Table 7.

Summary of observations on the MRI lesions in MS patients after vitamin D supplementation.

Refs.	First Author, Year	No Treated/Control Patients	Effects on MRI Lesions
[22]	Dörr et al., 2020 EVIDIMS trial	21/17	Lower number of T2-weighted lesions at month 18 in the high-dose vitamin D3 group compared to the low-dose vitamin D3 group [53.4 ± 7.3 (SE) vs. 84.1 ± 13.5], but the change from baseline did not differ between the two groups (1.3 ± 0.1 vs. 2.1 ± 1.4, p = 0.15). The change from baseline in the T2 lesion volume did not differ between the two groups (0.1 ± 0.1 vs. 0.2 ± 0.3 mL, p = 0.98). The cumulative number of new Gd lesions was 2 and 14 in the high-dose and low-dose groups (p = 0.09).
[21]	Hupperts et al., 2019 SOLAR trial	98/88	32% reduction in the number of new Gd-enhancing or new/enlarging T2 lesions in the vitamin D3 group compared to the placebo at week 48 (incidence rate ratio 0.68, p = 0.005). No difference between treatments in the proportion of patients free from new T1 hypointense lesions at week 48 (79 vs. 64%, p = 0.30). Higher difference in the change in the total volume of T2 lesions (p = 0.035).
[23]	Camu et al., 2019 CHOLINE trial	44/41	Significant reduction in the volume of hypointense T1-weighted lesions (−312 mm3, 95% CI −596 to −29, p = 0.03) and new T1 lesions (rate ratio 0.494, 95% CI 0.267–0.913, p = 0.03) in vitamin D3-treated patients compared to the placebo. No difference in the number of Gd-enhancing T1 and new T2 lesions.
[27]	O’Connell et al., 2017	19/7	No difference in the number of new T2 lesions or new Gd-enhancing lesions between groups at month 6. The number of CIS patients with new disease activity based on MRI was 50% (10,000 IU/day of vitamin D3), 56% (5000 IU/day of vitamin D3), and 43% (placebo).
[29]	Soilu-Hänninen et al., 2012 Finnish Vitamin D Study	32/30	Lower number of Gd-enhancing T1 lesions in the vitamin D3-treated group compared to the placebo at month 12 (0.1 ± 0.2 vs. 0.7 ± 3.5, p = 0.004). No difference in the number of new/enlarging T2 lesions (0.5 ± 1.0 vs. 1.1 ± 2.2, p = 0.29) and in the change in the total volume of T2 lesions (83 ± 128 vs. 287 ± 283 mm3, p = 0.105).
[42]	Stein et al., 2011	11/12	No difference in the cumulative number of Gd-enhancing lesions in the high-dose vitamin D2-treated group compared to the low-dose vitamin D2 group (14 ± 0.2 vs. 0.7 ± 3.5, p = 0.004), in the number of patients with new lesions and in the change in the total volume of T2 lesions [−330 (IQR −950 to −30) vs. −95 (−310 to −25) mm3, p = 0.6).
[38]	Mosayebi et al., 2011	26/33	No difference in the number of Gd-enhancing lesions between the MS patients taking 300,000 IU monthly of vitamin D3 or the placebo (from 1.5 ± 1 to 1.9 ± 0.7 and 1.6 ± 0.8 to 2.0 ± 1.0, respectively).
[47]	Kimball et al., 2007	12/0	Reduction in the mean number of Gd-enhancing lesions after vitamin D3 supplementation (from 1.75 ± 1.42 to 0.83 ± 0.72, p = 0.03).
[41]	Wingerchuk et al., 2005	15/0	New T2-weighted lesions were found in 43% of patients at week 24 and in 29% at week 48.