Highlights
- •The prevalence of MS in the Tokachi area has steadily increased over 20 years.
- •The female-to-male ratio of MS in the Tokachi area has also been increasing.
- •Among MS cases in Tokachi, primary-progressive type comprises only 3%.
- •The incidence of MS increased up to 2009; since then, it has remained stable.
Abstract
Objectives
The prevalence of multiple sclerosis (MS) in East Asia is thought to be lower than
in Western countries. Globally, there is a trend of increasing MS prevalence. We investigated
the changes in the prevalence and clinical phenotype of MS in the Tokachi province
of Hokkaido in northern Japan, from 2001 to 2021.
Methods
Data processing sheets were sent to all related institutions inside and outside the
Tokachi area of Hokkaido island in Japan and were collected from April to May 2021.
The prevalence according to the Poser's diagnostic criteria for MS was determined
on March 31, 2021.
Results
In 2021, the crude MS prevalence in northern Japan was 22.4/100,000 (95% confidence
interval, 17.6–28.0). The prevalences of MS standardized by the Japanese national
population in 2001, 2006, 2011, 2016, and 2021 were 6.9, 11.5, 15.3, 18.5, and 23.3,
respectively. The female/male ratio was 4.0 in 2021, increased from 2.6 in 2001. We
checked the prevalence using the 2017 revised McDonald criteria, and found only additional
male patient who had not fulfilled Poser's criteria. The age- and sex-adjusted incidence
of MS per 100,000 individuals increased from 0.09 in 1980–1984 to 0.99 in 2005–2009;
since then, it has remained stable. The proportions of primary-progressive, relapsing-remitting,
and secondary-progressive MS types in 2021 were 3%, 82%, and 15%, respectively.
Conclusion
Our results demonstrated a consistent increase in the prevalence of MS among the northern
Japanese over 20 years, particularly in females, and consistently lower rates of progressive
MS in northern Japan than elsewhere in the world.
Keywords
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Article info
Publication history
Published online: April 02, 2023
Accepted:
April 1,
2023
Received in revised form:
March 27,
2023
Received:
February 4,
2023
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
