Serum neurofilament as a predictor of 10-year grey matter atrophy and clinical disability in multiple sclerosis: a longitudinal study. Issue 8 (1st June 2022)

• Record Type: Journal Article
• Authors: Lie, Ingrid Anne; Kaçar, Sezgi; Wesnes, Kristin; Brouwer, Iman; Kvistad, Silje S; Wergeland, Stig; Holmøy, Trygve; Midgard, Rune; Bru, Alla; Edland, Astrid; Eikeland, Randi; Gosal, Sonia; Harbo, Hanne F; Kleveland, Grethe; Sørenes, Yvonne S; Øksendal, Nina; Varhaug, Kristin N; Vedeler, Christian A; Barkhof, Frederik; Teunissen, Charlotte E; Bø, Lars; Torkildsen, Øivind; Myhr, Kjell-Morten; Vrenken, Hugo
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 93:Issue 8(2022)
• Page Start: 849
• Page End: 857
• Publication Date: 2022-06-01
• Subjects: MULTIPLE SCLEROSIS -- CLINICAL NEUROLOGY -- BIOCHEMISTRY -- MRI; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2021-328568
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: The predictive value of serum neurofilament light chain (sNfL) on long-term prognosis in multiple sclerosis (MS) is still unclear. Objective: Investigate the relation between sNfL levels over a 2-year period in patients with relapsing-remitting MS, and clinical disability and grey matter (GM) atrophy after 10 years. Methods: 85 patients, originally enrolled in a multicentre, randomised trial of ω−3 fatty acids, participated in a 10-year follow-up visit. sNfL levels were measured by Simoa quarterly until month 12, and then at month 24. The appearance of new gadolinium-enhancing (Gd+) lesions was assessed monthly between baseline and month 9, and then at months 12 and 24. At the 10-year follow-up visit, brain atrophy measures were obtained using FreeSurfer. Results: Higher mean sNfL levels during early periods of active inflammation (Gd+ lesions present or recently present) predicted lower total (β=−0.399, p=0.040) and deep (β=−0.556, p=0.010) GM volume, lower mean cortical thickness (β=−0.581, p=0.010) and higher T2 lesion count (β=0.498, p=0.018). Of the clinical outcomes, higher inflammatory sNfL levels were associated with higher disability measured by the dominant hand Nine-Hole Peg Test (β=0.593, p=0.004). Mean sNfL levels during periods of remission (no Gd+ lesions present or recently present) did not predict GM atrophy or disability progression. Conclusion: Higher sNfL levels during periods of active inflammation predicted more GM atrophy and specific aspects of clinical disability 10 years later. The findings suggest that subsequent long-term GM atrophy is mainly due to neuroaxonal degradation within new lesions.