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dc.contributor.author
Cortese, Marianna
dc.contributor.author
Munger, Kassandra L.
dc.contributor.author
Martínez-Lapiscina, Elena H.
dc.contributor.author
Barro, Christian
dc.contributor.author
Edan, Gilles
dc.contributor.author
Freedman, Mark S.
dc.contributor.author
Hartung, Hans-Peter
dc.contributor.author
Montalban, Xavier
dc.contributor.author
Foley, Frederick W.
dc.contributor.author
Penner, Iris K.
dc.contributor.author
Hemmer, Bernhard
dc.contributor.author
Fox, Edward J.
dc.contributor.author
Schippling, Sven
dc.contributor.author
Wicklein, Eva-Maria
dc.contributor.author
Kappos, Ludwig
dc.contributor.author
Kuhle, Jens
dc.contributor.author
Ascherio, Alberto
dc.contributor.author
BENEFIT Study Group
dc.date.accessioned
2020-07-13T05:11:34Z
dc.date.available
2020-07-07T02:39:10Z
dc.date.available
2020-07-13T05:11:34Z
dc.date.issued
2020-05-05
dc.identifier.issn
0028-3878
dc.identifier.other
10.1212/WNL.0000000000009371
en_US
dc.identifier.uri
http://hdl.handle.net/20.500.11850/424792
dc.description.abstract
Objective To investigate whether vitamin D, smoking, and anti-Epstein-Barr virus (EBV) antibody concentrations predict long-term cognitive status and neuroaxonal injury in multiple sclerosis (MS). Methods This study was conducted among 278 patients with clinically isolated syndrome who participated in the clinical trial BENEFIT (Betaferon/Betaseron in Newly Emerging Multiple Sclerosis for Initial Treatment) and completed the 11-year assessment (BENEFIT-11). We measured serum 25-hydroxyvitamin-D (25(OH)D), cotinine (smoking biomarker), and anti-Epstein-Barr virus nuclear antigen 1 (EBNA-1) immunoglobulin G (IgG) at baseline and at months 6, 12, and 24 and examined whether these biomarkers contributed to predict Paced Auditory Serial Addition Test (PASAT)-3 scores and serum neurofilament light chain (NfL) concentrations at 11 years. Linear and logistic regression models were adjusted for sex, baseline age, treatment allocation, steroid treatment, multifocal symptoms, T2 lesions, and body mass index. Results Higher vitamin D predicted better, whereas smoking predicted worse cognitive performance. A 50-nmol/L higher mean 25(OH)D in the first 2 years was related to 65% lower odds of poorer PASAT performance at year 11 (95% confidence intervals [95% CIs]: 0.14–0.89). Standardized PASAT scores were lower in smokers and heavy smokers than nonsmokers (ptrend = 0.026). Baseline anti–EBNA-1 IgG levels did not predict cognitive performance (ptrend = 0.88). Associations with NfL concentrations at year 11 corroborated these findings—a 50-nmol/L higher mean 25(OH)D in the first 2 years was associated with 20% lower NfL (95% CI: −36% to 0%), whereas smokers had 20% higher NfL levels than nonsmokers (95% CI: 2%–40%). Anti–EBNA-1 antibodies were not associated with NfL. Conclusions Lower vitamin D and smoking after clinical onset predicted worse long-term cognitive function and neuronal integrity in patients with MS. ( © 2020 American Academy of Neurology 2020).
en_US
dc.language.iso
en
en_US
dc.publisher
American Academy of Neurology
en_US
dc.title
Vitamin D, smoking, EBV, and long-term cognitive performance in MS 11-year follow-up of BENEFIT
en_US
dc.type
Journal Article
dc.date.published
2020-04-16
ethz.journal.title
Neurology
ethz.journal.volume
94
en_US
ethz.journal.issue
18
en_US
ethz.pages.start
E1950
en_US
ethz.pages.end
E1960
en_US
ethz.identifier.wos
ethz.publication.place
Hagerstown, MD
en_US
ethz.publication.status
published
en_US
ethz.date.deposited
2020-07-07T02:39:22Z
ethz.source
WOS
ethz.eth
yes
en_US
ethz.availability
Metadata only
en_US
ethz.rosetta.installDate
2020-07-13T05:11:45Z
ethz.rosetta.lastUpdated
2020-07-13T05:11:45Z
ethz.rosetta.exportRequired
true
ethz.rosetta.versionExported
true
ethz.COinS
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