Vitamin D and axonal injury in multiple sclerosis

Mult Scler. 2016 Jul;22(8):1027-31. doi: 10.1177/1352458515606986. Epub 2015 Oct 13.


Background: Previous studies in patients with multiple sclerosis (MS) have shown an association between high serum 25-hydroxyvitamin D (25[OH]D) levels and decreased inflammatory activity.

Objective: The purpose of this study was to examine the association between 25(OH)D levels and axonal injury in MS. Cerebrospinal fluid neurofilament light (CSF-NFL) was used as a marker for axonal injury.

Methods: Patients were identified through clinical practice at the Department of Neurology in Umeå University Hospital, Sweden. Blood draw, magnetic resonance imaging, scoring of disability and lumbar puncture were performed at inclusion in 153 patients, and also at median 12 months follow-up in 87 patients. For analyses of serum 25(OH)D levels and CSF-NFL, enzyme-linked immunosorbent assays were used.

Results: There was an inverse association between serum 25(OH)D and CSF-NFL levels in categorical (dichotomized at 75 or 100 nmol/l) analyses. A dose-response effect for 25(OH)D levels on CSF-NFL levels (p for trend=0.034) was also present. Serum 25(OH)D levels above 100 nmol/l were associated with lower CSF-NFL levels independently of ongoing MS treatment.

Conclusion: High 25(OH)D levels are associated with decreased axonal injury in MS.

Keywords: Vitamin D; axonal injury; multiple sclerosis; neurofilament light.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Axons / metabolism
  • Axons / pathology*
  • Biomarkers / blood
  • Biomarkers / cerebrospinal fluid
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Brain / pathology*
  • Disability Evaluation
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis / blood*
  • Multiple Sclerosis / cerebrospinal fluid
  • Multiple Sclerosis / diagnosis
  • Multiple Sclerosis / pathology*
  • Neurofilament Proteins / cerebrospinal fluid
  • Prospective Studies
  • Protective Factors
  • Risk Factors
  • Spinal Puncture
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Young Adult


  • Biomarkers
  • Neurofilament Proteins
  • neurofilament protein L
  • Vitamin D
  • 25-hydroxyvitamin D