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Stressful events can induce immunological alterations and could possibly impact the course of multiple sclerosis (MS)1 ,2 Thus stress management may be important to prevent relapse and reduce brain lesions in MS.3 ,4 Although major natural disasters cause severe physical and psychological stresses, few studies have analysed the influence of such natural disasters on MS and neuromyelitis optica spectrum disorders (NMOSD).
The Great East Japan Earthquake that measured magnitude 9.0 and triggered tsunami on 11 March 2011, devastated the Pacific coastal regions of Eastern Japan, especially the Iwate, Miyagi and Fukushima prefectures. Numerous aftershocks followed. Meltdown at the Fukushima No.1 nuclear power plant also resulted from the disaster. A total of 18 000 people died or are still unaccounted for, and half of them were Miyagi residents. About 320 000 people had to be evacuated at least temporarily in Miyagi prefecture alone. We studied the impact of the disaster in people with MS and NMOSD in Sendai City, the Miyagi prefecture's capital with a population of one million.
Patients and methods
Two hundred and three patients (140 with MS fulfilling the 2010 McDonald Criteria and 63 with aquaporin 4-IgG-positive NMOSD fulfilling the 2015 International Consensus Diagnostic Criteria) seen at Tohoku University Hospital and three other major hospitals in Sendai, Japan, enrolled in the study (age: 42.8±11.9 in MS, 54.0±13.4 in NMOSD, disease duration: 12.7±9.9 in MS, 13.0±10.7 in NMOSD, annualised relapse rate: 0.68±0.57 in MS, 0.62±0.58 in NMOSD in the previous year of the disaster). They accounted for 62% of the patients registered in Miyagi prefecture for the national registry of MS and NMOSD.
We surveyed the survival, living conditions including refuge, continuation of therapy (interferon β for MS and oral corticosteroid and/or immunosuppressants for NMOSD), available healthcare services by a self-developed questionnaire and stress by the Visual Analogue Scale (VAS), …
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