Lorenzo Gaetani1, Paolo Eusebi2, Andrea Mancini2, Lucia Gentili2, Angela Borrelli2, Lucilla Parnetti2, Paolo Calabresi3, Paola Sarchielli2, Kaj Blennow4, Henrik Zetterberg5, Massimiliano Di Filippo2. 1. Section of Neurology, Department of Medicine, University of Perugia, piazzale Gambuli 1, 06156 Perugia (PG) Italy. Electronic address: lorenzo.gaetani@studenti.unipg.it. 2. Section of Neurology, Department of Medicine, University of Perugia, piazzale Gambuli 1, 06156 Perugia (PG) Italy. 3. Section of Neurology, Department of Medicine, University of Perugia, piazzale Gambuli 1, 06156 Perugia (PG) Italy; IRCCS Santa Lucia Foundation, via Ardeatina 306-354, 00179 Roma (RM), Italy. 4. Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Blå Stråket 15, Vån 3, SU/Sahlgrenska, SE-413 45 Göteborg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital/Mölndal, House V3, SE-431 80 Mölndal, Sweden. 5. Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Blå Stråket 15, Vån 3, SU/Sahlgrenska, SE-413 45 Göteborg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital/Mölndal, House V3, SE-431 80 Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom; UK Dementia Research Institute at UCL, Queen Square, London WC1N 3BG, United Kingdom.
Abstract
BACKGROUND: The prediction of disease activity in patients with a first demyelinating event suggestive of multiple sclerosis (MS) is of high clinical relevance. Cerebrospinal fluid (CSF) neurofilament light chain (NfL) has shown to have prognostic value in MS patients. In this work, we measured CSF NfL in patients at the first demyelinating event in order to find a cut-off value able to discriminate patients who will have disease activity from those who will remain stable during the follow-up. METHODS: We included CSF samples collected within 30 days after the onset of the first demyelinating event from 32 patients followed-up for 3.8 ± 2.5 years. CSF NfL was measured with a newly developed in-house enzyme linked immunosorbent assay (ELISA). RESULTS: At the first demyelinating event, patients with subsequent disease activity had significantly higher baseline CSF NfL values compared to clinically and radiologically stable patients (median 812.5 pg/mL, range 205-2359 pg/mL vs 329.5 pg/mL, range 156-3492 pg/mL, p = 0.002). A CSF NfL cut-off value of 500 pg/mL significantly discriminated these two groups of patients with a 90% sensitivity and an 83.3% specificity. CONCLUSION: Our results confirm that CSF NfL is a prognostic marker in the very early phases of MS. The validation of a cut-off value of 500 pg/mL could provide clinicians with a dichotomous variable that can simplify the prognostic assessment of patients at the first demyelinating event.
BACKGROUND: The prediction of disease activity in patients with a first demyelinating event suggestive of multiple sclerosis (MS) is of high clinical relevance. Cerebrospinal fluid (CSF) neurofilament light chain (NfL) has shown to have prognostic value in MSpatients. In this work, we measured CSF NfL in patients at the first demyelinating event in order to find a cut-off value able to discriminate patients who will have disease activity from those who will remain stable during the follow-up. METHODS: We included CSF samples collected within 30 days after the onset of the first demyelinating event from 32 patients followed-up for 3.8 ± 2.5 years. CSF NfL was measured with a newly developed in-house enzyme linked immunosorbent assay (ELISA). RESULTS: At the first demyelinating event, patients with subsequent disease activity had significantly higher baseline CSF NfL values compared to clinically and radiologically stable patients (median 812.5 pg/mL, range 205-2359 pg/mL vs 329.5 pg/mL, range 156-3492 pg/mL, p = 0.002). A CSF NfL cut-off value of 500 pg/mL significantly discriminated these two groups of patients with a 90% sensitivity and an 83.3% specificity. CONCLUSION: Our results confirm that CSF NfL is a prognostic marker in the very early phases of MS. The validation of a cut-off value of 500 pg/mL could provide clinicians with a dichotomous variable that can simplify the prognostic assessment of patients at the first demyelinating event.
Authors: C B Tauil; A D Rocha-Lima; B B Ferrari; F M da Silva; L A Machado; C Ramari; C O Brandão; L M B Dos Santos; L L Dos Santos-Neto Journal: Braz J Med Biol Res Date: 2021-01-15 Impact factor: 2.590
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Authors: Peter A Calabresi; Douglas L Arnold; Dipen Sangurdekar; Carol M Singh; Arman Altincatal; Carl de Moor; Bob Engle; Jaya Goyal; Aaron Deykin; Suzanne Szak; Bernd C Kieseier; Richard A Rudick; Tatiana Plavina Journal: Mult Scler Date: 2020-12-14 Impact factor: 6.312
Authors: Tamás Biernacki; Zsófia Kokas; Dániel Sandi; Judit Füvesi; Zsanett Fricska-Nagy; Péter Faragó; Tamás Zsigmond Kincses; Péter Klivényi; Krisztina Bencsik; László Vécsei Journal: Int J Mol Sci Date: 2022-03-21 Impact factor: 5.923