Hajeer Shorouk, Nasr Farah, Nabha Sanaa, Saab Marie-Belle, Harati Hayat, Desoutter Alban, Al Ahmar Elie, Estephan Elias
Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Faculty of Pedagogy, Lebanese University, Furn-El-Chebbak, Lebanon.
Heliyon. 2023 Apr 23;9(5):e15754. doi: 10.1016/j.heliyon.2023.e15754. eCollection 2023 May.
BACKGROUND/OBJECTIVE: Multiple Sclerosis is a common demyelinating disease of the central nervous system. Several studies suggested a link between vitamin D deficiency and multiple sclerosis disease activity, which can be evaluated by magnetic resonance imaging. Thereby, the main objective of the following scoping review is to summarize the magnetic resonance imaging findings assessing the probable effects of vitamin D on MS disease activity.
PRISMA checklist for systematic reviews and meta-analyses was employed to structure this review. Literature was searched for observational and clinical studies tackling the given matter using several search engines including PubMed, CORE, and Embase. Data was extracted in a systematic manner, and the articles meeting the inclusion criteria were quality-assessed by Jadad scale for randomized clinical trials (RCTs) and Newcastle-Ottawa scale for observational studies.
A total of 35 articles were included. Twenty-one (60%) studies noted a statistically significant association between vitamin D and Multiple Sclerosis MRI-detected disease activity. MRI-detected features involved lower contrast-enhancing T1 lesions, lower hyperintense T2 lesions, and a decrease in lesions volume. On the other hand, 40% (14 articles) of the articles did not detect any significant effect of vitamin D on Multiple Sclerosis disease activity. Due to the heterogeneity of the studies involved, meta-analysis was not employed in the given review.
DISCUSSION/CONCLUSION: There was an abundance in the number of research studies investigating the relationship between vitamin D and Multiple Sclerosis while highlighting the significant role of MRI in assessing the activity of the disease. Numerous studies found that higher serum vitamin D levels are associated with decreased new active cortical and subcortical lesions and lower lesions volume. These findings highlight the importance of imaging modalities in the various aspects of neurological diseases and encourage further research to focus on the preventive effects of vitamin D on MS patients.
背景/目的：多发性硬化症是中枢神经系统常见的脱髓鞘疾病。多项研究表明维生素D缺乏与多发性硬化症疾病活动之间存在联系，这可以通过磁共振成像进行评估。因此，以下范围综述的主要目的是总结磁共振成像结果，以评估维生素D对多发性硬化症疾病活动的可能影响。
采用系统评价和荟萃分析的PRISMA清单来构建本综述。使用包括PubMed、CORE和Embase在内的多个搜索引擎搜索关于该主题的观察性和临床研究。以系统的方式提取数据，并通过随机临床试验（RCT）的Jadad量表和观察性研究的纽卡斯尔-渥太华量表对符合纳入标准的文章进行质量评估。
共纳入35篇文章。21项（60%）研究指出维生素D与多发性硬化症磁共振成像检测到的疾病活动之间存在统计学上的显著关联。磁共振成像检测到的特征包括对比度增强的T1病变减少、高信号T2病变减少以及病变体积减小。另一方面，40%（14篇文章）的文章未检测到维生素D对多发性硬化症疾病活动有任何显著影响。由于所涉及研究的异质性，本综述未采用荟萃分析。
讨论/结论：有大量研究调查维生素D与多发性硬化症之间的关系，同时强调了磁共振成像在评估疾病活动方面的重要作用。许多研究发现，较高的血清维生素D水平与新的活动性皮质和皮质下病变减少以及病变体积减小有关。这些发现突出了成像方式在神经疾病各个方面的重要性，并鼓励进一步研究关注维生素D对多发性硬化症患者的预防作用。
