Cerebrospinal fluid neurofilament light chains predicts early disease-activity in Multiple Sclerosis

Simona Toscano; Vittorio Oteri; Clara Grazia Chisari; Chiara Finocchiaro; Salvatore Lo Fermo; Paola Valentino; Antonio Bertolotto; Mario Zappia; Francesco Patti

doi:10.1016/j.msard.2023.105131

Cerebrospinal fluid neurofilament light chains predicts early disease-activity in Multiple Sclerosis

Mult Scler Relat Disord. 2023 Dec:80:105131. doi: 10.1016/j.msard.2023.105131. Epub 2023 Nov 7.

Authors

Simona Toscano¹, Vittorio Oteri², Clara Grazia Chisari³, Chiara Finocchiaro², Salvatore Lo Fermo³, Paola Valentino⁴, Antonio Bertolotto⁵, Mario Zappia², Francesco Patti⁶

Affiliations

¹ Department "GF Ingrassia", Section of Neurosciences, Neurology Clinic, University of Catania, Catania 9126, Italy; Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Catania, Italy.
² Department "GF Ingrassia", Section of Neurosciences, Neurology Clinic, University of Catania, Catania 9126, Italy.
³ Department "GF Ingrassia", Section of Neurosciences, Neurology Clinic, University of Catania, Catania 9126, Italy; Operative Unit of Multiple Sclerosis, University-Hospital G. Rodolico - San Marco, Catania, Italy.
⁴ Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, Orbassano 10043, Italy; CRESM Biobank, University Hospital San Luigi Gonzaga, Regione Gonzole 10, Orbassano 10043, Italy.
⁵ Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, Orbassano 10043, Italy; Koelliker Hospital, C.so Galileo Ferraris, 247/255, Turin 10134, Italy.
⁶ Department "GF Ingrassia", Section of Neurosciences, Neurology Clinic, University of Catania, Catania 9126, Italy; Operative Unit of Multiple Sclerosis, University-Hospital G. Rodolico - San Marco, Catania, Italy. Electronic address: patti@unict.it.

PMID: 37951096
DOI: 10.1016/j.msard.2023.105131

Abstract

Background: Among biomarkers of axonal damage, neurofilament light chains (NFL) seem to play a major role, representing a promising and interesting tool in Multiple Sclerosis (MS). Our aim was to explore the predictive role of cerebrospinal fluid (CSF) NFL in patients with a recent diagnosis of MS, naïve to any MS therapy.

Methods: We retrospectively collected data of patients diagnosed with MS, referred to the Neurology Clinic of the University-Hospital G. Rodolico of Catania between January 1^st 2005 and December 31^st 2015. All patients underwent CSF collection at the time of MS diagnosis and were followed-up for at least three years afterwards. NFL levels were measured in CSF samples with Simoa NFLight advantage kit at the CRESM (University Hospital San Luigi Gonzaga, Orbassano, Torino). NFL levels were expressed as LogNFL. Symbol Digit Modalities test (SDMT) was performed at baseline, at 1-year and at 3-year follow-up. Multivariate logistic regression analysis was performed to investigate LogNFL as a potential risk factor of different clinical outcomes.

Results: 244 MS patients (230 relapsing-remitting, RRMS; 94.3 %), with a mean age at diagnosis of 37.0 ± 11.1 years, were recruited. LogNFL did not correlate neither with EDSS score at diagnosis and at subsequent follow-up up to 12 years, nor with SDMT performed at diagnosis, at 1 year and at 3 years. LogNFL were an independent factor for the occurrence of at least one relapse during the first two years after MS diagnosis (OR = 2.75; 95 % CI 1.19-6.31; p = 0.02) and for the occurrence of gadolinium-enhanced (Gd+) lesions during the first 2 years from diagnosis at brain and spine MRI scans (OR = 3.45, 95 % CI 1.81-6.57; p < 0.001).

Conclusion: The detection of CSF NFL at the time of MS diagnosis can be a useful support to predict the two-year risk of clinical and radiological relapses, thus affecting therapeutic choices in the very early phases of the disease.

Keywords: Axonal damage; Biomarkers; Cerebrospinal fluid; Disease-activity; Multiple Sclerosis; Neurofilaments; Prognosis.

MeSH terms

Adult
Axons
Biomarkers / cerebrospinal fluid
Humans
Intermediate Filaments
Middle Aged
Multiple Sclerosis* / cerebrospinal fluid
Multiple Sclerosis* / complications
Multiple Sclerosis* / diagnosis
Retrospective Studies

Substances

Biomarkers