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Mult Scler. 2018 Mar 1:1352458518765666. doi: 10.1177/1352458518765666. [Epub ahead of print]

Serum neurofilament light chain is a biomarker of acute and chronic neuronal damage in early multiple sclerosis.

Author information

1
Department of Neurology and Focus Program Translational Neuroscience (FTN), Research Center for Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
2
Neurologic Clinic and Policlinic and Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.

Abstract

BACKGROUND:

Monitoring neuronal injury remains one key challenge in early relapsing-remitting multiple sclerosis (RRMS) patients. Upon axonal damage, neurofilament - a major component of the neuro-axonal cytoskeleton - is released into the cerebrospinal fluid (CSF) and subsequently peripheral blood.

OBJECTIVE:

To investigate the relevance of serum neurofilament light chain (sNfL) for acute and chronic axonal damage in early RRMS.

METHODS:

sNfL levels were determined in 74 patients (63 therapy-naive) with recently diagnosed clinically isolated syndrome (CIS) or RRMS using Single Molecule Array technology. Standardized 3 T magnetic resonance imaging (MRI) was performed at baseline and 1-3 consecutive follow-ups (42 patients; range: 6-37 months).

RESULTS:

Baseline sNfL correlated significantly with T2 lesion volume ( r = 0.555, p < 0.0001). There was no correlation between baseline sNfL and age, Expanded Disability Status Scale (EDSS) score or other calculated MRI measures. However, T2 lesion volume increased ( r = 0.67, p < 0.0001) and brain parenchymal volume decreased more rapidly in patients with higher baseline sNfL ( r = -0.623, p = 0.0004). Gd-enhancing lesions correlated positively with sNfL levels. Initiation of disease-modifying treatment led to a significant decrease in sNfL levels.

CONCLUSION:

sNfL indicates acute inflammation as demonstrated by correlation with Gd+ lesions. It is a promising biomarker for neuro-axonal damage in early multiple sclerosis (MS) patients, since higher baseline sNfL levels predicted future brain atrophy within 2 years.

KEYWORDS:

MRI; Multiple sclerosis; biomarker; clinical progression; disease activity; neurodegeneration; neurofilament

PMID:
29542376
DOI:
10.1177/1352458518765666

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