Research: Conjugal MS; is MS transmissible?

Epub ahead of printHawkes et al. MRI and visual-evoked potentials in partners of multiple sclerosis patients. Acta Neurol Scand. 2011 Aug 25. doi: 10.1111/j.1600-0404.2011.01586.x

Objective:  There is some evidence, particularly concerning the role of Epstein Barr Virus, MS may be transmissible and if correct, this might be revealed by increased prevalence of MS in cohabiting partners.

Methods: This study addressed this problem by neurological assessment, visual-evoked potentials and MRI in 112 partners of MS'ers in comparison to a control group of 93 individuals with clinically non-significant head or neck pain and in comparison with the UK prevalence. 

"Visual-evoked potentials or VEPs are the electrical tests we to detect MS lesions in the visual pathway; a slowed VEP implies demyelination ans supports the diagnosis of MS."

Results: The investigators found one instance of conjugal definite MS. Including this case VEPs were abnormal in five instances raising the possibility of sub-clinical demyelination in the optic nerve. There were no significant differences in MRI findings between the two groups. 

Conclusion: The finding of one conjugal pair and abnormal VEPs in a further four MS partners could have several explanations. It is compatible with the concept of a transmissible agent, although their observations could be due to bias as well as due to chance.

"This study is under powered (too few pairs) to test the proposed hypothesis. The results are borderline and would need to confirmed. The results are also incompatible with the large Canadian Conjugal Pair study that showed no evidence of an increase in MS in partners of MS'ers. Other studies suggest that the environmental factors act earlier in life; well before the age people get married. The exception being infectious mononucleosis (IM); a Danish national study has shown that IM is a risk factor at any age during life." 

"In conclusion, there is no evidence at present that MS is a transmissible disease." 

"In other words, MS'ers cannot transmit MS to another person."

Additional reading: VEPs

CoI: Professor Chris Hawkes is an honorary member of staff at Barts and The London.