Baseline neurological exposome characteristics in a nationwide community-based screening cohort for movement disorders in marginalized and integrated Roma populations
Fricova, D.; Belak, A.; Necpal, J.; Ferenc, M.; Giertlova, M.; Krauz, M.; Balko, R.; Baranova, A.; Buransky, M.; Drencakova, P.; Grofik, M.; Gurcik, L.; Han, V.; Haring, J.; Jaselska, S.; Jelenova, B.; Kalafusova, G.; Koren, M.; Kulcsarova, K.; Kusnirova, A.; Mosejova, A.; Mankos, J.; Matiskova, Z.; Mazerikova, Z.; Mistrik, M.; Okalova, K.; Orkuty, S.; Ostrozovicova, M.; Papikova, J.; Shabatiuk, O.; Trckova, L.; Skorvanek, M.; PURE-MD study group,
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Background: Roma, the largest ethnic minority in Europe,, are almost absent from movement-disorder research despite living in environments with biomass combustion, poor sanitation, and unprotected water, creating a high-risk neurological exposome. Objective: To describe baseline exposome profiles in a nationwide Roma screening cohort and compare exposures between marginalized and integrated communities, and between screen-positive and screen-negative participants. Methods: A nationwide community-based program combined door-to-door recruitment of marginalized Roma with recruitment of integrated Roma through neurological services. Participants completed standardized exposome questionnaires and a brief, non-diagnostic motor symptom screen. Results: Among 541 Roma (350 marginalized; 191 integrated), marginalized participants showed greater environmental and socioeconomic disadvantage, and screen-positive individuals tended to cluster at the more adverse end of this exposome spectrum. Conclusion: This nationwide Roma movement-disorder screening cohort with exposome assessment reveals substantial disparities relevant for future clinical and genetic research.
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