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Examining the Environmental Risk Factors of Progressive-Onset and Relapsing-Onset Multiple Sclerosis: Recruitment Challenges, Potential Bias, and Statistical Strategies Publisher Pubmed



Li Y1 ; Saul A1 ; Taylor B1 ; Ponsonby AL2 ; Simpsonyap S1, 3 ; Blizzard L1 ; Broadley S4 ; Lechnerscott J5 ; Karabudak R6 ; Patti F7, 8 ; Eichau S9 ; Onofrj M10 ; Ozakbas S11 ; Horakova D12 Show All Authors
Authors
  1. Li Y1
  2. Saul A1
  3. Taylor B1
  4. Ponsonby AL2
  5. Simpsonyap S1, 3
  6. Blizzard L1
  7. Broadley S4
  8. Lechnerscott J5
  9. Karabudak R6
  10. Patti F7, 8
  11. Eichau S9
  12. Onofrj M10
  13. Ozakbas S11
  14. Horakova D12
  15. Kubala Havrdova E12
  16. Grandmaison F13
  17. Alroughani R14
  18. Gerlach O15, 16
  19. Amato MP17
  20. Altintas A18
  21. Girard M19
  22. Duquette P19
  23. Blanco Y20
  24. Ramotello C21
  25. Laureys G22
  26. Kalincik T23, 24
  27. Khoury SJ25
  28. Shaygannejad V26
  29. Etemadifar M27
  30. Singhal B28
  31. Mrabet S29, 30
  32. Foschi M31, 32
  33. Habek M33, 34
  34. John N35, 36
  35. Hughes S37
  36. Mccombe P38, 39
  37. Ampapa R40
  38. Van Der Walt A41, 42
  39. Butzkueven H43
  40. De Gans K44
  41. Mcguigan C45, 46
  42. Orejaguevara C47
  43. Sa MJ48, 49
  44. Petersen T50
  45. Alharbi T51
  46. Sempere AP52
  47. Van Wijmeersch B53
  48. Grigoriadis N54
  49. Prevost J55
  50. Gray O56
  51. Castillotrivino T57
  52. Macdonell R58, 59, 60
  53. Lugaresi A61, 62
  54. Sajedi SA63
  55. Van Der Mei I1
Show Affiliations
Authors Affiliations
  1. 1. Menzies Institute of Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000, TAS, Australia
  2. 2. Florey Institute for Neuroscience, University of Melbourne, Melbourne, VIC, Australia
  3. 3. Melbourne School of Population and Global Health, Neuroepidemiology Unit, The University of Melbourne, Melbourne, VIC, Australia
  4. 4. School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
  5. 5. Hunter Medical Research Institute, University of Newcastle, Callaghan, Australia
  6. 6. Hacettepe University, Ankara, Turkey
  7. 7. Department of Medical and Surgical Sciences and Advanced Technologies, GF Ingrassia, Catania, Italy
  8. 8. UOS Sclerosi Multipla, AOU Policlinico “G Rodloico-San Marco”, University of Catania, Catania, Italy
  9. 9. Hospital Universitario Virgen Macarena, Seville, Spain
  10. 10. University G. d’Annunzio, Chieti, Italy
  11. 11. Dokuz Eylul University, Izmir, Konak, Turkey
  12. 12. Charles University in Prague and General University Hospital, Prague, Czech Republic
  13. 13. Neuro Rive-Sud, QC, Canada
  14. 14. Amiri Hospital, Sharq, Kuwait
  15. 15. Zuyderland Medical Center, Sittard-Geleen, Netherlands
  16. 16. School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
  17. 17. University of Florence, Florence, Italy
  18. 18. Department of Neurology and Koc University Research Center for Translational Medicine (KUTTAM), Koc University, School of Medicine, Istanbul, Turkey
  19. 19. CHUM and Universite de Montreal, Montreal, Canada
  20. 20. Hospital Clinic de Barcelona, Barcelona, Spain
  21. 21. Hospital Germans Trias i Pujol, Badalona, Spain
  22. 22. Universitary Hospital Ghent, Ghent, Belgium
  23. 23. Department of Neurology, Neroimmunology Centre, Royal Melbourne Hospital, Melbourne, Australia
  24. 24. Department of Medicine, CORe, University of Melbourne, Melbourne, Australia
  25. 25. American University of Beirut Medical Center, Beirut, Lebanon
  26. 26. Isfahan University of Medical Sciences, Isfahan, Iran
  27. 27. Al Zahra Hospital, Isfahan, Iran
  28. 28. Bombay Hospital Institute of Medical Sciences, Mumbai, India
  29. 29. Department of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, University Hospital Razi-Manouba, Tunis, Tunisia
  30. 30. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, 1007, Tunisia
  31. 31. S. Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy
  32. 32. Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio 1, L’Aquila, Italy
  33. 33. University Hospital Center Zagreb, Zagreb, Croatia
  34. 34. University of Zagreb, School of Medicine, Zagreb, Croatia
  35. 35. Monash Medical Centre, Melbourne, Australia
  36. 36. Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
  37. 37. Royal Victoria Hospital, Belfast, United Kingdom
  38. 38. Royal Brisbane and Women’s Hospital, Brisbane, Australia
  39. 39. University of Queensland, Brisbane, Australia
  40. 40. Nemocnice Jihlava, Jihlava, Czech Republic
  41. 41. The Alfred Hospital, Melbourne, Australia
  42. 42. Central Clinical School, Monash University, Melbourne, Australia
  43. 43. Monash University, Melbourne, Australia
  44. 44. Groene Hart Ziekenhuis, Gouda, Netherlands
  45. 45. St Vincent’s University Hospital, Dublin, Ireland
  46. 46. University College Dublin, Dublin, Ireland
  47. 47. Hospital Clinico San Carlos, Madrid, Spain
  48. 48. Centro Hospitalar Universitario de Sao Joao, Porto, Portugal
  49. 49. Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
  50. 50. Aarhus University Hospital, Aarhus, Denmark
  51. 51. King Fahad Specialist Hospital-Dammam, Khobar, Saudi Arabia
  52. 52. Hospital General Universitario de Alicante, Alicante, Spain
  53. 53. Pelt and Hasselt University, Hasselt, Belgium
  54. 54. AHEPA University Hospital, Thessaloniki, Greece
  55. 55. CSSS Saint-Jerome, Saint–Jerome, Canada
  56. 56. South Eastern HSC Trust, Belfast, United Kingdom
  57. 57. Hospital Universitario Donostia and IIS Biodonostia, San Sebastian, Spain
  58. 58. Austin Health, Melbourne, Australia
  59. 59. Department of Medicine, The University of Melbourne, Melbourne, Australia
  60. 60. Florey Institute for Neuroscience, The University of Melbourne, Melbourne, VIC, Australia
  61. 61. IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
  62. 62. Dipartimento di Scienze Biomediche e Neuromotorie, Universita di Bologna, Bologna, Italy
  63. 63. Golestan University of Medical Sciences, Gogan, Iran

Source: Journal of Neurology Published:2024


Abstract

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. © The Author(s) 2023.
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