Vitamin D levels and risk of multiple sclerosis in patients with clinically isolated syndromes

Martinelli, Vittorio; Costa, Gloria Dalla; Colombo, Bruno; Libera, Dacia Dalla; Rubinacci, Alessandro; Filippi, Massimo; Furlan, Roberto; Comı, Gıancarlo

doi:10.1177/1352458513494959

Cited by 99 publications

(77 citation statements)

References 32 publications

(43 reference statements)

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“…Clinical presentation in combination with MRI of the brain and CSF analysis can be used in CIS patients to detect the patients who at risk for clinically definite MS (Alroughani et al 2012). It was found in this study that eight patients (19.6%) of CIS after 1-year follow-up were converted to clinically definite MS in concordance to these results, those of Martinelli et al (2014) which that stated that only 19% of their CIS patients had converted to clinically definite MS in the first year of follow-up, and those of Zhang et al (2016) which found that 22% of patients with CIS converted to clinically definite MS in first year follow-up and 52% patients converted to clinically definite MS at 5-year follow-up.…”

Section: Discussionsupporting

confidence: 77%

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Early predictors of conversion in patients with clinically isolated syndrome: a preliminary Egyptian study

Shaheen

Sayed

Daker

et al. 2018

Egypt J Neurol Psychiatry Neurosurg

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Background: Clinically isolated syndrome (CIS) is the first neurologic episode of multiple sclerosis (MS). Clinical presentation, neurophysiological studies, and magnetic resonance imaging (MRI) are used to predict risk of conversion to MS. There is little information regarding the risk factors of CIS conversion to MS so far in the Egyptian patients. This study aimed to evaluate the predictors of early conversion of the Egyptian patients with CIS to MS. Methods: A longitudinal prospective study was conducted on 43 Egyptian patients diagnosed as CIS according to the McDonald criteria (2010). The CIS patients underwent clinical assessment of disability using Expanded Disability Status Scale(EDSS), brain imaging by magnetic resonance imaging (MRI), and visual evoked potential (VEP) at baseline and after 1-year follow-up. Results: Eight patients (19.6%) with CIS converted to clinically definite MS after 1 year. A logistic regression analysis revealed that the CIS patients with initial clinical presentation with optic neuritis and higher MRI brain lesion number were associated with early conversion to MS (p = 0.003, p = 0.002, respectively). The total MRI brain T 2 lesion number that predicts early conversion to MS was four lesions with sensitivity (100%) and specificity (85.7%). Conclusions: The patients with CIS that early presented with optic neuritis and higher MRI brain lesion number are at higher risk for conversion to clinically definite MS.

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Section: Discussionsupporting

confidence: 77%

“…7%).While Martinelli et al (Martinelli et al 2014) stated that the number of MRI T 2 lesions at baseline appeared to be predictive of CDMS was nine lesions. For patients with fewer than nine lesions, the conversion rate to CDMS was 50 vs. 66% for the patients with nine or more lesions.…”

Section: Discussionmentioning

confidence: 99%

Early predictors of conversion in patients with clinically isolated syndrome: a preliminary Egyptian study

Shaheen

Sayed

Daker

et al. 2018

Egypt J Neurol Psychiatry Neurosurg

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“…In the recent years, this seasonal relationship is postulated to be associated with serum vitamin D levels (23). Data coming from relevant studies show that lower vitamin D levels are associated with more frequent relapses (24,25). It has been demonstrated that previously accused physical trauma, vaccinations, and epidural anesthesia do not have relapse triggering effects.…”

Section: The Definition and Features Of Relapsementioning

confidence: 99%

Relapses in Multiple Sclerosis: Definition, Pathophysiology, Features, Imitators, and Treatment

Sevim¹

2016

tnd

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Relapse in multiple sclerosis (MS) is defined as a neurologic deficit associated with an acute inflammatory demyelinating event that lasts at least 24 hours in the absence of fever and infection. Myelinoclasis and axonal transection occur in relapses. Diagnosis, prognosis, treatment, and many other features of the disease are directly related to the relapses. MS starts as the relapsing-remitting (RRMS) form in 85% of patients. A large number of relapses in the first years, polysymptomatic relapses, and pyramidal system, brain stem, and spinal cord involvement are signs of a poor outcome. The average frequency of relapses is approximately one per year during the first years of RRMS. The frequency of relapses increases during systemic infections, psychological stress, and in the first 3 months after birth. Seventy-five percent of relapses are monosymptomatic. Pseudo-relapses and paroxysmal symptoms are distinguished from relapses by their sudden onset, sudden termination, and shorter duration. Contrast enhancement is valuable in imaging, but undetectable in most relapses. The regression in the first few weeks of relapses is explained by reduction of the edema, and by remyelination in the following months. Relapses and their features are also among the main determinants of treatment. High-dose methylprednisolone and early treatment with adrenocorticotropic hormone reduce post-relapse disability and shorten the duration of relapses. Plasmapheresis is a good option for patients who do not respond to steroid treatment. Identification of relapses by patients and physicians, distinguishing them from imitators, proper evaluation, treatment when necessary, and monitoring the results are of great importance for patients with MS. The educational levels of patients and physicians regarding these parameters should be increased. Well-designed studies that evaluate the long-term effect of relapse treatment on disability are needed. Keywords: Multiple sclerosis, relapse, definition, features, treatmentMultipl sklerozda (MS) ateş ve enfeksiyon yokken en az 24 saat süren akut enflamatuvar demiyelinizan süreçle uyumlu nörolojik defisitler atak olarak tanımlanır. Ataklarda miyelin yıkımı ve aksonal transeksiyon oluşur. Hastalığın tanısı, seyri, tedavisi ve diğer birçok özelliği ataklarla doğrudan ilişkilidir. MS hastaların %85'inde atak ve düzelmelerle giden formda başlar. İlk yıllarda atak sayısının fazla olması, atakların birden çok semptomla ortaya çıkması, motor sistemi içermesi, beyin sapı ya da spinal atak formunda olması kötü prognoz göstergeleridir. Atak ve düzelmelerle giden formun başlangıç yıllarında yıllık ortalama atak sayısı 1'dir.Sistemik enfeksiyonlar, psişik stres ve postpartum 3 aylık dönemde atak sıklığı artar. Atakların %75'i monosemptomatiktir. Yalancı ataklar ve paroksismal bulgular genellikle ani başlayıp ani sonlanmalarıyla ve kısa sürmeleriyle ataklardan ayrılır. Görüntülemede kontrast tutulumu değerlidir, ancak atakların çoğunda saptanamaz. Ataklarda ilk birkaç hafta içindeki düzelme ödem etkisinin azalması...

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“…In another study lower vitamin D levels predicted conversion from CIS to clinically definite MS [111][112] , and no statistically significant differences in disease activity was found between the two groups. Vitamin D3 was associated with a statistically significant reduction in combined unique lesions (secondary endpoint).…”

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confidence: 99%

Vitamin D in Neurological Diseases: A Rationale for a Pathogenic Impact

Moretti

Morelli

Caruso

2018

Preprint

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It is widely known that vitamin D receptors have been found in neurons and glial cells and their highest expression is in the hippocampus, hypothalamus, thalamus and subcortical grey nuclei, and substantia nigra. The vitamin D helps the regulation of neurotrophin, neural differentiation and maturation, through the control operation of growing factors synthesis (ie NGF and GDNF), the trafficking of the septo-hyppocampal pathway, and the control of the synthesis process of different neuromodulators (such as Ach, DA, and GABA).Based on these assumptions, we have written this review in order to summarize the potential role of vitamin D in neurological pathologies. The work could be titanic, and might result very fuzzy and even incoherent, if we would not have conjectured to taper our first intentions and devoted our interests towards three mainstreams: demyelinating pathologies, vascular syndromes and neurodegeneration.Due to the lack of effective therapeutic options, a part from the disease modifying strategies, the role of different risk factors should be investigated in neurology, as far as their correction may lead to the improvement of the cerebral conditions.We have explored the relationships between the gene-environmental influence and long term vitamin D deficiency, as a risk factor for the development of different types of neurological disorders, along with the role and the rationale of therapeutic trials with vitamin D implementation. Peer-reviewed version available at Int. J. Mol. Sci. 2018, 19, 2245 doi:10.3390/ijms19082245 3 SEARCH STRATEGY AND SELECTION CRITERIAWe searched MEDLINE using the search terms: "vitamin D central nervous system" , both "vitamin D" and "central nervous system"; "vitamin D immune system/response", both "vitamin D" and "immune system" or "immune response"; "vitamin D multiple sclerosis risk", both "vitamin D" and "multiple sclerosis risk"; "vitamin D multiple sclerosis relapse", both "vitamin D" and "multiple sclerosis relapse"; "vitamin D multiple sclerosis magnetic resonance imaging", both "vitamin D" and "multiple sclerosis magnetic resonance imaging"; "vitamin D multiple sclerosis disability", both "vitamin D" and "multiple sclerosis disability"; "vitamin D supplementation/therapy/treatment multiple sclerosis", both "vitamin D supplementation" or "vitamin D therapy" or "vitamin D treatment" and "multiple sclerosis"; "vascular dementia", both as -vascular-and -dementia-, "subcortical vascular dementia", both assubcortical-and -dementia-, "Alzheimer's disease", "pathogenesis neurodegeneration" "amyloid", "cholinergic afferents", "arteriolosclerosis", "cerebral flow regulation", "stroke". Publications were selected mostly form the past 20years, but did not exclude frequently referenced and highly regarded older publications. . Congress abstracts and isolated case reports were not considered. We searched the reference lists of articles identified by this search strategy and selected those we judged relevant. Review articles and book chapters are cited to provide with ...

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Vitamin D levels and risk of multiple sclerosis in patients with clinically isolated syndromes

Abstract: Low serum vitamin D is associated with increased MS risk in patients with CIS.

Cited by 99 publications

References 32 publications

Early predictors of conversion in patients with clinically isolated syndrome: a preliminary Egyptian study

Early predictors of conversion in patients with clinically isolated syndrome: a preliminary Egyptian study

Relapses in Multiple Sclerosis: Definition, Pathophysiology, Features, Imitators, and Treatment

Vitamin D in Neurological Diseases: A Rationale for a Pathogenic Impact

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