The prognostic significance of early blood neurofilament light chain concentration and magnetic resonance imaging variables in relapse‐onset multiple sclerosis. Issue 9 (4th August 2022)

• Record Type: Journal Article
• Authors: Williams, Thomas; Heslegrave, Amanda; Zetterberg, Henrik; Miszkiel, Katherine A; Barkhof, Frederik; Ciccarelli, Olga; Brownlee, Wallace J; Chataway, Jeremy
• Is Part Of: Brain and behavior. Volume 12:Issue 9(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-08-04
• Subjects: magnetic resonance imaging -- multiple sclerosis -- neurofilament light chain -- prognosis; Neurology -- Periodicals; Neurosciences -- Periodicals; Psychology -- Periodicals; Psychiatry -- Periodicals; 616.8005
• DOI: 10.1002/brb3.2700
• Languages: English
• ISSNs: 2162-3279

Abstract

Abstract: Background: Improved prognostication remains vital in multiple sclerosis to inform personalized treatment approaches. Blood neurofilament light (bNfL) is a promising prognostic biomarker, but to what extent it provides additional information, independent of established MRI metrics, is yet to be established. Methods: We obtained all available bNfL data for 133 patients from a longitudinal observational cohort study. Patients were dichotomized into good or poor outcome groups based upon clinical and cognitive assessments performed 15 years after a clinically isolated syndrome. We performed longitudinal modeling of early NfL and MRI variables to examine differences between outcome groups. Results: The bNfL dataset was incomplete, with one to three (mean 1.5) samples available per participant. Within 3 months of onset, bNfL was similar between groups. The bNfL concentration subsequently decreased in those with a good outcome, and remained persistently elevated in those with a poor outcome. By year 5, NfL in the poor outcome group was approximately double that of those with a good outcome (14.58 [10.40–18.77] vs. 7.71 [6.39–9.04] pg/ml, respectively). Differences were reduced after adjustment for longitudinal changes in T2LV, but trends persisted for a greater rate of increase in NfL in those with a poor outcome, independent of T2LV. Conclusions: This analysis requires replication in cohorts with more complete bNfL datasets, but suggests that persistently elevated blood NfL may be more common in patients with a poor long‐term outcome. Persistent elevation of blood NfL may provide additional prognostic information not wholly accounted for by standard monitoring techniques. Abstract :