Epidemiology of multiple sclerosis in northern Greece

A total of 638 new cases of multiple sclerosis (MS) (365 females, 273 males) were found from 1970-1984 in northern Greece (Macedonia and Thrace); the average annual incidence rate was 1.79 per 100,000 inhabitants with increasing incidence from 1980-1984. A total of 729 people living in northern Greece suffered from MS on December 31, 1984 (prevalence rate 29.5 per 100,000 inhabitants). No difference was found between urban and rural areas. No difference from the international standards was found for sex incidence. The study confirms the quite high prevalence of MS despite the fact that northern Greece is in the intermediate risk zone.     

Prevalence of dementia and cognitive impairment in Southeastern Spain: the Ariadna study

Objectives – To estimate the prevalence of amnestic mild cognitive impairment (aMCI), cognitive impairment, no dementia (CIND) and dementia in a general elderly population and to examine the associated socio‐demographic factors. Methods – The Ariadna study is a population‐based cross‐sectional study of cognitive function involving 1074 individuals aged 65–96 years from the Murcia Region of southeastern Spain. Prevalence, adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated. Results – The overall prevalence was 8.7% (95% CI 7.1–10.5) for aMCI, 14.5% (95% CI 12.4–16.8) for CIND and 5.5% (95% CI 4.3–7.1) for dementia. Dementia was associated with age (OR 1.13 95% CI 1.09–1.18 for a 1‐year increase in age). Illiterate subjects were more likely to present aMCI (OR 2.59; 95% CI 1.09–6.14) and dementia (OR 4.09; 95% CI 1.28–13.08) than subjects with secondary or higher education. Rural area residents (OR 2.13, 95% CI 1.07–4.24) and women (OR 1.53, 95% CI 1.06–2.22) were more likely to have CIND. Conclusion – The prevalence of dementia was low, despite a high prevalence of aMCI and CIND. Dementia was strongly associated with age and education. CIND was associated with living in a rural area and with female sex, while aMCI was associated with illiteracy.     

Mini-Mental State Examination: standardization and validation for the elderly Slovenian population

For more than two decades Mini-Mental State Examination (MMSE) has been adapted to the Slovenian language as 'Kratek preizkus spoznavnih sposobnosti' (KPSS). In this study, we evaluated the influences of age and education on the KPSS score, looking for the cut-off point with the optimal ratio of sensitivity (SE) and specificity (SP) to support the use of the KPSS as a screening tool. During the years 2000-03 we examined 258 Slovenian volunteers. Volunteers were divided in two groups based on clinical criteria. A total of 189 were healthy, aged from 45 to 96 years, 69 were demented patients aged from 46 to 91 years, of both sexes, all different levels of education and different degrees of dementia. Median value, SE, SP, positive predictive power and negative predictive power were calculated at cut-off points 23/24, 24/25, 25/26 and 26/27. Younger age and higher education (at least 10 years of education) were each associated with higher KPSS scores. The Slovenian modification of the MMSE demonstrates an optimal cut-off score at 25/26 points for screening dementia in the Slovenian population, due to the best SP (75%)/SE (73%) ratio. The cut-off level 26/27 is recommended for screening highly educated persons.     

Lack of evidence for an association between UCHL1 S18Y and Parkinson's disease

UCHL1 has been proposed as a candidate gene for Parkinson's disease (PD). A meta-analysis of white and Asian subjects reported an inverse association between the non-synonymous UCHL1 S18Y polymorphism and PD risk. However, this finding was not replicated in a large case–control study and updated meta-analysis restricted to white subjects. We performed a case–control study of 1757 PD patients recruited from movement disorder clinics and 2016 unrelated controls from four regions of the United States. All subjects self-reported as white. We did not observe evidence for an association between S18Y genotypes and PD (overall P -value for association: P  = 0.42). After adjustment for age, sex, and recruitment region, the odds ratio for Y/S versus S/S was 0.91 (95% CI: 0.78–1.06) and for Y/Y versus S/S was 0.87 (95% CI: 0.58–1.29). We also did not observe a significant association for recessive or dominant models of inheritance, or after stratification by age at onset, age at blood draw, sex, family history of PD, or recruitment region. Our results suggest that UCHL1 S18Y is not a major susceptibility factor for PD in white populations although we cannot exclude the possibility that the S18Y variant exerts weak effects on risk, particularly in early-onset disease.     

Adapted Finnish Migraine‐Specific Questionnaire for family studies (FMSQFS): a validation study in two languages

Background and purpose: The hypothesis of a genetic component in the etiology of migraine is getting a foothold. However, to explore genetic associations, precision in clinical phenotypization is crucial. For this reason, migraine‐specific questionnaires, well discriminating between primary headaches, are required when large numbers of individuals need to be assessed. Methods: We adapted and translated in two languages, German and Italian, the Finnish Migraine‐Specific Questionnaire for use in family studies. Results and conclusions: This adaptation proved to be reliable when differentiating from primary headaches, and to be in very good agreement with the standard for comparison. However, discriminating between migraine with and without aura still relays on a specialist evaluation. This article describes the validation of this questionnaire.     

Targeting Epstein‐Barr virus infection as an intervention against multiple sclerosis

We here review contemporary data on genetic and environmental risk factors, particularly Epstein‐Barr virus infection, for multiple sclerosis. There is an important immunogenetic etiological factor for multiple sclerosis. However, a general assumption is that immune defense genes are activated by the environment, basically by infections. We contend that the relationship between infectious mononucleosis and multiple sclerosis cannot be completely explained by genetics and inverse causality. Epstein‐Barr infection as indicated by positive serology is an obligatory precondition for multiple sclerosis, which is a stronger attribute than a risk factor only. Data on events in the early pathogenesis of multiple sclerosis are cumulating from bio‐banks with presymptomatic specimens, but there is only little information from the critical age when Epstein‐Barr infection including infectious mononucleosis is acquired, nor on the detailed immunological consequences of this infection in individuals with and without multiple sclerosis. We discuss how focused bio‐banking may elaborate a rationale for the development of treatment or vaccination against Epstein‐Barr virus infection. A cohort in which intervention against Epstein‐Barr infections was performed should be the object of neurological follow‐up .