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The role of serum Zinc in the pathogenesis of relapsing remittent multiple sclerosis (RRMS) and its impact on motor disability and radiological findings remains a matter of debate. To assess the level of serum Zinc in patients with RRMS at time of relapse and during remission and to correlate serum zinc with degree of disability, fatigue, response to disease modifying drugs, and magnetic resonance imaging (MRI) findings. A case-control study was carried out on 75 subjects divided into three groups, 25 patients diagnosed as RRMS during relapse, 25 patients during remission, and 25 healthy controls. All included patients were subjected to neurological assessment including Expanded Disability Status Scale (EDSS), Modified fatigue impact scale (MFIS), and Modified RIO score (MRS). Zinc serum level was measured for all patients and controls using direct colorimetric test method. Brain and spine MRI were done for all included patients. MS patients in relapse and during remission were found to have significantly lower zinc level than the control group (P value = 0.001 and < 0.001 respectively). There was a statistically significant negative correlation between serum zinc level and disease duration, number of relapses in the last 2 years, total number of relapses, EDSS before and after pulse steroids, MRS, MFIS, and MRI lesion load (P value = 0.017, 0.037, 0.001, 0.001, 0.004, 0.005, and 0.001, respectively). Serum zinc level is significantly lower in patients with MS than healthy controls. It is negatively correlated with disease duration, number of relapses, motor disability, fatigue, and MRI lesion load.

The emerging role of serum zinc in motor disability and radiological findings in patients with multiple sclerosis