> 1: Neurology. 2004 Dec 14;63(11):2039-45.  Links
> Comment in:
> Neurology. 2005 Jun 28;64(12):2163.
> Clinical characteristics of African Americans vs Caucasian Americans
> with multiple sclerosis.
> Cree BA, Khan O, Bourdette D, Goodin DS, Cohen JA, Marrie RA, Glidden
> D, Weinstock-Guttman B, Reich D, Patterson N, Haines JL, Pericak-Vance
> M, DeLoa C, Oksenberg JR, Hauser SL.
> Multiple Sclerosis Center, Department of Neurology, University of
> California San Francisco, 350 Parnassus Ave., Suite 908, San Francisco,

> BACKGROUND: African American (AA) individuals are thought to develop
> multiple sclerosis (MS) less frequently than Caucasian American (CA)
> individuals. OBJECTIVE: To compare the clinical characteristics of AA
> and CA patients with MS. METHODS: The clinical features of MS were
> compared in a large retrospective cohort of AA (n = 375) and CA (n =
> 427) subjects. RESULTS: The proportion of women to men was similar in
> AA and CA subjects (81% [AA] vs 77% [CA]; p = 0.122). There were no
> differences in the proportions of subjects with relapsing-remitting,
> secondary progressive, primary progressive, and progressive relapsing
> MS. The median time to diagnosis was 1 year after symptom onset in AA
> subjects and 2 years after symptom onset in CA subjects (p = 0.0013).
> The age at onset was approximately 2.5 years later in AA than CA
> subjects (33.7 vs 31.1 years; p = 0.0001). AA subjects presented with
> multisite signs and symptoms at disease onset more often than CA
> subjects (p = 0.018). Clinical involvement restricted to the optic
> nerves and spinal cord (opticospinal MS) occurred in 16.8% of AA
> patients compared with 7.9% of CA patients (p < 0.001). Transverse
> myelitis also occurred more frequently in AA subjects (28 vs 18%; p =
> 0.001). Survival analysis revealed that AA subjects were at higher risk
> for development of ambulatory disability than CA subjects. After
> adjusting for baseline variations and differences in therapeutic
> interventions, AAs were at 1.67-fold greater risk for requiring a cane
> to ambulate than CA patients (p < 0.001). There was a trend suggesting
> that AAs were also at greater risk for development of wheelchair
> dependency (p = 0.099). Adjusted Cox proportional hazard models showed
> that this effect was in part attributable to the older age at onset in
> AAs (p < 0.001). CONCLUSIONS: Compared with multiple sclerosis (MS) in
> Caucasian Americans, African American patients with MS have a greater
> likelihood of developing opticospinal MS and transverse myelitis and
> have a more aggressive disease course.

> PMID: 15596747 [PubMed - indexed for MEDLINE]