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In this MD Newsline exclusive interview with neurologist Dr. Mitzi Williams, we discuss how multiple sclerosis presents in minority patients. We also discuss the outcomes of minority patients with multiple sclerosis.

MD Newsline:

Does MS present differently in different racial/ethnic groups?

Dr. Mitzi Williams:

“Yes, there are some racial and ethnic groups where MS presents somewhat differently. For example, Black individuals and Japanese individuals with MS often present with optic neuritis, a loss of vision in one eye, and transverse myelitis, which causes numbness and weakness in the legs and difficulty walking.”

 

MD Newsline:

Why do you think minority groups with MS seem to have worse symptoms and outcomes? 

Dr. Mitzi Williams:

“Yes, minority groups with MS seem to have worse symptoms and outcomes. For example, the medical literature suggests that walking disability and needing to use a cane can present up to 6 years earlier in Black patients with MS than in white patients with MS. There may also be worse vision changes and optic neuritis in Black patients with MS and Latino patients with MS than in white patients with MS.

The big question is what role is biology—genetics and epigenetics—playing, and what roles are social determinants of health—access to care, health insurance, discrimination, bias, and systemic racism—playing in MS symptoms and outcomes? The answer is we don’t know how each of these factors contributes, but likely biological and social factors are both at play as far as the disparate outcomes of minority groups with MS are concerned.”

 

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Responses have been condensed and lightly edited.

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