Tag: Vitamin D

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Association of Global Ultraviolet Radiation With the Incidence of Aneurysmal Subarachnoid Hemorrhage

Neurosurgery 96:396–401, 2025

• Study Focus: The research investigates the association between global ultraviolet (UV) radiation and the incidence of aneurysmal subarachnoid hemorrhage (SAH).

• Inverse Correlation: A significant inverse correlation between UV radiation and SAH incidence was found, suggesting higher UV exposure is linked to lower SAH rates.

• Methodology: Data from 32 countries were analyzed using UV indices from the Tropospheric Emission Monitoring Internet Service, with statistical analyses performed using R and Excel.

• Geographic Variations: The study found significant regional differences, with higher UV indices in Europe associated with lower SAH incidences, but this was not significant in non-European countries.

• Biological Implications: UV radiation may reduce inflammation, potentially decreasing the risk of aneurysm rupture, and may also boost vitamin D synthesis, which is linked to improved immune response.

• Limitations: The study faced limitations, including lack of data from some countries and inability to assess seasonal influences due to variability in study periods.

• Conclusion: The findings suggest that environmental factors like UV exposure may influence SAH incidence, warranting further investigation into potential therapeutic implications.

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Clinical significance of vitamin D in idiopathic normal pressure hydrocephalus

Acta Neurochirurgica (2021) 163:1969–1977

Although recent studies show vitamin D deficiency is associated with cognitive decline, urinary incontinence, and gait instability, there has been no study on the effect of vitamin D on idiopathic normal pressure hydrocephalus (iNPH) characterized by the classic symptom triad of cognitive decline, urinary incontinence, and gait instability. We investigated the clinical significance of vitamin D in patients with iNPH.

Methods Between 2017 and 2020, 44 patients who underwent ventriculoperitoneal shunt surgery were divided into low (< 15 ng/mL) and high (≥ 15 ng/mL) vitamin D groups according to the concentration of 25(OH)D, an effective indicator of vitamin D status. They were respectively evaluated according to clinical and radiological findings.

Results The low vitamin D group (n = 24) showed lower preoperative cognition compared to the high vitamin D group (n = 20) in terms of Korean-Mini Mental Status Examination (K-MMSE) and iNPH grading scale (iNPHGS) (K-MMSE: 20.5   5.4 versus 24.0   4.5, p = 0.041; iNPHGS cognitive score: 2   0.9 versus 1   0.6, p = 0.025). And the low vitamin D group showed pre- and postoperatively more severe urinary incontinence (preoperative iNPHGS urinary score: 1   1.0 versus 0   0.9, p = 0.012; postoperative iNPHGS urinary score:1   1.0 versus 0   0.9, p = 0.014). The score of narrow high-convexity sulci for the low vitamin D group was lower (low vitamin D group: 1   0.7 versus high vitamin D group: 2   0.4, p = 0.031).

Conclusion Lower concentration of vitamin D in iNPH may be related to lower preoperative cognition, pre- and postoperative urinary incontinence, and brain morphological change.

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Vitamin D—A New Perspective in Treatment of Cerebral Vasospasm

Neurosurgery 88 (3) 2021: 674–685

Cerebral vasospasm (CVS) is a frequent complication after subarachnoid hemorrhage (SAH), with no sufficient therapy and a complex pathophysiology.

OBJECTIVE: To explore the vitamin D system as a potential treatment for CVS.

METHODS: 25-vitamin D3 levels tested between 2007 and 2015 and data of SAH patients admitted during themonthswith a peak vs nadir of VitD3 valueswere analyzed, retrospectively. We prospectively correlated VitD3 and vasospasm/outcome data in SAH patients admitted in 2017. An experimental mice SAH model and cell culture model were used to investigate the effect of 1,25-dihydroxyvitamin D3 (1,25-VitD3). Additionally, the mediators acting in the VitD mechanism were researched and detected.

RESULTS: Based on the retrospective analysis demonstrating an increased frequency of vasospasm in SAH patients during the low vitamin D period in winter, we started basic research experiments. Active 1,25-VitD3 hormone attenuated CVS, neurological deficit, and inflammation after intrathecal blood injection inmice. Deletion of the vitaminDreceptor in the endothelium or in myeloid cells decreased the protective 1,25-VitD3 effect. Co-culture experiments ofmyeloid and endothelial cells with blood confirmed the anti-inflammatory 1,25-VitD3 effect but also revealed an induction of stroma-cell-derived factor 1α (SDF1α), vascular endothelial growth factor, and endothelial nitric oxide synthase by 1,25-VitD3. In mice, SDF1α mimicked the protective effect of 1,25-VitD3 against CVS. From bench to bedside, CVS severity was inversely correlated with vitamin D plasma level, prospectively. Patients with more severe CVS exhibited attenuated expression of SDF1α and 1,25-VitD3- responsive genes on circulating myeloid cells.

CONCLUSION: 1,25-VitD3 attenuates CVS after SAH by inducing SDF1α. However, VitD administration should be tested as optional treatment to prevent CVS.

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