title: Riboflavin supplementation to patients with multiple sclerosis does not improve disability status nor is riboflavin supplementation correlated to homocysteine.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. Riboflavin is involved in myelin formation in nerve cells. Riboflavin is a precursor of flavin adenine D-nucleotide (FAD), which is a coenzyme of methylene tetrahydrofolate reductase (MTHFR), which is an important enzyme for remethylation of homocysteine. Riboflavin supplementation has been shown to affect the serum levels of homocysteine in healthy volunteers. The aim of the present study was to test the effect of riboflavin supplementation on the status and disability of patients with MS and whether this effect could be mediated by serum homocysteine levels.
  
  
  METHODS
  This was a randomized, double-blind, controlled trial in which 29 MS patients with a mean age of 33 were tested with riboflavin, and the placebo group, with a mean age of 31, received either riboflavin supplementation (10 mg) or the placebo daily for six months. Disability, measured by the Expanded Disability Status Scale (EDSS) scores, erythrocyte glutathione reductase activity coefficient (EGRAC), and serum homocysteine levels were measured before and after the study.
  
  
  RESULTS
  The mean ± SD of EDSS score was significantly decreased in both groups over the six months of the study (2.3 ± 0.7 vs. 1.6 ± 0.6 for the riboflavin group and 2.8 ± 1.1 vs. 2.3 ± 1.3 for the placebo groups. The comparison across both groups yielded a non-significant change (P = 0.001 and 0.02, respectively). No significant differences were observed between the two groups in terms of EGRAC, riboflavin deficiency levels by EGRAC category, and serum homocysteine levels before and after the study.
  
  
  CONCLUSIONS
  Riboflavin supplementation (10 mg/day) to patients with MS does not improve disability status. It appears that this effect is not related to serum homocysteine levels.
authors.affiliation: Student Research committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran and Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.
authors.forename: Mahshid
authors.initials: M
authors.lastname: Naghashpour
authors.affiliation: Department of Neurology, Faculty of Medicine, Multiple Sclerosis Society of Khuzestan province, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.
authors.forename: Nastaran
authors.initials: N
authors.lastname: Majdinasab
authors.affiliation: Department of Health Education, Academic Center for Education,Culture and Research (ACECR)-Khuzestan, Ahvaz, Khuzestan, Iran.
authors.forename: Ghodratollah
authors.initials: G
authors.lastname: Shakerinejad
authors.affiliation: Department of Pharmaceutics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Kouchak
authors.affiliation: Department of Biostatistics and Epidemiology, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Haghighizadeh
authors.affiliation: Department of Health Education, Academic Center for Education,Culture and Research (ACECR)-Khuzestan, Ahvaz, Khuzestan, Iran.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Jarvandi
authors.affiliation: Department of Health Education, Academic Center for Education,Culture and Research (ACECR)-Khuzestan, Ahvaz, Khuzestan, Iran.
authors.forename: Saideh
authors.initials: S
authors.lastname: Hajinajaf
mesh_terms: D000328:Adult; D019587:Dietary Supplements; D004311:Double-Blind Method; D004912:Erythrocytes / Q000187:drug effects; D005260:Female; D005980:Glutathione Reductase / Q000097:blood / Q000187:drug effects; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000097:blood*; D012256:Riboflavin / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology*; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology*
chemical_list: D006710:Homocysteine; D014803:Vitamin B Complex; D005980:Glutathione Reductase; D012256:Riboflavin
keywords: EDSS; homocysteine; multiple sclerosis; riboflavin