Influence of seasonal environmental factors on number of multiple sclerosis relapses

April 3, 2019
1183
Specialities :
Resume

Relapse is one of the inherent clinical signs of multiple sclerosis (MS), but an assessment of the factors that can affect the aggravation of MS remains inadequate. According to the available studies, there are contradictory results regarding seasonal factors that can affect the frequency of relapses. The purpose of this study — to assess the impact of environmental factors on the frequency of exacerbations of MS in the remitting-recurring course of four consecutive years of observation. Materials and methods. Our study envisaged the complete registration of all cases of exacerbations of MS in the Volyn region, because to date no large-scale studies have been conducted on the change of seasonal recurrence of MS in Ukraine. A prospective study of exacerbations in patients with MS was conducted for further study of seasonal fluctuations in the frequency of relapses and comparison of observed patterns with selected climatic variables. Results. During the four-year interval from January 2014 to January 2018, 197 exacerbations were registered in patients with MS (n=128). The statistical analysis of the data showed the predominance of exacerbations in the winter and spring periods and showed the presence of weak and average correlation between factors (tav, tmax, tmin, partial pressure of water vapor, relative humidity, saturation deficits, S¹, D, Q, B, Ak, T, wind speed, total cloud, low cloud, fog, light thunderstorm, large thunderstorm, hail) and the frequency of exacerbations of the MS. It has been established that seasonal recurrence of MS should be considered as the result of multifactorial effects, rather than the effects of individual, disparate factors. It is also suggested that the low status of vitamin D is a consequence rather than a risk factor for MS in general and relapse in particular.

Published: 03.04.2019

References:

  • Halik O.I., Basyuk T.O. (2014) Dovidkovi dani z klimatu Ukrayiny: Metod. vkazivky (http://ep3.nuwm.edu.ua/591/1/01-03-16.pdf).
  • Bergamaschi R. (2007) Prognostic factors in multiple sclerosis. Int. Rev. Neurobiol., 79: 423–447.
  • Browne P., Chandraratna D., Angood C. et al. (2014) Atlas of Multiple Sclerosis 2013: A growing global problem with widespread inequity. Neurology, 83(11): 1022–1024.
  • Damasceno A., Von Glehn F., de Deus-Silva L., Damasceno B.P. (2012) Monthly variation of multiple sclerosis activity in the southern hemisphere: analysis from 996 relapses in Brazil. Eur. J. Neurol., 19(4): 660–662.
  • Fonseca A.C., Costa J., Cordeiro C. et al. (2009) Influence of climatic factors in the incidence of multiple sclerosis relapses in a Portuguese population. Eur. J. Neurol., 16(4): 537–539.
  • Handel A.E., Disanto G., Jarvis L. et al. (2011) Seasonality of admissions with multiple sclerosis in Scotland. Eur. J. Neurol., 18(8): 1109–1111.
  • Harding K., Tilling K., MacIver C. et al. (2017) Seasonal variation in multiple sclerosis relapse. J. Neurol., 264(6): 1059–1067.
  • Hartl C., Obermeier V., Gerdes L.A. et al. (2017) Seasonal variations of 25-OH vitamin D serum levels are associated with clinical disease activity in multiple sclerosis patients. J. Neurol. Sci., 375: 160–164.
  • Jagannath V.A., Filippini G., Di Pietrantonj C. et al. (2018) Vitamin D for the management of multiple sclerosis. Cochrane Database Syst. Rev., 9: CD008422.
  • Krupp L.B., Tardieu M., Amato M.P. et al.; International Pediatric Multiple Sclerosis Study Group (2013) International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Mult. Scler., 19(10): 1261–1267.
  • Ogawa G., Mochizuki H., Kanzaki M. et al. (2004) Seasonal variation of multiple sclerosis exacerbations in Japan. Neurol. Sci., 24(6): 417–419.
  • Salvi F., Bartolomei I., Smolensky M.H. et al. (2010) A seasonal periodicity in relapses of multiple sclerosis? A single-center, population-based, preliminary study conducted in Bologna, Italy. BMC Neurol., 10: 105.
  • Spelman T., Gray O., Trojano M. et al. (2014) Seasonal variation of relapse rate in multiple sclerosis is latitude dependent. Ann. Neurol., 76(6): 880–890.
  • Tremlett H., van der Mei I.A., Pittas F. et al. (2008) Monthly ambient sunlight, infections and relapse rates in multiple sclerosis. Neuroepidemiology, 31(4): 271–279.
  • Vojinović S., Savić D., Lukić S. et al. (2015) Disease relapses in multiple sclerosis can be influenced by air pollution and climate seasonal conditions. Vojnosanit. Pregl., 72(1): 44–49.