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Updated: Oct 19, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Correlation between vitamin D and alterations in MRI among patients with multiple sclerosis
Faustyna Piędel1, Agata Rocka1, Mikołaj Piwek1
1Department of Neurology, Medical University, Lublin, Poland.
Introduction:
Multiple sclerosis (MS) is a disease of unknown etiology. Diagnosis of MS is primarily based on detection of myelin damage by magnetic resonance imaging (MRI) and classification of demyelination according to the McDonald Criteria. Cholecalciferol (vitamin D3) has been shown to affect the onset and progression of MS via its immunomodulating properties. The role of vitamin D in MS pathogenesis and treatment deserves further investigation, as there is sufficient evidence to suggest a correlation between vitamin D blood level and brain MRI lesion load.
State Of Knowledge:
Elevated blood vitamin D concentration is linked with demyelination, as determined by T2-weighted and gadolinium-enhanced MRI. Blood vitamin D blood levels are affected by sun exposure, among other factors; however, there is no evident connection between abnormalities in myelination and seasonality. Vitamin D supplementation among MS patients has been associated with a lower probability of new lesions and loss of existing lesion volume, as observed seen in T1-weighted MRI scans (p=0.03). An increase in TGF-beta levels was noted among patients using vitamin D supplementation, which may suggest a mechanism by which cholecalciferol may improve MS prognosis. Patients with clinically isolated syndrome (CIS) exhibited an inverse correlation between vitamin D concentration and risk of new lesions as seen in T2-weighted MRI scans. Moreover, vitamin D intake among these patients lowered the risk of progression to clinically definite multiple sclerosis (CDMS). Daily intake of vitamin D during fingolimod treatment correlated strongly with lower numbers of new lesions. High dose vitamin D supplementation during interferon beta-1a treatment was linked to lower mean percentage of lesions compared with volume pre-treatment seen by T2-weighted MRI.
Results:
Recent findings advocate for the monitoring of vitamin D blood levels in MS patients. Vitamin D supplementation should be considered in both MS patients and patients with CIS, where other signs of disease may be delayed. Moreover, vitamin D supplementation appears to lower the likelihood of new demyelination changes apparent in MRI examinations.
Insights
Vitamin D supplementation may reduce new lesions in multiple sclerosis (MS) and clinically isolated syndrome (CIS). Monitoring vitamin D levels is recommended for MS patients to potentially improve prognosis and reduce demyelination.
Area of Science:
- Neurology
- Immunology
- Endocrinology
Background:
- Multiple sclerosis (MS) is a demyelinating disease with unknown etiology.
- Magnetic resonance imaging (MRI) is crucial for diagnosing MS and monitoring disease progression.
- Vitamin D (cholecalciferol) possesses immunomodulating properties and its role in MS warrants further investigation due to observed correlations with disease activity.
Purpose of the Study:
- To investigate the role of vitamin D in the pathogenesis and treatment of MS.
- To explore the correlation between vitamin D blood levels and MRI-detected demyelination in MS patients.
- To evaluate the impact of vitamin D supplementation on disease progression and lesion development in MS and CIS.
Main Methods:
- Analysis of existing literature and clinical findings relating vitamin D levels to MS.
- Review of MRI data (T1-weighted, T2-weighted, and gadolinium-enhanced) in relation to vitamin D status.
- Examination of the effects of vitamin D supplementation on lesion load, new lesion formation, and progression to clinically definite MS (CDMS).
Main Results:
- Elevated vitamin D levels are associated with reduced demyelination on MRI.
- Vitamin D supplementation in MS patients correlated with a lower probability of new lesions and reduced lesion volume.
- In patients with CIS, vitamin D intake lowered the risk of new lesions and progression to CDMS.
- Vitamin D supplementation during disease-modifying therapy (fingolimod, interferon beta-1a) was linked to fewer new lesions.
Conclusions:
- Monitoring vitamin D blood levels is recommended for patients with MS and CIS.
- Vitamin D supplementation should be considered for MS and CIS patients to potentially mitigate demyelination.
- Vitamin D may play a protective role in MS by reducing the likelihood of new demyelinating changes visible on MRI.
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