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.
Reduced Childhood Outdoor Exposure Raises Pediatric Multiple Sclerosis (PedMS) Risk / Pilotto, S., Ghezzi, A., Bova, S.M., Fronza, M., Annovazzi, P., Simone, M., Gallo, A., Suppiej, A., Lanzillo, R., Rasia, S., Berardinelli, A., Clerici, V.T., Moiola, L., Viri, M., Sotgiu, S., Malucchi, S., Protti, A., Canavese, C., Lus, G., Grimaldi, L.M.E., et al.. - In: NEUROLOGY AND THERAPY. - ISSN 2193-8253. - ELETTRONICO. - (2026), pp. 0-0. [10.1007/s40120-026-00956-6]
Reduced Childhood Outdoor Exposure Raises Pediatric Multiple Sclerosis (PedMS) Risk
Amato, Maria Pia;
2026
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.
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