Semin Neurol 2016; 36(02): 103-114
DOI: 10.1055/s-0036-1579693
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Epidemiology of Multiple Sclerosis: From Risk Factors to Prevention—An Update

Alberto Ascherio
1   Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
2   Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
,
Kassandra L. Munger
1   Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

Publication Date:
26 April 2016 (online)

Abstract

Although genetic susceptibility explains the clustering of multiple sclerosis (MS) within families and the sharp decline in risk with increasing genetic distance, it cannot fully explain the geographical variations in MS frequency and the changes in risk that occur with migration, which support the action of strong environmental factors. Among these, vitamin D status, obesity in early life, infection with the Epstein-Barr virus, and cigarette smoking are the most consistent environmental predictors of MS risk. The authors review the epidemiological data, critically discuss the evidence for causality of these and other associations, and briefly review the possibility of interventions to reduce MS risk.