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Historical changes of seasonal differences in the frequency of multiple sclerosis clinical attacks: a multicenter study

Journal of Neurology volume 260, pages 1258–1262 (2013)Cite this article

Abstract

Previous papers show discordant patterns of monthly and seasonal differences in the frequency of multiple sclerosis relapses. Attacks are more often reported in spring and summer, but there are many variations, mainly as to summer peaks. This paper, an MSBase collaboration substudy, reports multiple series of relapses from 1980 to 2010, comparing ultradecennal trends of seasonal frequency of attacks in different countries. The MSBase international database was searched for relapses in series recording patient histories from 1980 up to 2010. The number of relapses by month was stratified by decade (1981–1990, 1991–2000, 2001–2010). Positive spring versus summer peaks were compared by odds ratios; different series were compared by weighted odds ratio (Peto OR). Decade comparison of the 1990s versus 2000s shows inversion of spring–summer peak (2000s = March; 1990s = July), significant in the whole group (Peto odds ratio = 1.31, CI = 1.10–1.56, p = 0.003) and in Salerno series (OR = 1.97, CI = 1.14–1.40). The global significance persisted also excluding Salerno series (Peto odds ratio = 1.25, CI = 1.04–1.50, p = 0.002). Multicentric data confirm a summer peak of relapses in the 1991–2000 decade, significantly different from the spring peak of 2001–2010. Seasonal frequency of relapses shows long-term variations, so that other factors such as viral epidemics might have more relevance than ultraviolet exposure.

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Conflicts of interest

Gerardo Iuliano has had travel/accommodation/meeting expenses funded by Bayer Schering, Sanofi Aventis, Merck Serono, Novartis, and Biogen Idec, Cavit Boz, Edgardo Cristiano, and Pierre Duquette declare no conflicts of interest. Alessandra Lugaresi has received honoraria or grants from Bayer Schering, Biogen Idec, Merck Serono, Sanofi Aventis, Novartis, and Teva. Dr. Oreja-Guevara has participated in clinical trials and other research projects promoted by Biogen Idec, GSK, Merck-Serono, Teva, and Novartis. Vincent Van Pesch has received compensation for serving on an advisory board for Biogen Idec (2010–11), travel/accommodations/meeting expenses funded by Bayer Schering, Sanofi Aventis, Merck Serono, Novartis, and Biogen Idec, and honoraria for speaking engagement funded by Biogen Idec (2011).

Ethical standard

All human studies must state that they have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Affiliations

  1. Department of Neurosciences, U.O.S.D. Malattie Demielinizzanti, A.O.U. Ospedali Riuniti di Salerno, piazza P.Paoli no 6, 84123, Salerno, Italy

    Gerardo Iuliano

  2. Department of Neurology, Karadeniz Technical University, Trabzon, Turkey

    Cavit Boz

  3. Hospital Italiano, Guise 1870, 1425, Buenos Aires, Argentina

    Edgardo Cristiano

  4. CHUM Hopital, Notre Dame 1560, Sherbrooke East, Montreal, H2L 4M1, Canada

    Pierre Duquette

  5. Centro Sclerosi multipla, Department of Neuroscience and Imaging, Univ. “G. d’Annunzio”, Chieti, Italy

    Alessandra Lugaresi

  6. Hospital Universitario La Paz, Madrid, Spain

    Celia Oreja-Guevara

  7. Cliniques Universitaires, Saint-Luc avenue Hippocrate 10 UCL10/80, 1200, Brussels, BXL, Belgium

    Vincent Van Pesch

Authors
  1. Gerardo Iuliano
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  2. Cavit Boz
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  3. Edgardo Cristiano
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  4. Pierre Duquette
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  5. Alessandra Lugaresi
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  6. Celia Oreja-Guevara
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  7. Vincent Van Pesch
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Correspondence to Gerardo Iuliano.

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Iuliano, G., Boz, C., Cristiano, E. et al. Historical changes of seasonal differences in the frequency of multiple sclerosis clinical attacks: a multicenter study. J Neurol 260, 1258–1262 (2013). https://doi.org/10.1007/s00415-012-6785-y

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  • DOI: https://doi.org/10.1007/s00415-012-6785-y

Keywords

  • Multiple sclerosis
  • Relapse
  • Seasonal variation
  • Temporal trends