Ultraviolet B Radiation Therapy Versus Vitamin D3 Supplementation: Effects on Cognitive Functions and Fatigue in Egyptian Relapsing Remitting Multiple Sclerosis Patients

Abstract

Vitamin D independent benefits of ultraviolet B radiation therapy has been previously outlined. The current work aimed to compare the impact of Broadband ultraviolet B radiation (BB-UVB) therapy to vitamin D3 supplementation on cognitive functions and fatigue in relapsing remitting multiple sclerosis (RRMS) patients. Randomized controlled trial conducted on 40 RRMS patients attending the Kasr Al Ainy hospital multiple sclerosis clinic. Patients were assigned into two equal groups receiving either BB-UVB radiation (3 sessions/week for 4 weeks) or oral vitamin D3 (weekly 50,000 IU for 3 months). Comprehensive cognitive battery [Montreal Cognitive Assessment (MoCA), Symbol Digit Modalities Test (SDMT) and Brief Visuospatial Memory Test-Revised (BVMT-R)], Fatigue Severity Scale (FSS) and serum vitamin D3 levels were done at baseline and 3 months following either treatments. Baseline vitamin D3 levels and scores of fatigue and cognitive scales were comparable in both groups. Median scores of MoCA, SDMT, BVMT-R and FSS pre and post BB-UVB treatment were [27 (3.0)) vs 28.5 (2.0), 33.5 (9.8) vs 37 (10.5), 24 (11.7) vs 32 (6) and 4.4 (1.6) vs 3.2 (2.5)], p-value (˂0.001, ˂0.001 ˂0.001 and ˂0.001) respectively, and the median scores pre and post vitamin D3 were [26.0 (2.8) vs 28.0 (2.0), 29.5 (8.3) vs 35.0 (5.0), 27.0 (9.0) vs 31.0 (5.0) and 4.1 (1.0) vs 3.2 (1.2), p-values (˂0.001, ˂0.001 ˂0.001 and ˂0.001) respectively. No statistically significant difference was found when comparing both groups post therapies vitamin D3 levels, MoCA, SDMT, BVM-R and FSS scores (p= 0.512, p = 0.355, p = 0.779, p = 0.620 and p=0.758). Both BB-UVB therapy and oral vitamin D3 supplementation are equally effective in improving cognition and fatigue in RRMS patients.