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Epidemiological and radiological aspects of multiple sclerosis
Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Department of Neuroscience and Locomotion. Linköping University, Faculty of Health Sciences.
1996 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The first aim of this investigation was to analyse possible risk factors for multiple sclerosis (MS) with focus on animal contacts and occupational exposures, especially to organic solvents. Another aim was to search for specific features in solvent-exposed MS patients mainly by the radiological techniques magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy ( 1 H MRS) and also by cerebrospinal fluid (CSF) analysis along with a disability scoring. A further aim was to use 1 H MRS to investigate the metabolite status of brain lesions in the three established clinical subtypes of MS and to analyse for possible differences that may explain their different clinical and pathological characteristics. Finally, the national and countywise distribution of MS in Sweden was investigated during a forty year period by mortality and disability statistics. Both a case-control study and a best evidence synthesis with metaanalyses indicated an about doubled risk of MS from exposure to organic solvents, most clearly demonstrated for the male gender. MRI, 1 H MRS, CSF analyses and disability scoring showed no significant difference between the solvent-exposed and non-exposed MS patients, with one exception. Hypointensity in the basal ganglia, known from other studies of solvent-exposed persons, were overrepresented in the exposed MS patients. There were no differences in metabolite status of MS lesions in relapsing remitting, secondary progressive or primary progressive MS. One MRifl H MRS study showed ringlike appearances and lactate in two MS plaques during relapse, interpreted as oedematous transition forms between acute and chronic lesions. Finally, highly significant geographical variations in MS mortality were found, indicating real fluctuations, as well as a possible increase over time. Vämland county had a constantly high mortality and disability pensioning frequency during forty years and was therefore analysed municipalitywise which revealed a small high risk zone in two northern districts.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 1996. , 55 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 477
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-28054Local ID: 12817ISBN: 91-7871-332-2OAI: diva2:248605
Public defence
1996-01-19, Berzeliussalen, Hälsouniversitetet, Linköping, 13:00 (English)
Papers, included in the Ph.D. thesis, are not registered and included in the posts from 1999 and backwards.Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-07-13Bibliographically approved

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Landtblom, Anne-Marie
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Occupational and Environmental MedicineDepartment of Neuroscience and LocomotionFaculty of Health Sciences
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