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A Co-twin Study of a Nationwide Series

Esko Kinnunen, MD; Juhani Juntunen, MD; Leena Ketonen, MD; Saija Koskimies, MD; Yrjö T. Konttinen, MD; Tapani Salmi, MD; Markku Koskenvuo, MD; Jaakko Kaprio, MD

Arch Neurol. 1988;45(10):1108-1111.

Abstract
• The problems of differentiation between environmental and genetic influences on the development of multiple sclerosis are well known. Twin studies may provide valuable information on this question. However, most published twin series are selected and no thorough clinical twin studies based on epidemiologic series have been carried out. In this study, all available same-sex twin pairs with clinically definite multiple sclerosis derived from the Finnish Twin Cohort of 15815 pairs were studied by clinical evaluation, magnetic resonance imaging, and visual and auditory evoked responses. The mean length of follow-up of the pairs after the onset of symptoms of multiple sclerosis was 20 years. Two of the seven monozygotic pairs were concordant; one was definitely so, and in the other, the co-twin of the index case had, in addition to clinical findings, white matter changes suggestive of multiple sclerosis in magnetic resonance imaging and abnormal visual evoked responses. All six dizygotic pairs were discordant. The frequency of the HLA antigen DR2 in probands (69%) was significantly increased, but the distribution among the healthy subjects and patients showed nonsignificant differences. The results indicate a genetic influence on the susceptibility to multiple sclerosis, although still unknown genetic determinants are possibly involved.

Author Affiliations
From the Clinical Neurosciences, Institute of Occupational Health, Helsinki (Drs Kinnunen, Juntunen, and Salmi); the Departments of Radiology (Dr Ketonen), Medicine (Fourth Department) (Dr Konttinen), and Public Health (Drs Koskenvuo and Kaprio), the University of Helsinki; and Finnish Red Cross Blood Transfusion Service, Helsinki (Dr Koskimies).

Footnotes
Accepted for publication April 25, 1988.

Reprint requests to the Clinical Neurosciences, Institute of Occupational Health, Topeliuksenkatu 41aA, SF-00250 Helsinki, Finland (Dr Kinnunen).

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