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Neyal N, Atkinson EJ, Smith CY, Weis DM, Rocca LG, Rocca WA, Kantarci K, Kantarci OH, Zeydan B. Smoking, early menopause and multiple sclerosis disease course. Climacteric 2023; 26:560-564. [PMID: 37387356 PMCID: PMC10756919 DOI: 10.1080/13697137.2023.2221381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/10/2023] [Accepted: 05/27/2023] [Indexed: 07/01/2023]
Abstract
Smoking is associated with an increased risk of multiple sclerosis (MS), and smoking and early menopause are related to poor outcomes in MS. Smoking is also associated with early menopause. To explore this intricate relationship between smoking status, age at menopause and disease course in MS, 137 women with MS and 396 age-matched controls were included in this case-control study. Age at menopause (median 49.0 vs. 50.0 years; p = 0.79) and smoking status (40.3% vs. 47.6%; p = 0.15) were similar among MS and control women. Relapsing MS onset was earlier in ever-smoker women with early menopause compared to the rest of the women (median 30.4 vs. 37.0 years; p = 0.02) and also compared to ever-smoker women with normal age at menopause (median 30.4 vs. 41.0 years; p = 0.008) and never-smoker women with early menopause (median 30.4 vs. 41.5 years; p = 0.004). Progressive MS onset was also earlier in ever-smoker women with early menopause compared to ever-smoker women with normal age at menopause (median 41.1 vs. 49.4 years; p = 0.05) and never-smoker women with early menopause (median 41.1 vs. 50.1 years; p = 0.12). Our results suggest that smoking and menopause associate with MS disease course, including the onset of relapsing and progressive MS in women.
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Affiliation(s)
- Nur Neyal
- Mayo Clinic, Department of Neurology, Rochester, MN, United States
- Mayo Clinic, Department of Radiology, Rochester, MN, United States
| | - Elizabeth J. Atkinson
- Mayo Clinic, Department of Quantitative Health Sciences, Rochester, MN, United States
| | - Carin Y. Smith
- Mayo Clinic, Department of Quantitative Health Sciences, Rochester, MN, United States
| | - Delana M. Weis
- Mayo Clinic, Center for Multiple Sclerosis and Autoimmune Neurology, Rochester, MN, United States
| | | | - Walter A. Rocca
- Mayo Clinic, Department of Neurology, Rochester, MN, United States
- Mayo Clinic, Department of Quantitative Health Sciences, Rochester, MN, United States
- Mayo Clinic, Women’s Health Research Center, Rochester, MN, United States
| | - Kejal Kantarci
- Mayo Clinic, Department of Radiology, Rochester, MN, United States
- Mayo Clinic, Women’s Health Research Center, Rochester, MN, United States
| | - Orhun H. Kantarci
- Mayo Clinic, Department of Neurology, Rochester, MN, United States
- Mayo Clinic, Center for Multiple Sclerosis and Autoimmune Neurology, Rochester, MN, United States
| | - Burcu Zeydan
- Mayo Clinic, Department of Neurology, Rochester, MN, United States
- Mayo Clinic, Department of Radiology, Rochester, MN, United States
- Mayo Clinic, Center for Multiple Sclerosis and Autoimmune Neurology, Rochester, MN, United States
- Mayo Clinic, Women’s Health Research Center, Rochester, MN, United States
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Neyal N, Keegan BM, Kantarci OH, Zeydan B. Coexistence of multiple sclerosis and spinocerebellar ataxia type-8. Mult Scler 2023; 29:1195-1198. [PMID: 37401111 PMCID: PMC10463917 DOI: 10.1177/13524585231180549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Cerebellar dysfunction is likely to cause severe and treatment-resistant disability in multiple sclerosis (MS). Certain spinocerebellar ataxia (SCA)-related alleles can increase MS susceptibility, and channel polymorphisms can impact disability measures. Following an index patient with the coexistence of MS and SCA Type-8 (SCA8) in the MS clinic, an institutional engine search for MS and hereditary ataxia coexistence was conducted but did not reveal any other cases. This extremely rare coexistence of MS and SCA8 in our index patient may be incidental; however, a yet-to-be-identified contribution of coexistent hereditary ataxia(s) to the susceptibility of a prominent progressive ataxia MS phenotype cannot be ruled out.
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Affiliation(s)
- Nur Neyal
- Nur Neyal Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - B Mark Keegan
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA
| | - Orhun H Kantarci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Medical Genetics, Mayo Clinic, Rochester, MN, USA
| | - Burcu Zeydan
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA
- Women's Health Research Center, Mayo Clinic, Rochester, MN, USA
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Nathoo N, Zeydan B, Neyal N, Chelf C, Okuda DT, Kantarci OH. Do magnetic resonance imaging features differ between persons with multiple sclerosis of various races and ethnicities? Front Neurol 2023; 14:1215774. [PMID: 37448745 PMCID: PMC10338060 DOI: 10.3389/fneur.2023.1215774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Those of African American or Latin American descent have been demonstrated to have more severe clinical presentations of multiple sclerosis (MS) than non-Latin American White people with MS. Concurrently, radiological burden of disease on magnetic resonance imaging (MRI) in African Americans with MS has also been described as being more aggressive. Here, we review MRI studies in diverse racial and ethnic groups (adult and pediatric) investigating lesion burden, inflammation, neurodegeneration, and imaging response to disease modifying therapy. We also discuss why such disparities may exist beyond biology, and how future studies may provide greater insights into underlying differences.
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Affiliation(s)
- Nabeela Nathoo
- Division of Multiple Sclerosis and Autoimmune Neurology, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Burcu Zeydan
- Division of Multiple Sclerosis and Autoimmune Neurology, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Nur Neyal
- Division of Multiple Sclerosis and Autoimmune Neurology, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Cynthia Chelf
- Mayo Clinic College of Medicine and Science, Library-Public Services, Mayo Clinic, Rochester, MN, United States
| | - Darin T. Okuda
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Orhun H. Kantarci
- Division of Multiple Sclerosis and Autoimmune Neurology, Department of Neurology, Mayo Clinic, Rochester, MN, United States
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