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Review
. 2022 Apr;269(4):1817-1824.
doi: 10.1007/s00415-021-10782-5. Epub 2021 Sep 27.

Multiple sclerosis epidemiological trends in Italy highlight the environmental risk factors

M Puthenparampil  1   2 , P Perini  3 , R Bergamaschi  4 , M Capobianco  5 , M Filippi  6 , P Gallo  7   8
Affiliations
Review

Multiple sclerosis epidemiological trends in Italy highlight the environmental risk factors

M Puthenparampil et al. J Neurol. 2022 Apr.

Abstract

Italy is definitely a high-risk country for multiple sclerosis (MS). Over the last 50 years, several epidemiological studies, including longitudinal surveys, have disclosed that MS incidence and prevalence in Italy mainland and Islands (Sardinia and Sicily) have progressively increased, picturing a semi-parabolic curve. Based on the comprehensive scrutiny of 58 papers, we conclude that the latitude risk gradient does not fit to the Italian map of MS. The genetic heterogeneity of the Italian ethnicities, that likely forms the basis of MS predisposition, does not account for the dramatic increase of MS incidence and prevalence observed in Italy over the last half century that, rather, seems better explained by the effect of environmental factors.

Keywords: Epidemiology; Incidence; Multiple sclerosis; Prevalence.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Trend of MS prevalence in Italy over the last 5 decades. Bars report MS prevalence values described in the epidemiological studies conducted in Italy mainland over the last 50 years (Ref. 8–10, 12–23, Supplementary Bibliography, 1–10). The increase in MS prevalence describes a semi-parabolic curve, without plateau or slowing-down periods during the last 5 decades
Fig. 2
Fig. 2
Trends of MS prevalence in Padan Plain, Sardinia e Sicily. Graphics report the prevalence trend observed in the Padan Plain (Ref. 10, 12–18), Sicily (Ref. 35–44, Supplementary Bibliography, 11–15), and Sardinia (Ref. 24–31, Supplementary Bibliography, 16–18) over the last 50 years. In the map of Italy, loco-regional differences in MS prevalence are reported for Tuscany, Lazio, Sicily and Sardinia. RSM Republic of San Marino. See text for details
Fig. 3
Fig. 3
Locoregional differences in MS prevalence or incidence in Europe. Regional differences in MS prevalence and incidence that question the latitude gradient are observed throughout Europe. See text for details
See this image and copyright information in PMC

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