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Published on: December 9, 2015
Low serum 25‑hydroxy-vitamin D levels are associated with cognitive impairment in multiple sclerosis
Antonio Luca Spiezia1, Fabrizia Falco1, Andrea Manganelli1
1Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy.
Background:
Cognitive impairment frequently affects people with multiple sclerosis (MS). Low vitamin D has been associated with cognitive dysfunction in different neurodegenerative diseases, and, in MS, with motor disability and disease activity. We aim to investigate associations between vitamin D and cognitive status in MS.
Methods:
In this cross-sectional study, we included 181 MS patients, recruited consecutively at the MS Unit of the Policlinico Federico II University Hospital of Naples, Italy, between January and April 2022, with serum 25‑hydroxy (25-OH) vitamin D measurements using Chemiluminescence-ImmunoAssay, and cognitive assessment using the Brief International Cognitive Assessment for MS (BICAMS), which includes Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II) and Brief Visuospatial Memory Test-Revised (BVMT-R). We collected demographics (age, sex, education), and clinical variables (disease duration, disease subtype, expanded disability status scale (EDSS), disease modifying treatment, relapses in previous 12 months, vitamin D supplementation, comorbidities). For a subset of patients (n = 41, 23.2% of the total sample), we collected Beck Depression Inventory-II, Beck Anxiety Inventory, and Modified Fatigue Impact Scale.
Results:
At univariable linear regression models, serum 25-OH-vitamin D levels were 0.9 ng/mL higher for each unit increase of SDMT adjusted scores (Coeff=0.93; 95%CI=0.81, 1.04; p<0.01), 0.7 ng/mL higher for each unit increase of CVLT-II adjusted scores (Coeff=0.68; 95%CI=0.53, 0.83; p<0. 01), 0.6 ng/mL higher for each unit increase of BVMT-R adjusted scores (Coeff=0.58; 95%CI=0.43, 0.73; p<0.01), -9.63 ng/mL lower for each impaired BICAMS test (Coeff=-9.63; 95%CI=-11.48, -7.79; p<0.01), and -2.2 ng/mL lower for each unit increase of EDSS (Coeff=-2.16; 95%CI=-3.57, -0.75; p<0.01). At multivariable linear regression models, we confirmed associations between 25-OH-vitamin D and EDSS (Coeff=-2.09; 95%CI=-4.45, -0.43; p<0.01), SDMT (Coeff=0.75; 95%CI=0.60, 0.90; p<0.01), and CVLT-II (Coeff=0.14; 95%CI=0.01, 0.28; p = 0. 04). Results remained unchanged when including depression, anxiety and fatigue scores.
Conclusions:
Lower serum 25-OH-vitamin D was associated with worse cognitive function in MS. Future studies should consider longitudinal variations in cognitive function in relation to vitamin D supplementation.
Insights
Low vitamin D levels are linked to poorer cognitive function in multiple sclerosis (MS) patients. This study highlights the importance of vitamin D for maintaining cognitive health in individuals with MS.
Area of Science:
- Neuroscience
- Endocrinology
- Immunology
Background:
- Cognitive impairment is a common challenge for individuals with multiple sclerosis (MS).
- Low vitamin D levels have been implicated in cognitive dysfunction across various neurodegenerative conditions.
- In MS, vitamin D deficiency is also associated with motor disability and disease activity.
Purpose of the Study:
- To investigate the association between serum 25-hydroxy (25-OH) vitamin D levels and cognitive status in patients with multiple sclerosis.
- To determine if vitamin D levels correlate with performance on specific cognitive tests used in MS.
Main Methods:
- A cross-sectional study involving 181 MS patients was conducted.
- Serum 25-OH vitamin D levels were measured, and cognitive function was assessed using the Brief International Cognitive Assessment for MS (BICAMS), including the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II), and Brief Visuospatial Memory Test-Revised (BVMT-R).
- Demographic, clinical variables, and mental health assessments (depression, anxiety, fatigue) were collected for analysis.
Main Results:
- Lower serum 25-OH vitamin D levels were significantly associated with worse performance on all BICAMS cognitive tests.
- A positive correlation was found between vitamin D levels and scores on SDMT, CVLT-II, and BVMT-R.
- Vitamin D levels were inversely associated with the Expanded Disability Status Scale (EDSS), indicating a link with disability severity.
Conclusions:
- Reduced serum 25-OH vitamin D is associated with impaired cognitive function in individuals with MS.
- These findings suggest that maintaining adequate vitamin D levels may be important for cognitive health in MS.
- Future research should explore the long-term effects of vitamin D supplementation on cognitive function in MS patients.
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