Efficacy of ultraviolet B radiation versus vitamin D3 on postural control and cognitive functions in relapsing-remitting multiple sclerosis: A randomized controlled study

Background: The relapsing-remitting multiple sclerosis (RRMS) is the most common type of MS with prevalence rate 20-60 patients/100.000 individuals in Egypt. Poor postural control and cognitive dysfunctions are well -established complications of RRMS without potent remedy yet. The latest evidence highlighted the potential and independent immune-modulating effects of vitamin D3 and ultraviolet radiation in the management of RRMS.Objective: To investigate the efficacy of broadband ultraviolet B radiation (UVBR) versus moderate loading dose of vitamin D3 supplementation in improving postural control and cognitive functions.Design: Pretest-posttest randomized controlled study.Setting: Multiple sclerosis outpatient unit of Kasr Al-Ainy Hospital. Participants: Forty-seven patients with RRMS were recruited from both genders, yet only 40 completed the study. Interventions: Patients were randomized into two groups: UVBR group involved 24 patients, received sessions for 4 weeks and vitamin D3 group involved 23 patients, took vitamin D3 supplementation (50 000 IU/week) for 12 weeks.Main outcome measures: Overall balance system index (OSI) and symbol digit modalities test (SDMT). Results: Highly significant decrease (P < 0.001) of the OSI in both groups post-treatment, indicating improved postural control. Moreover, highly significant improvement in the SDMT scores was noted, indicating infor-mation processing speed enhancement. Nonetheless, no statistically significant (P >= 0.05) differences were evident between the two groups post-treatment in all tested measures.Conclusion: Both therapeutic programs were statistically equal in improving postural control and cognitive functions. However, clinically, UVBR therapy was more convenient owing to its shorter treatment time and higher percentage of change for all tested measures.