Neurology and Therapy · Published 2026-05-24 · DOI 10.1007/s40120-026-00956-6
Silvy Pilotto, Angelo Ghezzi, Stefania Maria Bova, Marzia Fronza, Pietro Annovazzi, Marta Simone, Antonio Gallo, Agnese Suppiej, Roberta Lanzillo, Sarah Rasia, Angela Berardinelli, Valentina Torri Clerici, Lucia Moiola, Maurizio Viri, Stefano Sotgiu, Simona Malucchi, Alessandra Protti, Carlotta Canavese, Giacomo Lus, Luigi M. E. Grimaldi, Marta Zaffira Conti, Giovanna Borriello, Giovanna De Luca, Valentina Tomassini, Alberto Priori, Martina Tosi, Nicola Pomella, Andrea Corona, Alen Zollo, Maria Pia Amato, Eleonora Cocco, Maria Trojano, Filippo Martinelli-Boneschi, Sandra D’Alfonso, Roberto Bergamaschi, Maura Pugliatti, and the PEDIGREE Study Group
Abstract Introduction Sun exposure may influence MS susceptibility, but evidence in pediatric-onset MS (PedMS) is limited. We examined whether reduced early-childhood outdoor time (a proxy for lower sun exposure) is associated with PedMS risk. Methods In the Italian multicenter PEDIGREE Study, environmental data were collected using the PEQ-IT questionnaire. We enrolled individuals < 18 years with PedMS and disease duration ≤ 5 years and controls without CNS inflammatory disorders. Outdoor time was reported by season and age (0–1, 1–2, 3–5 years); reduced activity was defined as < 60 min/week. Results We included 114 PedMS cases and 121 controls. Cases were 77.2% female; mean (SD) age 16.8 (2.7) years; mean (SD) age at onset 14.2 (2.6) years; median EDSS 1.0 (range 0–4.0). Associations were strongest in winter: reduced outdoor time was associated with higher odds of PedMS in the first year (adjOR 3.02, 95%CI 1.50–6.08), ages 1–2 (adjOR 2.72, 95%CI 1.45–5.09), and ages 3–5 (adjOR 2.66, 95%CI 1.40–5.07). Across ages 0–5, low winter outdoor activity remained strongly associated (adjOR 4.30, 95%CI 1.82–10.17). Other seasons showed weaker but overall significant trends. Conclusion Limited early-childhood outdoor activity may be associated with increased PedMS risk; larger longitudinal studies are needed.
Abstract from DOAJ. Public domain (CC0 1.0).
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Pilotto, S., Ghezzi, A., Bova, S., et al. (2026). Reduced Childhood Outdoor Exposure Raises Pediatric Multiple Sclerosis (PedMS) Risk. Neurology and Therapy. https://doi.org/10.1007/s40120-026-00956-6