Vitamin D status predicts new brain MRI activity in multiple sclerosis
Annals of Neurology ,  Clinical Article

Mowry EM et al. – Vitamin D levels are inversely associated with multiple sclerosis (MS) activity on brain MRI. These results provide further support for a randomized trial of vitamin D supplementation.

Methods
  • EPIC is a five-year longitudinal MS cohort study at the University of California, San Francisco.
  • Participants had clinical evaluations, brain MRI, and blood draws annually.
  • From the overall cohort, the authors evaluated patients with clinically isolated syndrome or relapsing-remitting MS at baseline.
  • In univariate and multivariate (adjusted for age, sex, ethnicity, smoking, and MS treatments) repeated measures analyses, annual 25-hydroxyvitamin D levels were evaluated for their association with subsequent new T2-weighted and gadolinium-enhancing T1-weighted lesions on brain MRI, clinical relapses, and disability (Expanded Disability Status Scale [EDSS]).

Results
  • 2,362 3T brain MRI scans were acquired from 469 subjects.
  • In multivariate analyses, each 10 ng/mL higher 25-hydroxyvitamin D was associated with a 15% lower risk of a new T2 lesion (incidence rate ratio [IRR]= 0.85, 95% CI [0.76, 0.95], p=0.004) and a 32% lower risk of a gadolinium-enhancing lesion (IRR=0.68, 95% CI [0.53, 0.87], p=0.002).
  • Each 10 ng/mL higher vitamin D level was associated with lower subsequent disability (-0.047, 95% CI [-0.091, -0.003], p=0.037).
  • Higher vitamin D levels were associated with lower, but not statistically significant, relapse risk.
  • Except for the EDSS model, all associations were stronger when the within-person change in vitamin D level was the predictor.

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