{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:12:17Z","timestamp":1777936337685,"version":"3.51.4"},"reference-count":41,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2010,2,18]],"date-time":"2010-02-18T00:00:00Z","timestamp":1266451200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2010,4]]},"abstract":"<jats:p>Increasing prevalence and variable geographic patterns of occurrence of multiple sclerosis suggest an environmental role in causation. There are few descriptive, population-level, data on whether such variability applies to first demyelinating events (FDEs). We recruited 216 adults (18\u201459 years), with a FDE between 1 November 2003 and 31 December 2006 in a multi-center incident case-control study in four locations on the south-eastern and eastern seaboard of Australia, spanning latitudes 27\u00b0 south to 43\u00b0 south. Population denominators were obtained from the Australian Bureau of Statistics censuses of 2001 and 2006. Age and sex adjusted FDE incidence rates increased by 9.55% (95% confidence interval (CI) 7.37\u201411.78, p &lt; 0.001) per higher degree of latitude. The incidence rate gradient per higher degree of latitude varied by gender (male: 14.69% (95% CI 9.68\u201419.94, p &lt; 0.001); female 8.13% (95% CI 5.69\u201410.62, p &lt; 0.001)); and also by the presenting FDE type: optic neuritis 11.39% (95% CI 7.15\u201415.80, p &lt; 0.001); brainstem\/cerebellar syndrome 9.47% (95% CI 5.18\u201413.93, p &lt; 0.001); and spinal cord syndrome 5.36% (95% CI 1.78\u20149.06, p = 0.003). Differences in incidence rate gradients were statistically significant between males and females ( p = 0.02) and between optic neuritis and spinal cord syndrome ( p = 0.04). The male to female ratio varied from 1 : 6.7 at 27\u00b0 south to 1 : 2.5 at 43\u00b0 south. The study establishes a positive latitudinal gradient of FDE incidence in Australia. The latitude-related factor(s) influences FDE incidence variably according to subtype and gender, with the strongest influence on optic neuritis presentations and for males. These descriptive case analyses show intriguing patterns that could be important for understanding the etiology of multiple sclerosis.<\/jats:p>","DOI":"10.1177\/1352458509359724","type":"journal-article","created":{"date-parts":[[2010,2,18]],"date-time":"2010-02-18T21:37:49Z","timestamp":1266529069000},"page":"398-405","source":"Crossref","is-referenced-by-count":72,"title":["Latitudinal variation in incidence and type of first central nervous system demyelinating events"],"prefix":"10.1177","volume":"16","author":[{"given":"Bruce V","family":"Taylor","sequence":"first","affiliation":[{"name":"Menzies Research Institute, University of Tasmania, Hobart, Australia,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn M","family":"Lucas","sequence":"additional","affiliation":[{"name":"National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Dear","sequence":"additional","affiliation":[{"name":"National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor J","family":"Kilpatrick","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience, University of Melbourne, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P","family":"Pender","sequence":"additional","affiliation":[{"name":"The University of Queensland & Royal Brisbane and Women's Hospital, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid AF","family":"van der Mei","sequence":"additional","affiliation":[{"name":"Menzies Research Institute, University of Tasmania, Hobart, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caron","family":"Chapman","sequence":"additional","affiliation":[{"name":"Barwon Health, Geelong, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Coulthard","sequence":"additional","affiliation":[{"name":"The University of Queensland & Royal Brisbane and Women's Hospital, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terence","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony J","family":"McMichael","sequence":"additional","affiliation":[{"name":"National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia C","family":"Valery","sequence":"additional","affiliation":[{"name":"Queensland Institute of Medical Research, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Williams","sequence":"additional","affiliation":[{"name":"John Hunter Hospital & The University of Newcastle, Newcastle, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Louise","family":"Ponsonby","sequence":"additional","affiliation":[{"name":"Murdoch Childrens Research Institute, University of Melbourne, Melbourne, 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