Body weight and height of patients with relapsing-remitting multiple sclerosis (RRMS) or clinically isolated syndrome suggesting MS (CIS) in the age range 18 to 60 years (154 males and 315 females) were compared with those of subjects (146 males and 212 females) free of any major neurological disease. In drug-free patients, CSF levels of the metabolites of noradrenaline (MHPG), serotonin (5-HIAA), and dopamine (HVA), neurotransmitters involved in eating behavior, were estimated in searching for associations with body mass index (BMI). Statistical evaluations were done separately for males and females. Lower BMI was found in female MS patients compared to female controls, more pronounced in RRMS. BMI was not associated with duration of illness, smoking, present or previous drug treatment, or disability score. Body height showed a shift towards greater values in MS patients compared to controls. Patients in the lower BMI quartile (limits defined from control subjects) had lower 5-HIAA and HVA compared to patients in the upper quartile. The results provide evidence for weight reduction during disease process in MS, possibly related to deficits in serotoninergic and dopaminergic activities that develop during disease course, resulting in impairments in food reward capacity and in motivation to eat. 1. Introduction Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system. Although viral and genetic factors have been postulated to trigger the autoimmune process, the pathogenetic mechanisms regulating the disease course remain unknown. Increasing amount of evidence suggests that physical comorbidities as well as adverse health factors might affect the disease course [1]. The impact of nutrition and diet in the aetiology and management of MS has been investigated in a large number of studies [2–6], but with only a limited number reported on body mass index (BMI) in MS. Ghadirian et al. [3] found an inverse association between high BMI and the risk of MS. The difference in BMI was significant for the whole sample and for female MS patients compared to controls, while it did not reach significance for males. Formica et al. [7] reported a lower BMI in women with MS compared to female controls, and Nortvedt et al. [8] reported significantly lower BMI of MS patients (75% females) compared to the general population. Similarly, Alschuler et al. [9] reported lower BMI in a large number ( ) of patients with MS in relation to general population. On the other hand, Khurana et al. [10] reported an increased prevalence of overweight and
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