PMID- 28832890
OWN - NLM
STAT- MEDLINE
DCOM- 20180620
LR  - 20180620
IS  - 1600-0404 (Electronic)
IS  - 0001-6314 (Linking)
VI  - 137
IP  - 1
DP  - 2018 Jan
TI  - The Gulf War era multiple sclerosis cohort: 3. Early clinical features.
PG  - 76-84
LID - 10.1111/ane.12810 [doi]
AB  - OBJECTIVES: To present clinical features at diagnosis for a large nationwide
      incident cohort of multiple sclerosis (MS) among those serving in the US military
      during the Gulf War era (GWE). MATERIALS & METHODS: Medical records and databases
      from the Department of Veterans Affairs (VA) for cases of MS with onset in or
      after 1990, active duty between 1990 and 2007 and service connection by the VA,
      were reviewed for diagnosis and demographic variables. Neurological involvement
      was summarized by the Kurtzke Disability Status Scale (DSS) and the Multiple
      Sclerosis Severity Score (MSSS). RESULTS: Among 1919 cases of clinically definite
      MS, 94% had a relapsing-remitting course and 6% were primary progressive at
      diagnosis. More males of all races and blacks of both sexes were progressive. At 
      diagnosis, functional system involvement was pyramidal 69%, cerebellar 58%,
      sensory 55%, brainstem 45%, bowel/bladder 23%, cerebral 23%, visual 18%, and
      other 5%. Mean DSS scores were: white males, females 2.9, 2.7; black males,
      females 3.3, 2.8; and other-race males, females 3.2, 2.6. Mean and median MSSS
      were marginally greater in black males and other males compared to the other
      sex-race groups. CONCLUSIONS: In this incident cohort, males and blacks had
      significantly higher proportions of primary progressive MS. DSS at diagnosis was 
      significantly more severe in blacks and significantly less so in whites and in
      women vs men, but MSSS was only marginally greater in black males and other-race 
      males. This morbidity assessment early in the course of MS provides
      population-based data for diagnosis, management, and prognosis.
CI  - wileyonlinelibrary.com/journal/ane.
FAU - Wallin, M T
AU  - Wallin MT
AUID- ORCID: http://orcid.org/0000-0003-1061-5714
AD  - Department of Veterans Affairs Multiple Sclerosis Center of Excellence - East,
      Washington, DC, USA.
AD  - Department of Neurology, Georgetown University Medical School, Washington, DC,
      USA.
AD  - Department of Neurology, University of Maryland School of Medicine, Baltimore,
      MD, USA.
FAU - Culpepper, W J
AU  - Culpepper WJ
AD  - Department of Veterans Affairs Multiple Sclerosis Center of Excellence - East,
      Washington, DC, USA.
AD  - Department of Neurology, University of Maryland School of Medicine, Baltimore,
      MD, USA.
FAU - Maloni, H
AU  - Maloni H
AD  - Department of Veterans Affairs Multiple Sclerosis Center of Excellence - East,
      Washington, DC, USA.
FAU - Kurtzke, J F
AU  - Kurtzke JF
AD  - Department of Veterans Affairs Multiple Sclerosis Center of Excellence - East,
      Washington, DC, USA.
AD  - Department of Neurology, Georgetown University Medical School, Washington, DC,
      USA.
LA  - eng
PT  - Journal Article
DEP - 20170822
PL  - Denmark
TA  - Acta Neurol Scand
JT  - Acta neurologica Scandinavica
JID - 0370336
SB  - IM
MH  - Adult
MH  - Cohort Studies
MH  - Disease Progression
MH  - Female
MH  - Gulf War
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis/*epidemiology
MH  - *Veterans
OTO - NOTNLM
OT  - cohort
OT  - disability
OT  - epidemiology
OT  - multiple sclerosis
OT  - symptoms
EDAT- 2017/08/24 06:00
MHDA- 2018/06/21 06:00
CRDT- 2017/08/24 06:00
PHST- 2017/07/27 00:00 [accepted]
PHST- 2017/08/24 06:00 [pubmed]
PHST- 2018/06/21 06:00 [medline]
PHST- 2017/08/24 06:00 [entrez]
AID - 10.1111/ane.12810 [doi]
PST - ppublish
SO  - Acta Neurol Scand. 2018 Jan;137(1):76-84. doi: 10.1111/ane.12810. Epub 2017 Aug
      22.