Click here to stream the public defence
Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Jan Hillert, Karolinska Institutet, Sweden
- Second opponent: Associate Professor Melinda Magyari, University of Copenhagen
- Third member and chair of the evaluation committee: Professor Benedicte A. Lie, University of Oslo
Chair of the Defence
Professor II Erik Taubøll, University of Oslo
Principal Supervisor
Professor Elisabeth Gulowsen Celius, University of Oslo
Summary
The overall aim of this project was to evaluate the impact of socioeconomic factors on different aspects of multiple sclerosis (MS). MS occurs with greater frequency in high-income nations, and some studies have concluded that there is a tendency for higher susceptibility to MS in households of greater affluence, the evidence is however inconsistent. The influence of socioeconomic status on progression in MS is sparsely investigated. Several studies report a trend of less access to disease modifying treatment to more deprived persons.
This thesis has used information from a large cohort of people with MS (pwMS) in Buskerud, Oslo and Telemark. The database consists of detailed clinical data from patient records combined with variables of socioeconomic status from Statistics Norway, like level of education, household income and marital status. The thesis concludes with a high prevalence of MS in Telemark, among the highest ever reported in Norway. It also describes a higher prevalence in the rural areas that is unlikely to be explained by possible risk factors like latitude, exposure to sunlight and diet.
A higher maternal level of education in pwMS’ adolescence is associated with less pronounced disease progression. High maternal education is also associated with younger age and lower expanded disability status score (EDSS) at disease onset, as well as shorter time from onset to diagnosis. PwMS with the highest levels of education were more likely to be ever treated with a disease modifying treatment in MS. However, when analysing access to high efficacy disease modifying treatment as a first drug, a strategy that has been focused in the updated national treatment strategies, we did not find that deprived pwMS had less access. Since 2012, the access to high efficacy treatment has been determined by disease severity, independent of the socioeconomic status, in this Norwegian cohort.
Additional information
Contact the research support staff.