Left-handedness has been studied as a marker for in-utero exposure to sex steroid hormones, and an increased risk of autoimmune and immune disorders among left-handed individuals has been suggested.
Objective
This study examines the relationship between hand preference and risk of multiple sclerosis, a presumed autoimmune disorder of unknown etiology.
Methods
The study population comprised participants in the Nurses’ Health Study, an ongoing prospective cohort study of 121,701 female nurses in the United States with followup from 1976 to 2002. The nurses were asked to report their natural hand preference (right, left, ambidextrous, forced to change).
Results
During followup 210 incident cases with multiple sclerosis were confirmed. A 62% increased risk of multiple sclerosis was observed among women who were naturally left handed as compared to those who were naturally right handed (95% CI: 1.04–2.53).
Conclusions
This study suggests a modest increase in risk of multiple sclerosis among left-handed women. Further investigation of this relationship is suggested in other populations including both males and females. While the current results suggest that prenatal exposure to sex hormones may play a role in multiple sclerosis risk, direct examination of the relationship between in-utero hormone exposure and hand preference is necessary before any conclusions can be drawn.
1 Sadovnick AD Armstrong H Rice GP . A population-based study of multiple sclerosis in twins: update. Ann Neurol1993; 33: 281–285.
2.
2 Ascherio A Munger KL . Environmental risk factors for multiple sclerosis. Part II: noninfectious factors. Ann Neurol2007; 61: 504–513.
3.
3 Ebers GC Sadovnick AD Dyment DA Yee IML Willer CJ Risch N . Parent-of-origin effect in multiple sclerosis: observations in half-siblings. Lancet2004; 363: 1773–1774.
4.
4 Titus-Ernstoff L Newcomb PA Egan KM . Left-handedness in relation to breast-cancer risk in postmenopausal women. Epidemiology2000; 11: 181–184.
5.
5 Morfit NS Weekes NY . Handedness and immune function. Brain Cogn2001; 46: 209–213.
6.
6 Searleman A Fugagli AK . Suspected autoimmune disorders and left-handedness: evidence from individuals with diabetes, Crohn’s disease, and ulcerative colitis. Neuropsychologia1987; 25: 367–374.
7.
7 Geschwind N Galaburda AM . Cerebral lateralization: biological mechanisms, associations, and pathology: I. A hypothesis and a program for research. Arch Neurol1985; 42: 428–459.
8.
8 Geschwind N Galaburda AM . Cerebral lateralization: biological mechanisms, associations, and pathology: II. A hypothesis and a program for research. Arch Neurol1985; 42: 521–552.
9.
9 Geschwind N Behan P . Left-handedness: association with immune disease, migraine, and developmental learning disorder. Proc Natl Acad Sci USA1982; 79: 5097–5100.
10.
10 Marx JP . Autoimmunity in left-handers. Science1982; 217: 141–144.
11.
11 Wisniewski AB . Sexually-dimorphic patterns of cortical asymmetry, and the role for sex steroid hormones in determining cortical patterns of lateralization. Psychoneuroendocrinology1998; 23: 519–547.
12.
12 Bouman A Heineman MJ Faas MM . Sex hormones and the immune response in humans. Hum Reprod Update2005; 11: 411–423.
13.
13 Bryden MP McManus IC Bulman-Fleming MB . Evaluating the empirical support for the Geschwind-Behan-Galaburda model of cerebral lateralization. Brain Cogn1994; 26: 103–167.
14.
14 Morris DL Montgomery SM Galloway ML Pounder ML Wakefield AJ . Inflammatory bowel disease and laterality: is left handedness a risk? Gut2001; 49: 199–202.
15.
15 Dane S Kumtepe Y Pasinlioglu T Aksoy A . Relationship between age of menopause and cell-mediated immune hypersensitivity in right- and left-handed women. Int J Neurosci2004; 114: 651–657.
16.
16 Colditz GA Manson JE Hankinson SE . The Nurses’ Health Study: 20-year contribution to the understanding of health among women. J Womens Health1997; 6: 49–62.
17.
17 Hernan MA Olek MJ Ascherio A . Cigarette smoking and incidence of multiple sclerosis. Am J Epidemiol2001; 154: 69–74.
18.
18 Munger KL Zhang SM O’Reilly E . Vitamin D intake and incidence of multiple sclerosis. Neurology2004; 62: 60–65.
19.
19 Hernan MA Olek MJ Ascherio A . Geographic variation of MS incidence in two prospective studies of US women. Neurology1999; 53: 1711–1718.
20.
20 Cerhan JR Folsom AR Potter JD Prineas RJ . Handedness and mortality risk in older women. Am J Epidemiol1994; 140: 368–374.
21.
21 Marks JS Williamson DF . Left-handedness and life expectancy. N Engl J Med1991; 325: 1042–1043.
22.
22 Ponsonby AL van der Mei I Dwyer T . Exposure to infant siblings during early life and risk of multiple sclerosis. JAMA2005; 293: 463–469.
23.
23 Kurtzke JF Page WF . Epidemiology of multiple sclerosis in US veterans: VII. Risk factors for MS. Neurology1997; 48: 204–213.
24.
24 Riise T Nortvedt MW Ascherio A . Smoking is a risk factor for multiple sclerosis. Neurology2003; 61: 1122–1124.
25.
25 Hernan MA Jick SS Logsroscino G Olek MJ Ascherio A Jick H . Cigarette smoking and the progression of multiple sclerosis. Brain2005; 128: 1461–1465.
26.
26 Miettenen OS . Theoretical epidemiology.New York: Wiley; 1985. p. 231.
27.
27 Fink B Manning JT Neave N Tan U . Second to fourth digit ratio and hand skill in Australian children. Biol Psychol2004; 67: 375–384.
28.
28 Manning JT Trivers RL Thornhill R Singh D . The 2nd:4th digit ratio and asymmetry of hand performance in Jamaican children. Laterality2000; 5: 121–132.
29.
29 Smith LL Hines M . Language lateralization and handedness in women prenatally exposed to diethylstilbestrol (DES). Psychoneuroendocrinology2000; 25: 497–512.
30.
30 Nass R Baker S Speiser P . Hormones and handedness: left-hand bias in female congenital adrenal hyperplasia patients. Neurology1987; 37: 711–715.
31.
31 Grimshaw GM Bryden MP Finegan JK . Relations between prenatal testosterone and cerebral lateralization in children. Neuropsychology1995; 9: 68–79.
32.
32 Medland SE Duffy DL Spurdle AB . Opposite effects of androgen receptor CAG repeat length on increased risk of left-handedness in males and females. Behav Genet2005; 35: 735–743.
33.
33 Elkadi S Nicholls MER Clode D . Handedness in opposite and same-sex dizygotic twins: testing the testosterone hypothesis. Neuroreport1999; 10: 333–336.
34.
34 Titus-Ernstoff L Perez K Hatch EE . Psychosexual characteristics of men and women exposed prenatally to diethylstilbestrol. Epidemiology2003; 14: 155–160.
35.
35 Naftolin F . Brain aromatization of androgens. J Reprod Med1994; 39: 257–261.
36.
36 Ramadhani MK Elias SG van Noord PAH Grobbee DE Peeters PHM Uiterwaal CSPM . Innate left-handedness and risk of breast cancer: case–cohort study. BMJ2005; 331: 882–883.
37.
37 Fritschi L Divitini M Talbot-Smith A Knuiman M . Left-handedness and risk of breast cancer. Br J Cancer2007; 97: 686–687.
38.
38 Ramadhani MK Elias SG van Noord PA Grobbee DE Peeters PH Uiterwaal CS . Innate handedness and disease specific mortality in women. Epidemiology2007; 18: 208–212.
39.
39 Basso O Olsen J Holm NV Skytthe A Vaupel JW Christensen K . Handedness and mortality: a follow-up study of Danish twins born between 1900 and 1910. Epidemiology2000; 11: 576–580.
40.
40 Meyers S Janowitz HD . Handedness and inflammatory bowel disease. J Clin Gastroenterol1985; 7: 33–35.
41.
41 Medland SE Duffy DL Wright MJ . Genetic influences on handedness: data from 25732 Australian and Dutch twin families. Neuropsychologia2009; 47: 330–337.
42.
42 Lengen C Regard M Joller H Landis T Lalive P . Anomalous brain dominance and the immune system: do left-handers have specific immunological patterns? Brain Cogn2009; 69: 188–193.
43.
43 Gutteling BM de Weerth C Buitelaar JK . Prenatal stress and mixed-handedness. Pediatr Res2007; 62: 586–590.
44.
44 Glover V O’Connor TG Heron J Golding J . ALSPAC Study Team.Antenatal maternal anxiety is linked with atypical handedness in the child. Early Hum Dev2004; 79: 107–118.
45.
45 Rodriguez A Waldenström U . Fetal origins of child non-right-handedness and mental health. J Child Psychol Psychiatry2008; 49: 967–976.
46.
46 Sandman CA Wadhwa PD Chicz-DeMet A Dunkel-Schetter C Porto M . Maternal stress, HPA activity, and fetal/infant outcome. Ann N Y Acad Sci1997; 814: 266–275.
47.
47 Ruiz RJ Avant KC . Effects of maternal prenatal stress on infant outcomes: a synthesis of the literature. Adv Nurs Sci2005; 28: 345–355.
48.
48 Brydon MP Steenhuis RE . Issues in assessment of handedness. In: FL Kitterle , (ed), Cerebral laterality theory and research.Hillsdale, NJ: Lawrence Erlbaum Associates; 1991. p. 35–52.
49.
49 Dragovic M Hammond G . A classification of handedness using the Annett Hand Preference Questionnaire. Br J Psychol2007; 98: 375–387.
50.
50 Reiss M Reiss G Freye H . Some aspects of self-reported hand preference. Percept Mot Skills1998; 86: 953–954.
