The effect of demographic features and environmental risk factors on the clinical course in patients with multiple sclerosis

Abstract

Objectives: This study aimed to investigate demographic, clinical, and environmental risk factors in patients with multiple sclerosis (MS) and their relationship with the disease. Patients and methods: The medical records of 913 patients with MS followed for ?6 months between January 1996 and December 2015 were retrospectively reviewed, and 221 patients (158 females, 63 males; mean age: 43.4±11.6 years; range, 18 to 73 years) with demographic, clinical, and laboratory data were included. Results: Relapsing-remitting MS was identified in 75.6% (n=167) of patients, and progressive MS was identified in 24.4% (n=54). The initial Expanded Disability Status Scale (EDSS) scores were lower in the relapsing-remitting MS group compared to the progressive MS group (2.3±1.0 vs. 2.6±1.4; p<0.05). Motor symptoms were the initial presenting symptoms in 33.0% of the patients, followed by sensory symptoms and optic neuritis. The transition to the progressive phase was observed to occur at a younger age in patients with an earlier onset age (p<0.001). Motor symptom onset correlated with later disease onset, progression, and higher final EDSS score (p<0.05). Vitamin D deficiency and insufficiency were observed in 18.1% and 73.5% of patients, respectively. Seropositivity for Epstein-Barr virus (EBV) antibodies was high. Vitamin D levels and EBV serology were similar between the groups. Conclusion: In our patient group, early disease onset correlated with earlier transition to progression phase. Onset with motor symptom correlated with progression and higher disability scores. Vitamin D deficiency and high EBV seropositivity were common but not directly linked to clinical course. These findings potentially reflect MS patient profiles, warranting further epidemiological studies. © 2025 by the Turkish Neurological Society.