Multiple Sclerosis: Munger K

Ascherio A, Munger K. · Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA. · Semin Neurol. · Pubmed #18256984 No free full text.

Abstract: Although genetic susceptibility explains the clustering of multiple sclerosis (MS) within families and the sharp decline in risk with increasing genetic distance, it cannot fully explain the geographical variations in MS frequency and the changes in risk that occur with migration, which support the action of strong environmental factors. Among these, vitamin D status, infection with the Epstein-Barr virus, and cigarette smoking are emerging as the most consistent predictors of MS risk. In this article, we review the epidemiological data, critically discuss the evidence for causality of these associations, and briefly discuss the possibility of interventions to reduce MS risk.

Gardener H, Munger K, Chitnis T, Spiegelman D, Ascherio A. · Department of Epidemiology, Harvard School of Public Health, Boston, MA, 02115, USA. · Mult Scler. · Pubmed #19389750 No free full text.

Abstract: BACKGROUND: Left-handedness has been studied as a marker for in-utero exposure to sex steroid hormones, and an increased risk of autoimmune and immune disorders among left-handed individuals has been suggested. OBJECTIVE: This study examines the relationship between hand preference and risk of multiple sclerosis, a presumed autoimmune disorder of unknown etiology. METHODS: The study population comprised participants in the Nurses' Health Study, an ongoing prospective cohort study of 121,701 female nurses in the United States with followup from 1976 to 2002. The nurses were asked to report their natural hand preference (right, left, ambidextrous, forced to change). RESULTS: During followup 210 incident cases with multiple sclerosis were confirmed. A 62% increased risk of multiple sclerosis was observed among women who were naturally left handed as compared to those who were naturally right handed (95% CI: 1.04-2.53). CONCLUSIONS: This study suggests a modest increase in risk of multiple sclerosis among left-handed women. Further investigation of this relationship is suggested in other populations including both males and females. While the current results suggest that prenatal exposure to sex hormones may play a role in multiple sclerosis risk, direct examination of the relationship between in-utero hormone exposure and hand preference is necessary before any conclusions can be drawn.

Di Pauli F, Reindl M, Ehling R, Schautzer F, Gneiss C, Lutterotti A, O'Reilly E, Munger K, Deisenhammer F, Ascherio A, Berger T. · Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria. · Mult Scler. · Pubmed #18632775 No free full text.

Abstract: BACKGROUND: Cigarette smoking increases the risk for development of multiple sclerosis and modifies the clinical course of the disease. In this study, we determined whether smoking is a risk factor for early conversion to clinically definite multiple sclerosis after a clinically isolated syndrome. METHODS: We included 129 patients with a clinically isolated syndrome, disseminated white-matter lesions on brain magnetic resonance imaging, and positive oligoclonal bands in the cerebrospinal fluid. The patients' smoking status was obtained at the time of the clinically isolated syndrome. RESULTS: During a follow-up time of 36 months, 75% of smokers but only 51% of non-smokers developed clinically definite multiple sclerosis, and smokers had a significantly shorter time interval to their first relapse. The hazard ratio for progression to clinically definite multiple sclerosis was 1.8 (95% confidence interval, 1.2-2.8) for smokers compared with non-smokers (P = 0.008). CONCLUSIONS: Smoking is associated with an increased risk for early conversion to clinically definite multiple sclerosis after a clinically isolated syndrome, and our results suggest that smoking is an independent but modifiable risk factor for disease progression of multiple sclerosis. Therefore, it should be considered in the counseling of patients with a clinically isolated syndrome.

Simon K, Yang X, Munger K, Ascherio A. · No affiliation provided · Mult Scler. · Pubmed #17881405 No free full text.

This publication has no abstract.

Ascherio A, Rubertone M, Spiegelman D, Levin L, Munger K, Peck C, Lennette E. · No affiliation provided · JAMA. · Pubmed #15914742 No free full text.

This publication has no abstract.