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Semin Neurol 2008; 28(1): 017-028
DOI: 10.1055/s-2007-1019126
© Thieme Medical Publishers

Epidemiology of Multiple Sclerosis: From Risk Factors to Prevention

Alberto Ascherio1 , Kassandra Munger2
  • 1Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts
  • 2Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
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Publication History

Publication Date:
07 February 2008 (online)

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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.

KEYWORDS

Multiple sclerosis - epidemiology - vitamin D - infection - environment

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Alberto AscherioM.D. Dr.P.H. 

Departments of Nutrition and Epidemiology, Harvard School of Public Health

655 Huntington Avenue, Boston, MA 02115

Email: aascheri@hsph.harvard.edu