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Striking changes in the demographic pattern of multiple sclerosis (MS), with increasing prevalence and incidence over time, especially in women, strongly indicate an influence of modifiable exposures on the disease.1 In understanding these important clues, it is difficult to pinpoint which of the many environmental, lifestyle, and sociodemographic changes that have occurred over the past decades such as higher smoking and obesity rates and earlier age at puberty are responsible. Genome-wide association studies (GWAS) have been highly successful in identifying genetic factors underlying many human traits, including >200 known genetic risk factors for MS.2 Environmental risk factors, including exposure to external or physiologic factors, have been much harder to pinpoint.
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Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
See page 743
- © 2019 American Academy of Neurology
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