MULTIPLE SCLEROSIS JOURNAL

Nelly Siller, Jens Kuhle, Muthuraman Muthuraman, Christian Barro, Timo Uphaus,
Sergiu Groppa, Ludwig Kappos, Frauke Zipp and Stefan Bittner

Multiple Sclerosis Journal

DOI: 10.1177/1352458518765666

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 neuroaxonal
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.