{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:59:20Z","timestamp":1791622760750,"version":"4.3.4"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"12","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Multiple sclerosis (MS) is an inflammatory and neurodegenerative disorder whose prevalence varies across Brazil (from 15\u201327 cases per 100 thousand inhabitants), and the absence of an extensive national study limits the understanding of MS epidemiology in a nation as diverse as Brazil.<\/jats:p>\n                  <jats:p>To compare epidemiological data, including healthcare access, among people with MS across four Brazilian regions.<\/jats:p>\n                  <jats:p>Data from 2,974 Brazilian MS patients in the Collaborative Latin American Database for Multiple Sclerosis (BRANDO) were analyzed. We assessed demographic and clinical outcomes, as well as healthcare access, to elucidate regional differences.<\/jats:p>\n                  <jats:p>The cohort was predominantly composed of female patients (72.5%) with MS onset at a mean age of 30.6 years. Regarding the regional differences, there was a lower predominance of female patients (68.7%; p\u2009=\u20090.003) in the Southeast, a higher rate of subjects of mixed ethnicity (p\u2009&lt;\u20090.001) in the Midwest (40.3%) and Northeast (63.7%), higher scores on the Expanded Disability Status Scale (EDSS) in the Northeast (4.0; p\u2009&lt;\u20090.001), a higher prevalence of relapsing-remitting MS (RRMS) in the Southeast and Midwest (87%; p\u2009&lt;\u20090.001), while the Northeast presented (p\u2009&lt;\u20090.001) the highest rates of primary progressive MS (PPMS) and secondary progressive MS (SPMS) (PPMS\u2009=\u200915.8%; SPMS\u2009=\u200918%). The Northeast presented the longest time (5.9 years; p\u2009&lt;\u20090.01) from disease onset until MS diagnosis (range for the other regions\u2009=\u20091.9\u20133.7 years). And the Midwest showed the shortest time (2.1 years; p\u2009&lt;\u20090.01) from disease onset until first access to disease-modifying therapies (DMTs; range for the other regions\u2009=\u20093.5\u20135.1 years).<\/jats:p>\n                  <jats:p>The present is the first nationwide epidemiological study on people with MS in Brazil. It underscores regional epidemiological variations and differences in healthcare access, advocating for tailored approaches in MS management and research.<\/jats:p>","DOI":"10.1055\/s-0045-1813263","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T23:54:24Z","timestamp":1766447664000},"page":"001-008","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology and healthcare access in Brazilian multiple sclerosis patients: insights from the BRANDO database"],"prefix":"10.1055","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7919-3989","authenticated-orcid":false,"given":"Alfredo","family":"Damasceno","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Faculdade de Ci\u00eancias M\u00e9dicas, Departamento de Neurologia, Campinas SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9405-5437","authenticated-orcid":false,"given":"Cintia","family":"Ramari","sequence":"additional","affiliation":[{"name":"University of Hasselt, Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1137-2398","authenticated-orcid":false,"given":"Carlos","family":"Tauil","sequence":"additional","affiliation":[{"name":"Universidade de Bras\u00edlia, Bras\u00edlia DF, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5582-1792","authenticated-orcid":false,"given":"Henry Koiti","family":"Sato","sequence":"additional","affiliation":[{"name":"Instituto Neurol\u00f3gico de Curitiba, Departamento de Neuroimunologia, Curitiba PR, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0077-173X","authenticated-orcid":false,"given":"Dagoberto","family":"Callegaro","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Faculdade de Medicina, Departamento de Neurologia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3983-6019","authenticated-orcid":false,"given":"Maria Fernanda","family":"Mendes","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias M\u00e9dicas da Santa Casa de S\u00e3o Paulo, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6627-6515","authenticated-orcid":false,"given":"Jos\u00e9 Artur Costa","family":"D'Almeida","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza, Departamento de Neurologia, Fortaleza CE, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3078-6804","authenticated-orcid":false,"given":"Denise Sisterolli","family":"Diniz","sequence":"additional","affiliation":[{"name":"Hospital Geral de Goi\u00e1s, Departamento de Neurologia, Goi\u00e2nia GO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3516-485X","authenticated-orcid":false,"given":"Osvaldo J. M.","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Ant\u00f4nio Pedro, Departamento de Neurologia, Fortaleza CE, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7229-7144","authenticated-orcid":false,"given":"Laura","family":"Parolin","sequence":"additional","affiliation":[{"name":"Neurovie Neurologia e Sa\u00fade, Departamento de Neurologia, Joinville SC, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7718-4288","authenticated-orcid":false,"given":"Thiago","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Departamento de Neurologia e Psiquiatria, Salvador BA, Brazil."},{"name":"Universidade do Estado da Bahia, Departamento de Ci\u00eancias da Vida, Salvador BA, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2585-1074","authenticated-orcid":false,"given":"Paulo","family":"Gama","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica de S\u00e3o Paulo, Faculdade de Ci\u00eancias M\u00e9dicas e da Sa\u00fade, Departamento de Neurologia, Sorocaba SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1694-0457","authenticated-orcid":false,"given":"Herval Soares","family":"Neto","sequence":"additional","affiliation":[{"name":"Hospital do Servidor Estadual de S\u00e3o Paulo, Departamento de Neuroimunologia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2454-681X","authenticated-orcid":false,"given":"Marco","family":"Lana-Peixoto","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais, Centro de Investiga\u00e7\u00e3o de Esclerose M\u00faltipla, Belo Horizonte MG, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8949-6115","authenticated-orcid":false,"given":"Giordani Rodrigues dos","family":"Passos","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Hospital S\u00e3o Lucas, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7806-8881","authenticated-orcid":false,"given":"Rayllene","family":"Caetano","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Hospital S\u00e3o Lucas, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7055-9194","authenticated-orcid":false,"given":"Kleber Cavalcante","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital das For\u00e7as Armadas, Bras\u00edlia DF, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7568-0897","authenticated-orcid":false,"given":"Caio C\u00e9sar Diniz","family":"Disserol","sequence":"additional","affiliation":[{"name":"Instituto Neurol\u00f3gico de Curitiba, Departamento de Neuroimunologia, Curitiba PR, Brazil."},{"name":"Universidade Federal do Paran\u00e1, Hospital das Cl\u00ednicas, Departamento de Neurologia, Curitiba PR, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8644-4937","authenticated-orcid":false,"given":"Gabriel de Deus","family":"Vieira","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Faculdade de Ci\u00eancias M\u00e9dicas, Departamento de Neurologia, Campinas SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9764-3763","authenticated-orcid":false,"given":"Guilherme Diogo","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Faculdade de Medicina, Departamento de Neurologia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3040-9865","authenticated-orcid":false,"given":"Eliana","family":"Cunha","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias M\u00e9dicas da Santa Casa de S\u00e3o Paulo, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2664-6534","authenticated-orcid":false,"given":"Nat\u00e1lia","family":"Talim","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais, Centro de Investiga\u00e7\u00e3o de Esclerose M\u00faltipla, Belo Horizonte MG, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3661-4851","authenticated-orcid":false,"given":"Mario B.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Social, Porto Alegre RS, Brazil."},{"name":"Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Social, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3298-0264","authenticated-orcid":false,"given":"Milena Sales","family":"Pitombeira","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza, Departamento de Neurologia, Fortaleza CE, 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A study based on 241 cases seen within three years of onset and followed up until the tenth year or more of the disease","volume":"84","author":"D McAlpine","year":"1961","journal-title":"Brain"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/S0140-6736(23)01473-3","article-title":"Multiple sclerosis","volume":"403","author":"D Jakimovski","year":"2024","journal-title":"Lancet"},{"issue":"09","key":"ref3","doi-asserted-by":"publisher","first-page":"e932","DOI":"10.1212\/WNL.0000000000008667","article-title":"Determinants of quality of life in pediatric- and adult-onset multiple sclerosis","volume":"94","author":"K A McKay","year":"2020","journal-title":"Neurology"},{"issue":"9648","key":"ref4","doi-asserted-by":"publisher","first-page":"1502","DOI":"10.1016\/S0140-6736(08)61620-7","article-title":"Multiple sclerosis","volume":"372","author":"A 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Neuro-Psiquiatr"},{"issue":"08","key":"ref8","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1590\/0004-282X-anp-2020-0221","article-title":"Prevalence of multiple sclerosis in key cities of Brazil: a study in Passo Fundo, Southern Brazil","volume":"79","author":"G RD Passos","year":"2021","journal-title":"Arq Neuropsiquiatr"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"108741","DOI":"10.1016\/j.clineuro.2025.108741","article-title":"Prevalence of multiple sclerosis in Brazil: An updated systematic review with meta-analysis","volume":"249","author":"J A Moura","year":"2025","journal-title":"Clin Neurol Neurosurg"},{"issue":"04","key":"ref10","doi-asserted-by":"publisher","first-page":"885","DOI":"10.4322\/2526-8910.ctoAR1840","article-title":"Interven\u00e7\u00f5es de Terapia Ocupacional com pessoas com esclerose m\u00faltipla: revis\u00e3o integrativa da literatura","volume":"27","author":"L AB Campos","year":"2019","journal-title":"Cad Bras Ter 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relapses in relapsing-remitting multiple sclerosis","author":"C A Young","year":"2024","journal-title":"Neurol Sci"},{"issue":"02","key":"ref16","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/S1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria","volume":"17","author":"A J Thompson","year":"2018","journal-title":"Lancet Neurol"},{"issue":"18","key":"ref17","doi-asserted-by":"publisher","first-page":"e1818","DOI":"10.1212\/WNL.0000000000200151","article-title":"Racial and Ethnic Disparities in Multiple Sclerosis Prevalence","volume":"98","author":"A M Langer-Gould","year":"2022","journal-title":"Neurology"},{"issue":"03","key":"ref18","doi-asserted-by":"publisher","first-page":"445","DOI":"10.3233\/NRE-182654","article-title":"Potential differences in cognition by race\/ethnicity among persons with multiple sclerosis in a clinical setting: A preliminary study","volume":"44","author":"G 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