OM, Yurko OA, Dubinets MI. Relapses In multiple sclerosis. Med. perspekt. [Internet]. 2019Nov.5 [cited 2024Mar.28];24(3):87-96. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/181888

Issue

Section

CLINICAL MEDICINE