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Al-Shibli R, Al-Asmi A, Islam MM, Al Sabahi F, Al-Aamri A, Butt M, Al-Lawati M, Al-Hashmi L, Al-Yahmadi J. Seasonal Variations in Multiple Sclerosis Relapses in Oman: A Single Tertiary Centre Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1371. [PMID: 39457344 DOI: 10.3390/ijerph21101371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Revised: 09/25/2024] [Accepted: 10/14/2024] [Indexed: 10/28/2024]
Abstract
(1) Background and Aims: The seasonal factors influencing multiple sclerosis (MS) relapses remain elusive. This study aims to investigate the seasonal variation of MS relapses in Oman and compare it globally. (2) Subject and Methods: This retrospective study was conducted on N = 183 Omani MS patients treated at Sultan Qaboos University Hospital, a tertiary hospital in Muscat, Oman, over sixteen-year period (2007-2022). Demographic and clinical data of all MS patients were juxtaposed with the monthly weather data during this period, using descriptive and inferential statistical techniques. (3) Results: Among the N = 183 MS patients studied, 508 relapses were recorded during the study period. The average number of relapses per patient was 2.8 (range: 1-15). There were significant seasonal variations in MS relapse rate, with the highest prevalence in the winter months of January and February. However, no correlation was found between MS relapses and other climatic parameters (humidity, temperature, and rainfall). (4) Conclusion: The seasonal patterns of MS relapses in Oman differ from other parts of the world, which the local clinicians should take into account while diagnosing and making management decisions. The potential impact of climate change on the anomalous changes in the seasonality of MS relapses warrants further investigation.
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Affiliation(s)
- Rashid Al-Shibli
- College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 17, Muscat 123, Oman
| | - Abdullah Al-Asmi
- Neurology Unit, Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 17, Muscat 123, Oman
| | - M Mazharul Islam
- Department of Statistics, College of Science, Sultan Qaboos University, P.O. Box 36, Al-Khoud, Muscat 123, Oman
| | - Fatema Al Sabahi
- Neurology Unit, Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 17, Muscat 123, Oman
| | - Amira Al-Aamri
- Department of Operation Management & Business Statistics, College of Economics and Political Science, Sultan Qaboos University, P.O. Box 20, Muscat 123, Oman
| | - Mehwish Butt
- Neurology Unit, Department of Medicine, Sultan Qaboos University Hospital, University Medical City, P.O. Box 35, Al-Khoud, Muscat 123, Oman
| | - Meetham Al-Lawati
- College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 17, Muscat 123, Oman
| | - Lubna Al-Hashmi
- College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 17, Muscat 123, Oman
| | - Jihad Al-Yahmadi
- College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 17, Muscat 123, Oman
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McNicholas OC, Jiménez-Jiménez D, Oliveira JFA, Ferguson L, Bellampalli R, McLaughlin C, Chowdhury FA, Martins Custodio H, Moloney P, Mavrogianni A, Diehl B, Sisodiya SM. The influence of temperature and genomic variation on intracranial EEG measures in people with epilepsy. Brain Commun 2024; 6:fcae269. [PMID: 39258258 PMCID: PMC11383581 DOI: 10.1093/braincomms/fcae269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/26/2024] [Accepted: 08/11/2024] [Indexed: 09/12/2024] Open
Abstract
Heatwaves have serious impacts on human health and constitute a key health concern from anthropogenic climate change. People have different individual tolerance for heatwaves or unaccustomed temperatures. Those with epilepsy may be particularly affected by temperature as the electroclinical hallmarks of brain excitability in epilepsy (inter-ictal epileptiform discharges and seizures) are influenced by a range of physiological and non-physiological conditions. Heatwaves are becoming more common and may affect brain excitability. Leveraging spontaneous heatwaves during periods of intracranial EEG recording in participants with epilepsy in a non-air-conditioned telemetry unit at the National Hospital for Neurology and Neurosurgery in London from May to August 2015-22, we examined the impact of heatwaves on brain excitability. In London, a heatwave is defined as three or more consecutive days with daily maximum temperatures ≥28°C. For each participant, we counted inter-ictal epileptiform discharges using four 10-min segments within, and outside of, heatwaves during periods of intracranial EEG recording. Additionally, we counted all clinical and subclinical seizures within, and outside of, heatwaves. We searched for causal rare genetic variants and calculated the epilepsy PRS. Nine participants were included in the study (six men, three women), median age 30 years (range 24-39). During heatwaves, there was a significant increase in the number of inter-ictal epileptiform discharges in three participants. Five participants had more seizures during the heatwave period, and as a group, there were significantly more seizures during the heatwaves. Genetic data, available for eight participants, showed none had known rare, genetically-determined epilepsies, whilst all had high polygenic risk scores for epilepsy. For some people with epilepsy, and not just those with known, rare, temperature-sensitive epilepsies, there is an association between heatwaves and increased brain excitability. These preliminary data require further validation and exploration, as they raise concerns about the impact of heatwaves directly on brain health.
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Affiliation(s)
- Olivia C McNicholas
- Sir Jules Thorn Telemetry Unit, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - Diego Jiménez-Jiménez
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- Chalfont Centre for Epilepsy, Buckinghamshire SL9 0RJ, UK
| | - Joana F A Oliveira
- Sir Jules Thorn Telemetry Unit, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Lauren Ferguson
- Institute for Environmental Design and Engineering, The Bartlett School of Environment, Energy and Resources, University College London, London WC1H 0NN, UK
- Department for Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Ravishankara Bellampalli
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- Chalfont Centre for Epilepsy, Buckinghamshire SL9 0RJ, UK
| | - Charlotte McLaughlin
- Sir Jules Thorn Telemetry Unit, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - Fahmida Amin Chowdhury
- Sir Jules Thorn Telemetry Unit, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Helena Martins Custodio
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- Chalfont Centre for Epilepsy, Buckinghamshire SL9 0RJ, UK
| | - Patrick Moloney
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- Chalfont Centre for Epilepsy, Buckinghamshire SL9 0RJ, UK
| | - Anna Mavrogianni
- Institute for Environmental Design and Engineering, The Bartlett School of Environment, Energy and Resources, University College London, London WC1H 0NN, UK
| | - Beate Diehl
- Sir Jules Thorn Telemetry Unit, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- Chalfont Centre for Epilepsy, Buckinghamshire SL9 0RJ, UK
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Adalat S, Hajat S, Ikiz B. Climate change has serious implications for children's brain health. BMJ 2024; 386:q1588. [PMID: 39038838 DOI: 10.1136/bmj.q1588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Affiliation(s)
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Burcin Ikiz
- Neuro Climate Working Group, Global Consortium on Climate and Health Education, Columbia University, New York, USA
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Junck L, Saad A, Andrews B. Neurology and climate change. Lancet Neurol 2024; 23:552-553. [PMID: 38760086 DOI: 10.1016/s1474-4422(24)00144-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Larry Junck
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
| | - Ali Saad
- Climate & Health Program, University of Colorado, Denver, CO, USA; Centura Health Physicians Group-Neuroscience and Spine, Denver, CO, USA
| | - Bret Andrews
- Department of Neurology, Kaiser-Permanente Health, Oakland, CA, USA
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