Journal
SEMINARS IN NEUROLOGY
Volume 28, Issue 1, Pages 17-28Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-2007-1019126
Keywords
multiple sclerosis; epidemiology; vitamin D; infection; environment
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Funding
- NINDS NIH HHS [R01 NS042194, R01 NS47467] Funding Source: Medline
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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.
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