Highlights
- •Case-control questionnaire of pre-symptomatic health-adverse behavior.
- •MS patients' responses compared to those with benign headache.
- •Significant differences confirmed for smoking, alcohol and glandular fever.
- •Also: drug abuse, parties, sunbathing; number of partners, pregnancies and terminations.
- •MS patients appear to adopt a riskier lifestyle than our control group.
Abstract
Background
It is generally accepted that individuals who subsequently develop MS are more likely
to be smokers, have suffered glandular fever and to have a low blood vitamin D level.
Previous research suggested that a unifying premise is risk-associated behavior before
MS onset. This survey explores several health-adverse premorbid behaviors using a
case-control design.
Methods
A questionnaire was completed by 94 patients with clinically definite MS. Their responses
were compared to a control group of 59 who were patients with benign headache. Questions
explored pre-symptomatic experience of: (a) alcohol, smoking, substance abuse, glandular fever; (b) blood
transfusion; (c) hazardous sport, gambling (d) sexual history, gynecologic infection,
number of pregnancies, terminations of pregnancy. Data were adjusted for age of first
symptoms, gender and smoking.
Results
Compared to the headache group, MS subjects showed significant differences prior to
symptom onset, adjusted for age of first symptoms, gender and smoking, with odds ratios
for reporting or means and 95% confidence intervals as follows: (a) consuming alcoholic
drinks, OR 6.91 (1.74 to 27.45; p=0.006) and at an earlier age, mean 16.9 y (16.4 to 17.5; p=0.046) (b) cigarette smoking, OR 2.24 (1.09 to 4.59; p=0.028) and to have smoked more per day, mean 9.45 (5.55 to 13.35; p=0.001) (c) history of glandular fever/infectious mononucleosis, OR 3.07 (1.11 to
8.49; p=0.031); (d) consumed recreational drugs, OR 3.90 (1.32 to 11.50; p=0.014), notably cannabis, OR 4.10 (1.40 to 12.09; p=0.011); (e) used a car seat belt, OR 4.45 (1.43 to 13.83; p=0.010); (f) attended all-night parties, OR 2.45 (1.12 to 5.36; p=0.025); (g) sunbathed, OR 2.770 (1.02 to 7.52; p=0.046); (h) had more sexual partners, mean 3.97 (2.00 to 5.95; p<0.001), more pregnancies, mean 1.43 (0.99 to 1.86; p=0.015) and one or more terminations of pregnancy, OR 5.05 (1.003 to 25.386; p=0.049).
Conclusion
All but one of the statistically significant variables (use of car seat belt) supports
our hypothesis that MS subjects lead a riskier premorbid lifestyle. Strong associations
were found for smoking, alcohol and glandular fever as suggested by others. Novel
associations were found for recreational drug use; attending all-night parties; gambling
on the lottery; more sexual partners, more pregnancies and one or more terminations
of pregnancy. Such behavior during the MS prodrome may expose an individual to a variety
of hostile environmental agents.
Keywords
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References
- Epstein-barr virus infection and multiple sclerosis: a review.Journal of Neuroimmune Pharmacology. 2010; 5: 271-277
- Correlates of college student marijuana use: results of a US National Survey.Addiction. 1997; 92: 571-581
- Drug abuse as a risk factor of multiple sclerosis: case-control analysis and a study of heterogeneity.Neuroepidemiology. 1993; 12: 6-14
- A cohort study among university students: identification of risk factors for Epstein-Barr virus seroconversion and infectious mononucleosis.Clinical Infectious Diseases. 2006; 43: 276-282
- Sexual history and Epstein-Barr virus infection.Journal of Infectious Diseases. 2002; 186: 731-736
- Relationship between impulsive sensation seeking traits, smoking, alcohol and caffeine intake, and Parkinson’s disease.Journal of Neurology, Neurosurgery & Psychiatry. 2006; 77: 317-321
- Migraine and multiple sclerosis: epidemiology and approach to treatment.Multiple Sclerosis and Related Disorders. 2013; 2: 73-79
- Prospective study of cigarette smoking and the risk of developing idiopathic Parkinson’s disease.American Journal of Epidemiology. 1994; 139: 1129-1138
- Severely threatening events and marked life difficulties preceding onset or exacerbation of multiple sclerosis.Journal of Neurology, Neurosurgery & Psychiatry. 1989; 52: 8-13
- Compared to what? Finding controls for case-control studies.Lancet. 2005; 365: 1429-1433
- Developmental relationships between adolescent substance use and risky sexual behavior in young adulthood.Journal of Adolescent Health. 2002; 31: 354-362
- Smoking and multiple sclerosis: an updated meta-analysis.PLoS One. 2011; 6: e16149
- An updated meta-analysis of risk of multiple sclerosis following infectious mononucleosis.PLoS One. 2010; : 5
- Multiple sclerosis and risk behavior.Multiple Sclerosis and Related Disorders. 2012; 1: 59-60
- Are multiple sclerosis patients risk-takers?.QJM: An International Journal of Medicine. 2005; 98: 895-911
- Smoking is a risk factor for multiple sclerosis: a metanalysis.Multiple Sclerosis. 2007; 13: 610-615
- Seroprevalence of herpes simplex virus type 2 in multiple sclerosis.Acta Neurologica Scandinavica. 2006; 114: 363-367
- Multiple sclerosis in Latter Day Saints (Mormons).Acta Neurologica Scandinavica. 2007; 115: 260-264
- High body mass index before age 20 is associated with increased risk for multiple sclerosis in both men and women.Multiple Sclerosis. 2012; 18: 1334-1336
- Cigarette smoking and incidence of multiple sclerosis.American Journal of Epidemiology. 2001; 154: 69-74
- Characteristics of women by smoking status in the San Francisco Bay Area.Cancer Epidemiology, Biomarkers & Prevention. 1992; 1: 491-497
- Multiple sclerosis patients’ benefit–risk preferences: serious adverse event risks versus treatment efficacy.Journal of Neurology. 2009; 256: 554-562
- Rising incidence of multiple sclerosis in females associated with urbanization.Neurology. 2012; 78: 1728-1735
- Epidemiology and etiology of multiple sclerosis.Physical Medicine and Rehabilitation Clinics of North America. 2005; 16: 327-349
- The risk of multiple sclerosis in bereaved parents: a nationwide cohort study in Denmark.Neurology. 2004; 62: 726-729
- Sexual habits before multiple sclerosis: a national case-control study.Multiple Sclerosis. 2008; 14: 67-72
- Diseases associated with multiple sclerosis and epilepsy. A population cohort study of 159,200 middle-aged, urban, native Swedes observed over 10 years (1970–79).Acta Neurologica Scandinavica. 1985; 71: 267-277
- High frequency of adverse health behaviors in multiple sclerosis.Multiple Sclerosis. 2009; 15: 105-113
- Caffeine and alcohol intakes have no association with risk of multiple sclerosis.Multiple Sclerosis. 2013; 19: 53-58
- Body size and risk of MS in two cohorts of US women.Neurology. 2009; 73: 1543-1550
- Lifestyles and health risks of collegiate athletes: a multi-center study.Clinical Journal of Sport Medicine. 1997; 7: 262-272
- Multiple sclerosis and lifestyle factors: the Hordaland Health Study.Neurological Science. 2005; 26: 334-339
- Associations between number of lifetime partners and other health behaviors.American Journal of Health Behavior. 2001; 25: 537-544
- Lifestyle factors and multiple sclerosis: a case-control study in Belgrade.Neuroepidemiology. 2006; 27: 212-216
- Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”.Annals of Neurology. 2005; 58: 840-846
- The relationship between risk attitude and treatment choice in patients with relapsing-remitting multiple sclerosis.Medical Decision Making. 2002; 22: 506-513
- Do risk attitudes differ across domains and respondent types?.Medical Decision Making. 2007; 27: 281-287
- Association of infectious mononucleosis with multiple sclerosis. A population-based study.Neuroepidemiology. 2009; 32: 257-262
- Stress and the risk of multiple sclerosis.Neurology. 2011; 76: 1866-1871
- Smoking is a risk factor for multiple sclerosis.Neurology. 2003; 61: 1122-1124
- Infectious mononucleosis and risk for multiple sclerosis: a meta-analysis.Annals of Neurology. 2006; 59: 499-503
- Dietary habits and multiple sclerosis. A retrospective study in Ferrara, Italy.Acta Neurologica (Napoli). 1994; 16: 189-197
- Relationship between number of sexual intercourse partners and selected health risk behaviors among public high school adolescents.Journal of Adolescent Health. 1999; 25: 328-335
- Emotional stress and the development of multiple sclerosis: case-control evidence of a relationship.Journal of Chronic Diseases. 1982; 35: 821-831
- Do alcoholics give valid self-reports?.Journal of Studies on Alcohol. 1984; 45: 344-348
Article info
Publication history
Published online: June 12, 2013
Accepted:
May 2,
2013
Received in revised form:
May 1,
2013
Received:
January 24,
2013
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
