ArticleFrontiers in neurology2018
Sun Exposure across the Life Course Significantly Modulates Early Multiple Sclerosis Clinical Course.
Article in Frontiers in neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed.
- Vitamin D did not reduce multiple sclerosis disease activity after a clinically isolated syndrome.Brain : a journal of neurology · 2024Trial
- Disrupted Vitamin D Signaling and Metabolism in Neurodevelopmental and Neurodegenerative Disorders.ASN neuro · 2026Review
- Higher sun exposure is associated with a reduced risk of primary biliary cholangitis.International journal of epidemiology · 2026Article
- Association Between Sun Exposure and Risk of Relapse in Pediatric-Onset Multiple Sclerosis.Neurology(R) neuroimmunology & neuroinflammation · 2025Article
- The risk of secondary progressive multiple sclerosis is geographically determined but modifiable.Brain : a journal of neurology · 2023Article
- The effects of exposure to solar radiation on human health.Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology · 2023Article
- Radiological Benefits of Vitamin D Status and Supplementation in Patients with MS-A Two-Year Prospective Observational Cohort Study.Nutrients · 2023Observational
- Ensemble machine learning identifies genetic loci associated with future worsening of disability in people with multiple sclerosis.Scientific reports · 2022Article
- Association of Latitude and Exposure to Ultraviolet B Radiation With Severity of Multiple Sclerosis: An International Registry Study.Neurology · 2022Observational
- Effect of Seasonal Variation on Relapse Rate in Patients With Relapsing-Remitting Multiple Sclerosis in Saudi Arabia.Frontiers in neurology · 2022Article
- Predictors of progression from a first demyelinating event to clinically definite multiple sclerosis.Brain communications · 2022Article
- Article
- Developing a clinical-environmental-genotypic prognostic index for relapsing-onset multiple sclerosis and clinically isolated syndrome.Brain communications · 2021Article
- The Relationship of the Mechanisms of the Pathogenesis of Multiple Sclerosis and the Expression of Endogenous Retroviruses.Biology · 2020Review
- Phenome-wide examination of comorbidity burden and multiple sclerosis disease severity.Neurology(R) neuroimmunology & neuroinflammation · 2020Article
- Long-term effects of latitude, ambient temperature, and ultraviolet radiation on the incidence of multiple sclerosis in two cohorts of US women.Environmental epidemiology (Philadelphia, Pa.) · 2020Article
- Review
- UV light suppression of EAE (a mouse model of multiple sclerosis) is independent of vitamin D and its receptor.Proceedings of the National Academy of Sciences of the United States of America · 2019Article
- Environmental and genetic risk factors for MS: an integrated review.Annals of clinical and translational neurology · 2019Review
- Short-term changes in frequencies of circulating leukocytes associated with narrowband UVB phototherapy in people with clinically isolated syndrome.Scientific reports · 2019Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow vitamin D and/or sun exposure have been associated with increased risk of multiple sclerosis (MS) onset. However, comparatively, few studies have prospectively examined associations between these factors and clinical course.
objectivesTo evaluate the association of sun exposure parameters and vitamin D levels with conversion to MS and relapse risk in a prospectively monitored cohort of 145 participants followed after a first demyelinating event up to 5-year review (AusLong Study).
methodsSun exposure prior to and after onset measured by annual questionnaire; ultraviolet radiation (UVR) "load" estimated by location of residence over the life course and ambient UVR levels. Serum 25-hydroxyvitamin D [25(OH)D] concentrations measured at baseline, 2/3-year, and 5-year review. MS conversion and relapse assessed by neurologist assessment and medical record review.
resultsOver two-thirds (69%) of those followed to 5-year review (100/145) converted to MS, with a total of 252 relapses. Higher pre-MS onset sun exposure was associated with reduced risk of MS conversion, with internal consistency between measures and dose-response relationships. Analogous associations were also seen with risk of relapse, albeit less strong. No consistent associations were observed between postonset sun exposure and clinical course, however. Notably, those who increased their sun exposure during follow-up had significantly reduced hazards of MS conversion and relapse. Serum 25(OH)D levels and vitamin D supplementation were not associated with conversion to MS or relapse hazard.
conclusionWe found that preonset sun exposure was protective against subsequent conversion to MS and relapses. While consistent associations between postonset sun exposure or serum 25(OH)D level and clinical course were not evident, possibly masked by behavior change, those participants who markedly increased their sun exposure demonstrated a reduced MS conversion and relapse hazard, suggesting beneficial effects of sun exposure on clinical course.
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