Multiple Sclerosis

Clinical evidence on acupuncture for symptom improvement in multiple sclerosis.

Chen Y, Cui Y, Zhou X, Zhang S, Wang Z, Yang J · Complementary therapies in medicine · 2025 · n=574

Clinical trials on acupuncture for multiple sclerosis (MS) have been growing, but the findings are ongoing controversy. To evaluate the existing randomized clinical trials (RCTs) for evidence of the efficacy of acupuncture on MS. We searched PubMed, Embase, CENTRAL, Web of Science, four Chinese-language databases, clinical research registration, gray literature, and reference lists of the selected studies. We evaluated the risk of bias in the included studies with RoB 2, and performed meta-analysis, subgroup analysis, meta-regression, and publication bias detection using STATA version 15.1. Moreover, we assessed the certainty of evidence using the GRADE approach. The protocol for this review was registered with PROSPERO (Prospective Register of Systematic Reviews) (CRD42024530800). A total of 11 RCTs (with 574 patients) were included in the study. The meta-analysis results showed that acupuncture, when combined with medicine, is more effective at improving disability status and enha

The association between vitamin D deficiency and multiple sclerosis: an updated systematic review and meta-analysis.

Balasooriya NN, Elliott TM, Neale RE, Vasquez P, Comans T, Gordon LG · Multiple sclerosis and related disorders · 2024 · n=4130

Although there is evidence of a link between vitamin D status and risk of multiple sclerosis (MS), there has been no systematic review where the exposure measure was vitamin D deficiency rather than 25 hydroxy vitamin D (25(OH)D) concentration. We conducted an updated systematic review and meta-analysis to estimate the association between vitamin D deficiency, defined in most studies as a serum 25(OH)D concentration of < 50 nmol L-1, and MS. We searched the MEDLINE, EMBASE, and CINAHL databases to identify relevant publications. We estimated the pooled odds ratio (OR) using a random effects model for the association between vitamin D deficiency and MS, overall and stratified by several factors, including whether or not studies included participants who were taking vitamin D supplements. We also analysed the association between mean 25(OH)D concentration and MS, and used meta-regression to assess the effects of vitamin D supplementation, latitude, age, ethnicity, vitamin D definitio

Mediterranean-like diets in multiple sclerosis: A systematic review.

Abbasi H, Shakouri F, Mosaddeghi-Heris R, Gholipour-Khalili E, Jahanshahlou F, Sanaie S · Revue neurologique · 2024 · n=563

Mediterranean-like diet is an anti-inflammatory diet with high-fiber consumption and lower intake of saturated fatty acids which is proposed to have beneficial effects in patients with multiple sclerosis (MS). This investigation aims to explore the impacts of this style of diet on people living with MS, based on clinical evidence. This study was conducted following the 2020 version of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Both interventional and observational clinical studies which evaluated the effects of Mediterranean-like diets on MS patients were considered for inclusion. Review articles, letters, commentaries, case reports, non-English papers, and conference abstracts were excluded. PubMed, Web of Science, Scopus, and EMBASE databases were searched until March 23rd, 2023, and risk of bias in randomized-controlled trials (RCTs) was evaluated based on the second version of the Cochrane RoB assessment tool (RoB.2). In addition, fo

Coenzyme Q10 supplementation in multiple sclerosis; A systematic review.

Salekzamani S, Pakkhesal S, Babaei M, Mirzaaghazadeh E, Mosaddeghi-Heris R, Talebi M · Multiple sclerosis and related disorders · 2025 · n=195

Multiple Sclerosis (MS) is a chronic and progressive inflammatory disease of the central nervous system (CNS). Oxidative stress is a crucial mediator in multiple conditions, including the MS. Coenzyme Q10 (CoQ10) is a potent antioxidant, present in enzyme complexes of mitochondria, and involved in oxidative phosphorylation to produce adenosine triphosphate (ATP). The objective of this systematic review was to investigate the outcomes of CoQ10 supplementation in oxidative stress, inflammatory, and clinical status of patients with MS. Following the Cochrane and PRISMA methods, a comprehensive search was conducted in PubMed, Scopus, Embase, and Web of Science databases, and clinical studies that reported the outcomes of CoQ10 supplementation in MS patients, are included. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials (RoB2). The initial search yielded 237 articles, of which eight reports from six studies (total n = 195), including three

Intermittent Fasting and the Possible Benefits in Obesity, Diabetes, and Multiple Sclerosis: A Systematic Review of Randomized Clinical Trials.

Morales-Suarez-Varela M, Collado Sánchez E, Peraita-Costa I, Llopis-Morales A, Soriano JM · Nutrients · 2021

Intermittent fasting has become popular in recent years and is controversially presented as a possible therapeutic adjunct. A bibliographic review of the literature on intermittent fasting and obesity, diabetes, and multiple sclerosis was carried out. The scientific quality of the methodology and the results obtained were evaluated in pairs. Intermittent fasting has beneficial effects on the lipid profile, and it is associated with weight loss and a modification of the distribution of abdominal fat in people with obesity and type 2 diabetes as well as an improvement in the control of glycemic levels. In patients with multiple sclerosis, the data available are too scarce to draw any firm conclusions, but it does appear that intermittent fasting may be a safe and feasible intervention. However, it is necessary to continue investigating its long-term effects since so far, the studies carried out are small and of short duration.

Effect of omega-3 fatty acids and fish oil supplementation on multiple sclerosis: a systematic review.

AlAmmar WA, Albeesh FH, Ibrahim LM, Algindan YY, Yamani LZ, Khattab RY · Nutritional neuroscience · 2021

Background: Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system, resulting in the degradation of the myelin sheath. Diet especially fish oils and omega-3 has been found to play an important role in MS. This work aimed to review the literature systematically for evidence on the effect of omega-3 fatty acids (EPA, DPA and DHA) on MS progression in adults.Methods: The literature search was conducted in PubMed, Oxford, Cochrane, Embase, International pharmaceutical abstract, PsychINFO, and clinical trials government. The inclusions were studies performed on humans both male and female, aged 18 years at minimum, diagnosed with MS according to McDonald 2010 criteria. Otherwise, all studies were excluded.Results: A total of 5554 studies were screened and seven were thoroughly focused on as they typically met the inclusion criteria. These studies showed the beneficial roles of fish oil supplementation and omega-3 fatty acids in improving the quality of life

Multiple sclerosis in adults: management

NICE

This guideline covers diagnosing and managing multiple sclerosis (MS) in adults. It aims to improve care from diagnosis through to long-term management of symptoms and complications.

High-Dose Vitamin D in Clinically Isolated Syndrome Typical of Multiple Sclerosis: The D-Lay MS Randomized Clinical Trial.

Thouvenot E, Laplaud D, Lebrun-Frenay C, Derache N, Le Page E, Maillart E · JAMA · 2025 · n=316

Vitamin D deficiency is a risk factor for multiple sclerosis (MS) and is associated with the risk of disease activity, but data on the benefits of supplementation are conflicting. To evaluate the efficacy of high-dose cholecalciferol as monotherapy in reducing disease activity in patients with clinically isolated syndrome (CIS) typical for MS. The D-Lay MS trial was a parallel, double-blind, randomized placebo-controlled clinical trial in 36 MS centers in France. Patients were enrolled from July 2013 to December 2020 (final follow-up on January 18, 2023). Untreated patients with CIS aged 18 to 55 years with CIS duration less than 90 days, serum vitamin D concentration less than 100 nmol/L, and diagnostic magnetic resonance imaging (MRI) meeting 2010 criteria for dissemination in space or 2 or more lesions and presence of oligoclonal bands were recruited. Patients were randomized 1:1 to receive oral cholecalciferol 100 000 IU (n = 163) or placebo (n =&#x20

Vitamin D did not reduce multiple sclerosis disease activity after a clinically isolated syndrome.

Butzkueven H, Ponsonby AL, Stein MS, Lucas RM, Mason D, Broadley S · Brain : a journal of neurology · 2024 · n=23

Low serum levels of 25-hydroxyvitamin D [25(OH)D] and low sunlight exposure are known risk factors for the development of multiple sclerosis. Add-on vitamin D supplementation trials in established multiple sclerosis have been inconclusive. The effects of vitamin D supplementation to prevent multiple sclerosis is unknown. We aimed to test the hypothesis that oral vitamin D3 supplementation in high-risk clinically isolated syndrome (abnormal MRI, at least three T2 brain and/or spinal cord lesions), delays time to conversion to definite multiple sclerosis, that the therapeutic effect is dose-dependent, and that all doses are safe and well tolerated. We conducted a double-blind trial in Australia and New Zealand. Eligible participants were randomized 1:1:1:1 to placebo, 1000, 5000 or 10 000 international units (IU) of oral vitamin D3 daily within each study centre (n = 23) and followed for up to 48 weeks. Between 2013 and 2021, we enrolled 204 participants. Brain MRI scans were performed a

A randomized cross-over trial of prebiotics and probiotics in multiple sclerosis: Trial feasibility, supplement tolerability and symptom abatement.

Straus Farber R, Walker EL, Diallo F, Onomichi K, Riley C, Zhang L · Multiple sclerosis and related disorders · 2024 · n=22

Dietary supplements can modulate the gut microbial ecosystem and affect the immune system. This has potential implications for autoimmune diseases, including multiple sclerosis (MS). Prior studies explored tolerability, symptomatic improvement, and immunologic effects of probiotics in people with MS (pwMS), but no study has examined prebiotics in this population or compared prebiotics with probiotics. This is a randomized, open-label trial of participants with relapsing-remitting MS on B-cell depletion therapy from two MS centers. 22 participants enrolled in the original cross-over study in which probiotic (Visbiome, containing Lactobacillus, Bifidobacterium and Streptococcus species) or prebiotic (Prebiotin, containing oligofructose enriched inulin) supplementation for 6 weeks was randomized, each followed by a washout period. Due to pandemic-related interruptions and expiration of the study supply of probiotics, another 15 participants enrolled in a single-arm study to receive prebi

A multi-domain lifestyle intervention in multiple sclerosis: a longitudinal observational study.

Nauta IM, Loughlin KNM, Gravesteijn AS, van Wegen J, Hofman RP, Wilmsen N · Journal of neurology · 2025 · n=668

To examine the effects of a multi-domain lifestyle intervention that advocated a Mediterranean style diet, and concurrently targeted physical activity, stress and sleep, on multiple sclerosis. A longitudinal observational study investigating the effect of a multi-domain lifestyle intervention (i.e., diet, exercise, stress, and sleep management) at four timepoints: start run-in, start and stop 3-month intensive interval, and 3-month follow-up. The primary outcome (i.e., impact of multiple sclerosis on daily functioning) and secondary outcomes (i.e., quality of life, general health, multiple sclerosis-specific symptoms, and lifestyle factors) were analyzed using mixed models. Analyses were repeated among subgroups based on program compliance, body mass index, education level, and multiple sclerosis-subtype. Out of 668 participants, 579 were included (age 46.2 ± 10.5 years, 84.5% women, and 71% relapsing-remitting multiple sclerosis). The impact of multiple scler

Vitamin D and Neurodegenerative Diseases Such as Multiple Sclerosis (MS), Parkinson's Disease (PD), Alzheimer's Disease (AD), and Amyotrophic Lateral Sclerosis (ALS): A Review of Current Literature.

Savran Z, Baltaci SB, Aladag T, Mogulkoc R, Baltaci AK · Current nutrition reports · 2025

This review explores the role of Vitamin D3 and its derivatives as inhibitors of pathological metabolic modifications in neurodegenerative diseases. The manuscript investigates how Vitamin D3 impacts neuronal calcium regulation, antioxidative pathways, immunomodulation, and neuroprotection during detoxification, beyond its known functions in intestinal, bone, and kidney calcium and phosphorus absorption, as well as bone mineralization. Recent studies have highlighted the synthesis of the active metabolite 1,25(OH)2D3 (vitamin D) in glial cells via the hydroxylation process of CY-P24A1, an enzyme in the cytochrome P450 system in the brain. The effects of vitamin D occur through the vitamin D receptor (VDR), a nuclear steroid receptor, which has been identified in various brain regions, including the cerebellum, thalamus, hypothalamus, basal ganglia, hippocampus, olfactory system, temporal, and orbital regions. Neurodegeneration is primarily associated with oxidative stress, protein agg

Vitamin D and cardiovascular outcomes in multiple sclerosis.

France-Ratcliffe M, Harrison SL, Verma LA, Abdul-Rahim AH, McCallum L, Young CA · Multiple sclerosis and related disorders · 2024

Vitamin D (25(OH)D) deficiency is linked to increased cardiovascular disease (CVD) risk in the general population, but its implications for people with multiple sclerosis (pwMS) remain unexplored. This study aimed to evaluate the association of 25(OH)D with long-term CVD outcomes in pwMS and the impact of vitamin D supplementation. This observational cohort study analysed anonymised medical records from 70 healthcare organisations following pwMS for 5-years (2019-2024). PwMS and deficient or inadequate 25(OH)D levels were 1:1 propensity-score matched with pwMS and adequate 25(OH)D levels, for demographics, comorbidities, and cardiovascular care. Cox proportional hazard models analysed the incidence of all-cause mortality, stroke, acute myocardial infarction, heart failure, angina, atrial fibrillation/flutter, and a composite measure of major adverse cardiovascular events (MACE). Propensity-matched pwMS who had deficient or inadequate 25(OH)D levels taking cholecalciferol were compared

Obstacles and Levers of the Therapeutic Adherence of Multiple Sclerosis Patients

n=153 · NCT04837352 · UNKNOWN · UNKNOWN

The goal of this study is to assess the role of sociocognitive and interpersonal factors in the therapeutic adherence of multiple sclerosis patients. This study will provide a better understanding of the socio-psychological issues associated with different types of non-adherence to treatment, and identify the risk factors and vulnerability of each patient.

A Phase 2, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy, Safety, and Tolerability of TAK-935 (OV935) as an Adjunctive Therapy in Pediatric Patients With Developmental and/or Epileptic Encephalopathies

n=141 · NCT03650452 · COMPLETED · COMPLETED

The purpose of this study is to investigate the effect on the frequency of all seizures (convulsive and drop) in participants treated with TAK-935 compared to placebo.

Prospective Study Evaluating the Role of Urinary Sphingosine 1-Phosphate as a Biomarker for Detrusor Hyperactivity in Multiple Sclerosis

n=400 · NCT06161376 · RECRUITING · RECRUITING

This study aims to establish a link between urinary Sphingosine 1-Phosphate (S1P) levels and detrusor activity in multiple sclerosis (MS) patients. MS often involves urological symptoms, primarily overactive bladder. The gold standard for evaluation and treatment monitoring is invasive urodynamic testing. Preliminary research at Toulouse University Hospital suggests urinary S1P levels may be a potential biomarker for detrusor activity in MS. This study aims to confirm this potential biomarker's utility.

Cochrane reviews on Multiple Sclerosis

Cochrane

Cochrane provides a collection of systematic reviews and meta-analyses on various interventions and aspects related to multiple sclerosis. These reviews synthesize the best available evidence to inform healthcare decisions.

Multiple Sclerosis

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly and easily find high quality research evidence to support their practice.