American Board of Internal Medicine (ABIM) Certification Practice Exam

What is recommended for all patients with multiple sclerosis to help reduce new MRI lesions?

1. Exercise regimen

2. Vitamin D supplementation

3. Acupuncture therapy

4. Vitamin B12 therapy

The correct answer is: Vitamin D supplementation

Vitamin D supplementation is recommended for all patients with multiple sclerosis (MS) to help reduce new MRI lesions due to its role in immune regulation and potential neuroprotective effects. Research has demonstrated that individuals with MS often have lower levels of vitamin D, and higher serum levels of vitamin D have been associated with a lower risk of disease activity and relapse. This connection suggests that maintaining adequate vitamin D levels could influence the progression of the disease and the formation of new lesions as seen on MRI. While an exercise regimen can be beneficial for overall health and managing symptoms in patients with MS, it does not have a direct impact on reducing MRI lesions specifically. Acupuncture therapy may provide symptomatic relief for some individuals but lacks sufficient evidence to support its efficacy in altering disease activity or MRI findings. Similarly, vitamin B12 therapy is important for general health and preventing deficiency, but it does not have a direct role in affecting MS lesions or activity on MRI. Therefore, vitamin D supplementation is supported by clinical guidelines and research as an important strategy in the management of MS, emphasizing its potential effects on disease modulation.