http://www.neurology.org/cgi/content/abstract/58/2/283
Neurology 2002;58:283-288
M. G. Marrosu, MD, M. Lai, MD, E.
Cocco, MD, V. Loi, MD, G. Spinicci, MD, M. P. Pischedda, MD, S. Massole,
MD, G. Marrosu, MD and P. Contu, MD
From the Multiple Sclerosis Center
(Drs. M. Marrosu, Lai, Cocco, Loi, Spinicci, Pischedda, Massole, and G.
Marrosu), Department of Neuroscience, Ospedale Binaghi, Cagliari, Italy;
and Department of Public Health (Dr. Contu), University of Cagliari, Italy.
Objective:
To estimate the presence of familial
aggregation and determine the contribution of genetic factors to familial
clustering of MS in patients coming from Sardinia, a Mediterranean island
considered a genetically homogeneous, isolated area having high disease
incidence and prevalence.
Methods:
Recurrence risk in siblings of 901
Sardinian patients and factors influencing risk (patient and sibling sex,
patient age at onset, sibling birth cohort, and presence of affected relatives
other than siblings) were examined. The presence of distant familial relationships
among patients was evaluated by tracing the extended pedigrees of all patients
with MS born in one Sardinian village.
Results:
Twenty-three brothers and 36 sisters
of the 2,971 siblings were affected with MS. Recurrence risk was greater
in siblings of index patients with onset age less than 30 years (p <
0.01, increased risk 2.33 times) and having a relative with MS other than
a sibling or parent (p < 0.01, increased risk 2.90 times). Pedigree
analysis of patients from the village of L. showed that all 11 patients
descended from 3 pairs of ancestors, whereas no cases occurred in the remaining
2,346 inhabitants. In descendants from the 3 couples, MS prevalence was
dramatically greater than the regional average and 1.5 times greater than
that observed in siblings of affected cases.
Conclusions:
Data from this study indicate that
MS familial aggregation in Sardinians is influenced by genetic factors
and that founder effect and the isolation of Sardinia can be considered
causes of the enrichment of "etiologic" MS genes.
© 2002 American Academy of Neurology