{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:54:06Z","timestamp":1781772846298,"version":"3.54.5"},"reference-count":23,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100012440","name":"Berrikuntza + Ikerketa + Osasuna Eusko Fundazioa","doi-asserted-by":"publisher","award":["2023 call for \u201cGrants for Research Projects in M"],"award-info":[{"award-number":["2023 call for \u201cGrants for Research Projects in M"]}],"id":[{"id":"10.13039\/501100012440","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Biobizkaia Health Research Institute","award":["2021 internal calls for \u201cContracts for the Inten"],"award-info":[{"award-number":["2021 internal calls for \u201cContracts for the Inten"]}]},{"name":"Biobizkaia Health Research Institute","award":["2023 internal calls for \u201cContracts for the Inten"],"award-info":[{"award-number":["2023 internal calls for \u201cContracts for the Inten"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple sclerosis (MS) prevalence has increased across Europe, yet contemporary population-based data from southern Europe remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In this retrospective population-based cohort study conducted in a healthcare area of the Basque Country (Barrualde-Galdakao Integrated Healthcare Organisation [BGIHO]), northern Spain, we estimated prevalence, incidence, and clinical characteristics of MS. Prevalence was estimated on 31 December 2023 using the 2017 McDonald criteria, and incidence was assessed from 1 January 2009 to 31 December 2023 using both symptom-onset and diagnosis-based definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prevalence was 131.8 per 100,000 inhabitants (95% CI 119.6\u2013145.2); age-adjusted prevalence (European Standard Population [ESP2013]) was 125.4 (95% CI 113.3\u2013138.1). Mean annual incidence (2009\u20132023) was 4.4 per 100,000 person-years (95% CI 3.9\u20135.1) by symptom onset and 5.3 (95% CI 4.7\u20136.0) by diagnosis date. Relapsing\u2013remitting MS (RRMS) accounted for 67.1% of cases; secondary progressive MS (SPMS) for 18.6%; and primary progressive MS (PPMS) for 14.2%. Median EDSS was 2 (IQR 0\u20135).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MS prevalence in this healthcare area is high. The findings reflect an aging MS population with evolving clinical characteristics. The use of complementary incidence definitions provides insight into disease occurrence and healthcare detection. Continued epidemiological monitoring is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552173261458067","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T08:49:02Z","timestamp":1781599742000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology of multiple sclerosis in a healthcare area of the Basque Country, Northern Spain: A population-based study (2009\u20132023)"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2634-8294","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"S\u00e1nchez-Menoyo","sequence":"first","affiliation":[{"name":"Department of Neurology, Galdakao-Usansolo University Hospital, Osakidetza (Basque Health Service), Usansolo, Bizkaia, Spain"},{"name":"Biobizkaia Health Research Institute, Central Nervous System Diseases Area, Barakaldo, Bizkaia, Spain"},{"name":"University of the Basque Country (EHU), Department of Neurosciences, Leioa, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabas","family":"Boyero-Dur\u00e1n","sequence":"additional","affiliation":[{"name":"Cruces University Hospital"},{"name":"Biobizkaia Health Research Institute, Central Nervous System Diseases Area, Barakaldo, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Llarena-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Basurto University Hospital"},{"name":"Biobizkaia Health Research Institute, Central Nervous System Diseases Area, Barakaldo, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Roncero-Colina","sequence":"additional","affiliation":[{"name":"Basurto University Hospital"},{"name":"Biobizkaia Health Research Institute, Central Nervous System Diseases Area, Barakaldo, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"Mendibe-Bilbao","sequence":"additional","affiliation":[{"name":"Cruces University Hospital"},{"name":"Biobizkaia Health Research Institute, Central Nervous System Diseases Area, Barakaldo, Bizkaia, Spain"},{"name":"University of the Basque Country (EHU), Department of Neurosciences, Leioa, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"V\u00e1zquez-Pic\u00f3n","sequence":"additional","affiliation":[{"name":"Biobizkaia Health Research Institute, Central Nervous System Diseases Area, Barakaldo, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8049-3030","authenticated-orcid":false,"given":"Urko","family":"Agirre-Larrakoetxea","sequence":"additional","affiliation":[{"name":"Research Unit, Galdakao-Usansolo University Hospital, Osakidetza (Basque Health Service), Usansolo, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itxaso","family":"Azkune-Calle","sequence":"additional","affiliation":[{"name":"Department of Neurology, Galdakao-Usansolo University Hospital, Osakidetza (Basque Health Service), Usansolo, Bizkaia, Spain"},{"name":"Biobizkaia Health Research Institute, Central Nervous System Diseases Area, Barakaldo, Bizkaia, Spain"},{"name":"University of the Basque Country (EHU), Department of Neurosciences, Leioa, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4539-6262","authenticated-orcid":false,"given":"Enrique","family":"Valdeolivas-Urbelz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Galdakao-Usansolo University Hospital, Osakidetza (Basque Health Service), Usansolo, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Rodr\u00edguez-Antig\u00fcedad","sequence":"additional","affiliation":[{"name":"Cruces University Hospital"},{"name":"Biobizkaia Health Research Institute, Central Nervous System Diseases Area, Barakaldo, Bizkaia, Spain"},{"name":"University of the Basque Country (EHU), Department of Neurosciences, Leioa, Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000622"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520970841"},{"key":"e_1_3_3_4_2","unstructured":"Llaneza Gonz\u00e1lez M. Epidemiolog\u00eda de la esclerosis m\u00faltiple en el \u00e1rea sanitaria de Ferrol. Spain: Universidad de La Coru\u00f1a A Coru\u00f1a 2016."},{"key":"e_1_3_3_5_2","volume-title":"Epidemiolog\u00eda de la esclerosis m\u00faltiple en la ciudad de Ourense","author":"Fraga Gonz\u00e1lez C","year":"2018","unstructured":"Fraga Gonz\u00e1lez C. Epidemiolog\u00eda de la esclerosis m\u00faltiple en la ciudad de Ourense. Vigo: Universidad de Vigo, 2018."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13265"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-025-04108-5"},{"key":"e_1_3_3_8_2","first-page":"32","article-title":"Epidemiology of multiple sclerosis in Spain","volume":"69","author":"Perez-Carmona N","year":"2019","unstructured":"Perez-Carmona N, Fernandez-Jover E, Sempere AP. Epidemiology of multiple sclerosis in Spain. 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Barcelona: Prous Science, 2001, pp.121\u2013125."},{"key":"e_1_3_3_13_2","volume-title":"Esclerosis m\u00faltiple, an\u00e1lisis cl\u00ednico retrospectivo y prospectivo de una serie hospitalaria de base poblacional","author":"Rodr\u00edguez-Antig\u00fcedad Zarranz A","year":"2001","unstructured":"Rodr\u00edguez-Antig\u00fcedad Zarranz A. Esclerosis m\u00faltiple, an\u00e1lisis cl\u00ednico retrospectivo y prospectivo de una serie hospitalaria de base poblacional. Bilbao: Universidad del Pais Vasco. 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