title: More severe disability of North Africans vs Europeans with multiple sclerosis in France.
abstract: OBJECTIVE
  To compare the clinical disease progression in European (E) and North African (NA) patients with multiple sclerosis (MS) patients in France.
  
  
  METHODS
  We compared the clinical features of MS in 211 NA patients and 2,945 E patients in a French population-based cohort with definite MS according to McDonald's criteria.
  
  
  RESULTS
  Among the NA patients with MS, 66.4% were women vs 72.9% of the E patients (p = 0.04), 15.6% had a primary progressive form of MS vs 11.7% of the E patients (p = 0.08), and the mean age at onset was 29.9 +/- 9.8 years in the NA patients vs 32.9 +/- 10.6 years in the E patients (p < 0.0001). In the NA patients, there was a higher proportion of patients with incomplete recovery from the first relapse (p < 0.0001), a shorter time between the first two relapses (p = 0.02), a higher number of relapses in the first 5 years (p = 0.03), and a shorter time to reach an Expanded Disability Status Scale score of 4.0 (p = 0.001) or 6.0 (p < 0.0001). The only statistical difference in these factors between NA patients born in France and those born in North Africa was the mean age at onset of symptoms: it was earlier in NA patients born in France (p < 0.0001).
  
  
  CONCLUSIONS
  The course of multiple sclerosis is more aggressive in North African than in European patients.
authors.affiliation: Department of Neurology, Central Hospital, Nancy, France. m.debouverie@chu-nancy.fr
authors.forename: M
authors.initials: M
authors.lastname: Debouverie
authors.forename: C
authors.initials: C
authors.lastname: Lebrun
authors.forename: S
authors.initials: S
authors.lastname: Jeannin
authors.forename: S
authors.initials: S
authors.lastname: Pittion-Vouyovitch
authors.forename: T
authors.initials: T
authors.lastname: Roederer
authors.forename: H
authors.initials: H
authors.lastname: Vespignani
mesh_terms: D000328:Adult; D000352:Africa, Northern / Q000453:epidemiology; D044383:Black People / Q000235:genetics; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology; D011446:Prospective Studies; D012189:Retrospective Studies; D044465:White People / Q000235:genetics