Epidemiology of multiple sclerosis in the Bryansk Region
Objective: to study the clinical and epidemiological features of multiple sclerosis (MS) in the Bryansk Region. Patients and methods. Information about 180 (31.0%) of 590 MS patients registered in the Bryansk Region with a valid diagnosis of MS according to the 2005 McDonald criteria was analyzed. All the patients are followed up at the Demyelinating Disease Office, Neurology Department, Bryansk Regional Hospital One. The Expanded Disability Status Scale (EDSS) was used to evaluate the severity of the disease and the degree of disability. The rate of MS progression was calculated from the ratio of EDSS scores at the time of examination to disease duration. Results. The Bryansk Region is shown to belong to a moderate MS risk area: the prevalence of the disease is 48.1 cases per 100,000; its incidence in the individual districts of the region is 5.0 to 211.4 cases per 100,000. There has been an approximately 1.2-fold increase in the prevalence of MS in the past 7 years. The mean age of MS patients in the Bryansk Region is 39.9+10.1 years; about 70% of the patients are in the age range of 29-49 years. The mean age at the onset of MS is 28.0+9.1 years. Early-onset MS before the age of 18 years is recorded in 20 (11.1%) patients; late-onset MS (after the age of 45 years) is in 7 (3.9%). There is a preponderance of its multifocal onset. Sensitive and motor disorders and optic neuritis more frequently occur as the first symptom at monofocal onset. The duration of MS averages 11.0+5.5 years (1 to 32 years). The mean duration of the first remission is as long as 33.1+26.1 (0-144) months and that of the second one is 19.2+17.7 (0-132) months. The mean EDSS score was 3.3+2.4 (0-9.0). The rate of MS progression in the region averages 0.38+0.28 per year. About 60% of the patients have Groups I, II, and III disability. Remitting MS is more common (69.4% of cases), its secondary and primary progressive course is noted in 28.9% and in nearly 2% of the patients, respectively. Conclusion. The findings may be useful in planning sociomedical care for patients with MS in some areas of the Bryansk Region.