Interdependence and contributions of sun exposure and vitamin D to MRI measures in multiple sclerosis

Robert Zivadinov, Cierra N. Treu, Bianca Weinstock-Guttman, Caitlin Turner, Niels Bergsland, Kerri O'Connor, Michael G. Dwyer, Ellen Carl, Deepa P. Ramasamy, Jun Qu, Murali Ramanathan

Research output: Contribution to journalArticlepeer-review


Purpose To assess the relationships of sun exposure history, supplementation and environmental factors to vitamin D levels in multiple sclerosis (MS) patients and to evaluate the associations between sun exposure and MRI measures. Methods This study included 264 MS patients (mean age 46.9±10 years, disease duration 14.6±10 years; 67.8% relapsing-remitting, 28% secondary progressive and 4.2% primary progressive MS) and 69 healthy controls. Subjects underwent neurological and 3 T MRI examinations, provided blood samples and answered questions to a structured questionnaire. Information on race, skin and eye colour, supplement use, body mass index (BMI) and sun exposure was obtained by questionnaire. The vitamin D metabolites (25-hydroxy vitamin D3, 1, 25-dihydroxy vitamin D3 and 24, 25- dihydroxy vitamin D3) were measured using mass spectrometry. Results Multivitamin supplementation ( partial correlation rp=0.29, pp=-0.24, p=0.001), summer sun exposure (r p=0.22, p=0.002) and darker eye colour (rp=-0.18, p=0.015) had the strongest associations with vitamin D metabolite levels in the MS group. Increased summer sun exposure was associated with increased grey matter volume (GMV, rp=0.16, p=0.019) and whole brain volume (WBV, r p=0.20, p=0.004) after correcting for Extended Disability Status Scale in the MS group. Inclusion of 25-hydroxy vitamin D3 levels did not substantially affect the positive associations of sun exposure with WBV (r p=0.18, p=0.003) and GMV (rp=0.14, p=0.026) in the MS group. Conclusions Sun exposure may have direct effects on MRI measures of neurodegeneration in MS, independently of vitamin D.

Original languageEnglish
Pages (from-to)1075-1081
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Issue number10
Publication statusPublished - Oct 2013

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Surgery
  • Arts and Humanities (miscellaneous)


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