A Population-Based Study of Multiple Sclerosis in Twins

George C. Ebers, Dennis E. Bulman, Adele D. Sadovnick, Donald W. Paty, Sharon Warren, Walter Hader, T. Jock Murray, T. Peter Seland, Pierre Duquette, Trevor Grey, Robert Nelson, Michael Nicolle, Donald Brunet

Résultat de recherche: Articleexamen par les pairs

525 Citations (Scopus)

Résumé

Results from studies of twin concordance in multiple sclerosis have not conclusively differentiated between environmental and genetic factors that determine susceptibility to the disease. Published studies that have been based on case finding by public appeal have been characterized by difficulties in ascertainment. The data reported here are from a large population-based study of multiple sclerosis in twins, in which ascertainment has been relatively unbiased and the cooperation of patients nearly complete. A total of 5463 patients attending 10 multiple sclerosis clinics across Canada were surveyed. Twenty-seven monozygotic and 43 dizygotic twin pairs were identified, and the diagnosis of multiple sclerosis was verified by examination and laboratory investigation. Seven of 27 monozygotic pairs (25.9 percent) and 1 of 43 dizygotic pairs (2.3 percent) were concordant for multiple sclerosis. The concordance rate for 4582 nontwin siblings of patients at two multiple sclerosis clinics was 1.9 percent, closely paralleling the concordance rate in dizygotic twins. To the extent that the difference in concordance rates between monozygotic and dizygotic twins indicates genetic susceptibility, the results of this study show a major genetic component in susceptibility to multiple sclerosis. (N Engl J Med 1986; 315:1638–42.), STUDIES of twins have been a classic way of distinguishing between environmental and genetic determinants of susceptibility to disease.1 Such studies are of special value in disorders in which either the mode of inheritance or the nature of the environmental effect is obscure. Multiple sclerosis is a chronic neurologic disorder in which both environmental2,3 and genetic factors3,4 appear to have a causal role. Evidence in support of genetic susceptibility to the disease has been inconclusive.3,4 The results of several previous studies of twins have been ambiguous.5 6 7 8 9 The largest of these studies5 showed little difference in concordance rates between dizygotic and…

Langue d'origineEnglish
Pages (de-à)1638-1642
Nombre de pages5
JournalNew England Journal of Medicine
Volume315
Numéro de publication26
DOI
Statut de publicationPublished - déc. 25 1986

ASJC Scopus Subject Areas

  • General Medicine

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