Evidence map›Paper›PMID 39938013›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2025

Association Between Sun Exposure and Risk of Relapse in Pediatric-Onset Multiple Sclerosis.

Gina Chang, Prince Sebastian, Akash Virupakshaiah, Vinicius A Schoeps, Nicolas Cherbuin, T Charles Casper, Mark P Gorman, Leslie A Benson, Tanuja Chitnis, Mary Rensel and 12 more

Abstract readMulticenter Study
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Gina ChangDivision of Child Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA.ORCID 0000-0002-0572-4847
Prince SebastianLiverpool Hospital, Sydney, Australia.
Akash VirupakshaiahUCSF Weill Institute for Neurosciences, University of California San Francisco.ORCID 0000-0003-2624-9974
Vinicius A SchoepsUCSF Weill Institute for Neurosciences, University of California San Francisco.ORCID 0000-0001-8875-0567
Nicolas CherbuinCentre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.ORCID 0000-0001-6481-0748
T Charles CasperUniversity of Utah School of Medicine, Salt Lake City.ORCID 0000-0001-7512-1294
Mark P GormanBoston Children's Hospital, MA.ORCID 0000-0003-3694-8832
Leslie A BensonBoston Children's Hospital, MA.ORCID 0000-0002-1680-4834
Tanuja ChitnisBrigham and Women's Hospital, Boston, MA.ORCID 0000-0002-9897-4422
Mary RenselCleveland Clinic, OH.ORCID 0000-0001-9613-8394
Aaron W AbramsCleveland Clinic, OH.ORCID 0000-0002-4607-5740
Tim LotzeTexas Children's Hospital, Houston, TX.
Soe S MarWashington University in St. Louis, MO.ORCID 0000-0001-8449-2003
Teri L SchreinerChildren's Hospital Colorado, Aurora.ORCID 0000-0002-3816-812X
Yolanda S WheelerChildren's Hospital of Alabama, Birmingham.ORCID 0000-0003-1391-4496
John W RoseGeorge E. Wahlen Department of Veterans Affairs Medical Center, University of Utah, Salt Lake City.ORCID 0000-0003-2382-5921
Jennifer GravesUniversity of California San Diego, CA.ORCID 0000-0003-1539-1940
Lauren B KruppNYU Grossman School of Medicine, New York, NY; and.ORCID 0000-0001-7003-807X
Amy T WaldmanDivision of Child Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA.ORCID 0000-0002-1054-0815
Robyn LucasNational Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.ORCID 0000-0003-2736-3541
Emmanuelle WaubantUCSF Weill Institute for Neurosciences, University of California San Francisco.ORCID 0000-0001-5188-0157
as the US Network of Pediatric Multiple Sclerosis Centers

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesLow sun and ultraviolet radiation (UVR) exposures have been associated with increased risk of developing pediatric-onset multiple sclerosis (MS); however, their effect on disease course has not been well characterized. We primarily investigated whether there was an association between time spent in the sun in early childhood and risk of relapse in pediatric MS. We secondarily investigated the effect of sun exposure during more recent periods on risk of relapse.

methodsWe conducted a multicenter cohort study of participants with pediatric-onset MS recruited from 18 pediatric MS clinics across the United States between November 1, 2011, and July 1, 2017. Relapses were identified prospectively after study enrollment; relapses preceding study enrollment were entered retrospectively. Time spent in the sun at various periods of life was measured using a detailed environmental questionnaire, and ambient UVR exposure was determined using zip codes. Multivariable Cox regression models were used to assess the association between time spent in the sun and UVR dose at specific periods of life and the risk of relapse. Models were adjusted for demographic, clinical, and sun exposure-related characteristics.

resultsIn our cohort of 334 children with MS, 206 (62%) experienced at least one relapse from disease onset to the end of the follow-up period. After adjustment, ≥30 minutes of daily sun exposure during the first summer of life was associated with a lower risk of relapse compared with <30 minutes (adjusted hazard ratio [aHR] 0.67, CI 0.48-0.92, DISCUSSION: In this large cohort study of children with MS, greater early childhood and prenatal sun exposure time was associated with lower risk of relapse. Further investigation of sun exposure at other periods is needed to better characterize its impact on disease course and guide potential future interventions.

Indexed as

Multiple SclerosisMultiple Sclerosis, Relapsing-RemittingSunlightAdolescentChildCohort StudiesFemaleHumansMaleRecurrenceRisk FactorsUnited States

Identifiers

PMID39938013
PMCPMC11820808

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.