The effect of demographic features and environmental risk factors on the clinical course in patients with multiple sclerosis
İrem İlgezdi Kaya1
, Bedile İrem Tiftikçioğlu2, Yaşar Zorlu3, Levent Öcek4, Ufuk Şener4, Figen Tokuçoğlu5
1Department of Neurology, Gaziantep Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Türkiye
2Department of Neurology, İzmir Bakırçay University Faculty of Medicine, İzmir, Türkiye
3Department of Neurology, Retired Education Supervisor, İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
4Department of Neurology, University of Health Sciences, İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
5Department of Neurology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
Keywords: Disease course, environmental factors, epidemiology, multiple sclerosis, progression.
Abstract
Objectives: This study aimed to investigate demographic, clinical, and environmental risk factors in patients with multiple sclerosis (MS) and their relationship with the disease.
Patients and methods: The medical records of 913 patients with MS followed for ≥6 months between January 1996 and December 2015 were retrospectively reviewed, and 221 patients (158 females, 63 males; mean age: 43.4±11.6 years; range, 18 to 73 years) with demographic, clinical, and laboratory data were included.
Results: Relapsing-remitting MS was identified in 75.6% (n=167) of patients, and progressive MS was identified in 24.4% (n=54). The initial Expanded Disability Status Scale (EDSS) scores were lower in the relapsing-remitting MS group compared to the progressive MS group (2.3±1.0 vs. 2.6±1.4; p<0.05). Motor symptoms were the initial presenting symptoms in 33.0% of the patients, followed by sensory symptoms and optic neuritis. The transition to the progressive phase was observed to occur at a younger age in patients with an earlier onset age (p<0.001). Motor symptom onset correlated with later disease onset, progression, and higher final EDSS score (p<0.05). Vitamin D deficiency and insufficiency were observed in 18.1% and 73.5% of patients, respectively. Seropositivity for Epstein-Barr virus (EBV) antibodies was high. Vitamin D levels and EBV serology were similar between the groups.
Conclusion: In our patient group, early disease onset correlated with earlier transition to progression phase. Onset with motor symptom correlated with progression and higher disability scores. Vitamin D deficiency and high EBV seropositivity were common but not directly linked to clinical course. These findings potentially reflect MS patient profiles, warranting further epidemiological studies.
Cite this article as: İlgezdi Kaya İ, İrem Tiftikçioğlu B, Zorlu Y, Öcek L, Şener U, Tokuçoğlu F. The effect of demographic features and environmental risk factors on the clinical course in patients with multiple sclerosis. Turk J Neurol 2025;31(2):118-127. doi: 10.55697/tnd.2025.211.
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Concept, design: İ.İ.K., B.İ.T., Y.Z.; Data collection or processing: İ.İ.K., L.Ö.; Analysis or interpretation: B.İ.T.; Literature search, writing: İ.İ.K., B.İ.T.; Supervision and review: U.Ş., F.T., Y.Z.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.