Cerebrospinal fluid levels of neurofilament light chain, a protein associated with nerve cell damage, can predict disease progression in people with clinical isolated syndrome (CIS) and relapsing-remitting multiple sclerosis (RRMS), a Swedish study found.
Higher levels of neurofilament light chain (NFL) in the fluid that surrounds the brain and spinal cord, the cerebrospinal fluid (CSF), were associated with the appearance of new brain lesions on magnetic resonance imaging (MRI) scans, and also loss of brain volume during a four-year follow-up period.
The study “Neurofilament levels, disease activity and brain volume during follow-up in multiple sclerosis” was published in the Journal of Neuroinflammation.
Better prognostic biomarkers, ones that are able to predict MS disease activity and identify who is at higher risk of developing new lesions or flare-ups, are needed.
Prior studies indicated that brain volume loss detected with MRI, and markers present in the CSF or blood, may be used as tools to assess disease progression and activity.
One of these potential biomarkers is NFL, a protein exclusive of nerve cells and one of the major byproducts released to the CSF and blood during nerve cell death. That makes NLF a potential “universal biomarker” of neurodegeneration.
CSF levels of NFL correlate with long-term prognosis, and are a risk factor for conversion from CIS to relapsing MS. But blood tests are preferable because they are less invasive compared to CSF sampling and MRI scans. In fact, increasing evidence suggests that measuring NFL levels in the blood can be a good test for prognosis and disease monitoring of MS.
Based on these promising findings, researchers now examined the correlation between NFL levels in the serum (blood) and CSF. The team also looked for links to other neurodegenerative and neuroinflammatory biomarkers, disease activity measured on MRI scans, disability level, and relapses.
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