Environmental determinants of disability accumulation in Multiple Sclerosis

Project Details


Multiple sclerosis, an autoimmune, neurodegenerative condition, is the most common cause of non-traumatic neurological disability in young adults.  There is mounting evidence that, like disease risk, disease outcomes in MS likely involve the interplay between genetic factors and environment.  In particular, it has been noted that cigarette smoking is associated with worse MS outcomes in the Swedish population.  Here we seek to identify environmental factors that modulate the accrual of disability in MS including smoking behaviour, alcohol consumption, exercise, and vitamin D supplementation.

This project will assist in the implementation of an environmental impact survey into the international MSBase registry. Further, it will utilise existing clinical outcomes data and environmental data derived from the international MSBase Registry to identify environmental determinants of disease outcome.

Outcomes and impact

The identification of environmental factors associated with disease progression risk will create evidence for appropriate counselling of patients with regards to behavioural changes that can be made to improve their MS outcomes.

Research Environment

The proposed project will be undertaken using the MSBase Registry, an international, prospective, observational MS cohort study.  It currently contains over 50,000 longitudinal patient records, with over 230,000-patient years of follow-up.



  • A. Prof Tomas Kalincik, Department of Medicine, CORe Unit, University of Melbourne, VIC, Australia
  • Prof Dana Horakova, and Prof Eva Havrdova, Charles University Prague, Czech Republic
  • MSBase collaborative network

Research Publications

  1. Lorscheider J, Buzzard K, Jokubaitis V, et al., Defining secondary progressive multiple sclerosis. Brain. 2016;139(Pt 9):2395-405
  2. Jokubaitis VG, Spelman T, Kalincik T, et al., Predictors of long-term disability accrual in relapse-onset multiple sclerosis. Annals of Neurology. 2016; 80(1): 89-100Jokubaitis VG, Spelman T, Kalincik T, et al., Predictors of disability worsening in clinically isolated syndrome. Ann Clin Transl Neurol. 2015; 2(5): 479-91
  3. Trojano M, Lucchese G, Graziano G, et al., Geographical variations in sex ratio trends over time in multiple sclerosis.  PLoS One. 2012; 7(10): e48078

Research Group

MS Biology, Genomics and Prognostics Group

Faculty Research Themes


School Research Themes

Neuroscience & Psychiatry

Key Contact

For further information about this research, please contact the research group leader.

Department / Centre

Medicine and Radiology


Royal Melbourne Hospital

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