INFLUENCE OF SOME ETIOLOGIC RISK FACTORS OF MULTIPLE SCLEROSIS ON CLINICAL CHARACTERISTICS OF THE DISEASE

Aim. The objective of the research was to study influence of history of brain or spinal cord injury, stress, and genetic predisposition in patients with multiple sclerosis (MS) on clinical characteristics of the disease. Material and Methods. The study involved 242 patients with relapsing-remitting multiple sclerosis in remission (residents of Ivano-Frankivsk city and Ivano-Frankivsk region), 168 women and 74 mån with reliably confirmed diagnosis of MS. The patients' average age was 37.96±0.67 years; the average severity on Expanded Disability Status Scale (EDSS) was 4.5±0.08 points. The research methodology did not envisage a control group. The patients' life and disease history was collected and a clinical and neurological examination was conducted. Results and Discussion. Among the 242 examined patients with MS in 52 patients (21.49%) familial cases of the disease were found. Eighty-seven (36%) patients had a history of traumatic brain injury or spinal cord injury: 155 patients (64%) had no history of injuries before the onset of the disease. It was revealed that, among 87 examined patients suffering from MS with the history of brain injury, 19 patients (21.8±4.4%) had a shift of course t from relapsing-remitting to secondary-progressive, whereas in the group of patients without history of injury the same shift of course to secondary-progressive occurred in 25 patients (16.1±3.0%) among the examined 155:however, the difference between them did not reach the statistically significant level (t=1.07; p>0.05). The time of shifting from relapsing-remitting course to secondary-progressive one in patients suffering from MS with the history of brain or spinal cord injury averaged 8.84±1.13 years, whereas in the group of patients without history of similar injuries the transformation into secondaryprogressive course occurred after 11.52±1.44 years: the difference between these indices did not reach the statistically significant level (t=1.46; ?>0.05). Emotional stress preceded the first symptoms of MS in 69 patients (28.5%), while 173 patients (71.5%) did not mention stress symptoms. In a part of examined patients (18.18%) a shift to secondaryprogressive course of MS was observed. In patients with the history of emotional stress before the onset of MS such shift occurred in 13 patients (18.8%), without stress in 31 patients (17.9%). It was revealed that the average time of transformation into secondary-progressive phase between the compared groups was not statistically significant (t=1.40; ?>0.05). In all the groups, regardless of the above mentioned etiologic risk factors, patients with remittingrelapsing type of MS course significantly prevailed. The number of patients with secondary-progressive type of MS was significantly higher as compared to the patients with primarily-progressive course of the pathologic process. EDSS score did not depend on indicated risk factors. The age of the MS first symptoms onset did not depend on the presence or absence of MS familial cases. Conclusions. The history of brain or spinal cord injury and stress before the clinical onset of the disease, and the presence of familial cases of ÌS does not influence on the disease course type and the speed of transformation of remitting-relapsing course into secondary-progression phase, and does not contribute to the progression of MS on EDSS.