Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1998 Dec;65(6):842–847. doi: 10.1136/jnnp.65.6.842

Geographical epidemiology of residence of patients with motor neuron disease in Lancashire and south Cumbria

J Mitchell 1, A Gatrell 1, A Al-Hamad 1, R Davies 1, G Batterby 1
PMCID: PMC2170391  PMID: 9854959

Abstract

OBJECTIVES—To seek objective evidence for geographical clustering of places of residence of patients with motor neuron disease (MND).
METHODS—A complete residential history from birth to onset of disease was obtained from a cohort of 130 patients with MND from Lancashire and south Cumbria presenting to the Department of Neurology in Preston between 1 January 1989 and 31 December 1993. These data were compared with population based reference data from the 1991UK Census.
RESULTS—Some areal units showed a greater, others a lesser, number of MND patient residences than expected. The results suggest that the background population incidence of MND is relatively low and that the overall incidence figures previously quoted have been skewed upwards by areas in which the incidence of MND is relatively increased. These findings were further tested by Poisson modelling. The Poisson model provided a poor fit for the data at postcode district and sector levels confirming that patients with MND were significantly more likely to have lived in some areas than others after allowing for variation in population of the different areal units and for variation in duration of residence.
CONCLUSIONS—These findings reinforce the results of previous work, much of which has been qualitative rather than quantitative. The results presented here suggest a low background incidence of MND in the context of generally quoted overall incidence figures. This low background incidence is, however, skewed upwards by some areal units with a relatively high incidence, thus achieving overall incidence rates comparable with generally quoted figures. We conclude that there is prima facie evidence of spatial patterns in the distribution of places of residence of patients with MND. Further examination of occupational and environmental factors in the lives of the patients with MND is required to obtain a better understanding of the importance of these findings.



Full Text

The Full Text of this article is available as a PDF (105.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Betemps E. J., Buncher C. R. Birthplace as a risk factor in motor neurone disease and Parkinson's disease. Int J Epidemiol. 1993 Oct;22(5):898–904. doi: 10.1093/ije/22.5.898. [DOI] [PubMed] [Google Scholar]
  2. Bharucha N. E., Schoenberg B. S., Raven R. H., Pickle L. W., Byar D. P., Mason T. J. Geographic distribution of motor neuron disease and correlation with possible etiologic factors. Neurology. 1983 Jul;33(7):911–915. doi: 10.1212/wnl.33.7.911. [DOI] [PubMed] [Google Scholar]
  3. Brooks B. R. El Escorial World Federation of Neurology criteria for the diagnosis of amyotrophic lateral sclerosis. Subcommittee on Motor Neuron Diseases/Amyotrophic Lateral Sclerosis of the World Federation of Neurology Research Group on Neuromuscular Diseases and the El Escorial "Clinical limits of amyotrophic lateral sclerosis" workshop contributors. J Neurol Sci. 1994 Jul;124 (Suppl):96–107. doi: 10.1016/0022-510x(94)90191-0. [DOI] [PubMed] [Google Scholar]
  4. Buckley J., Warlow C., Smith P., Hilton-Jones D., Irvine S., Tew J. R. Motor neuron disease in England and Wales, 1959-1979. J Neurol Neurosurg Psychiatry. 1983 Mar;46(3):197–205. doi: 10.1136/jnnp.46.3.197. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hochberg F. H., Bryan J. A., 2nd, Whelan M. A. Letter: Clustering of amyotrophic lateral sclerosis. Lancet. 1974 Jan 5;1(7845):34–34. doi: 10.1016/s0140-6736(74)93037-2. [DOI] [PubMed] [Google Scholar]
  6. Holloway S. M., Emery A. E. The epidemiology of motor neuron disease in Scotland. Muscle Nerve. 1982 Feb;5(2):131–133. doi: 10.1002/mus.880050209. [DOI] [PubMed] [Google Scholar]
  7. Holloway S. M., Mitchell J. D. Motor neurone disease in the Lothian Region of Scotland 1961-81. J Epidemiol Community Health. 1986 Dec;40(4):344–350. doi: 10.1136/jech.40.4.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hudson A. J., Davenport A., Hader W. J. The incidence of amyotrophic lateral sclerosis in southwestern Ontario, Canada. Neurology. 1986 Nov;36(11):1524–1528. doi: 10.1212/wnl.36.11.1524. [DOI] [PubMed] [Google Scholar]
  9. Jokelainen M. The epidemiology of amyotrophic lateral sclerosis in Finland. A study based on the death certificates of 421 patients. J Neurol Sci. 1976 Sep;29(1):55–63. doi: 10.1016/0022-510x(76)90080-0. [DOI] [PubMed] [Google Scholar]
  10. Melmed C., Krieger C. A cluster of amyotrophic lateral sclerosis. Arch Neurol. 1982 Sep;39(9):595–596. doi: 10.1001/archneur.1982.00510210065018. [DOI] [PubMed] [Google Scholar]
  11. Mitchell J. D., Gibson H. N., Gatrell A. Amyotrophic lateral sclerosis in Lancashire and South Cumbria, England, 1976-1986. A geographical study. Arch Neurol. 1990 Aug;47(8):875–880. doi: 10.1001/archneur.1990.00530080057011. [DOI] [PubMed] [Google Scholar]
  12. Qizilbash N., Bates D. Incidence of motor neurone disease in the northern region. J Epidemiol Community Health. 1987 Mar;41(1):18–20. doi: 10.1136/jech.41.1.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Sienko D. G., Davis J. P., Taylor J. A., Brooks B. R. Amyotrophic lateral sclerosis. A case-control study following detection of a cluster in a small Wisconsin community. Arch Neurol. 1990 Jan;47(1):38–41. doi: 10.1001/archneur.1990.00530010046017. [DOI] [PubMed] [Google Scholar]
  14. Taylor J. A., Davis J. P. Evidence for clustering of amyotrophic lateral sclerosis in Wisconsin. J Clin Epidemiol. 1989;42(6):569–575. doi: 10.1016/0895-4356(89)90153-4. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES