RT Journal Article SR Electronic T1 Impact of Dietary Intervention on Serum Neurofilament Light Chain in Multiple Sclerosis JF Neurology - Neuroimmunology Neuroinflammation JO Neurol Neuroimmunol Neuroinflamm FD Lippincott Williams & Wilkins SP e1102 DO 10.1212/NXI.0000000000001102 VO 9 IS 1 A1 Bock, Markus A1 Steffen, Falk A1 Zipp, Frauke A1 Bittner, Stefan YR 2022 UL http://nn.neurology.org/content/9/1/e1102.abstract AB Background and Objectives Adapted ketogenic diet (AKD) and caloric restriction (CR) have been suggested as alternative therapeutic strategies for multiple sclerosis (MS), but information on their impact on neuroaxonal damage is lacking. Thus, we explored the impact of diets on serum neurofilament light chain (sNfL) levels in patients with relapsing-remitting MS.Methods We retrospectively evaluated a prospective randomized controlled trial of 60 patients with MS who were on a common diet or ketogenic diet or fasting. We examined sNfL levels of 40 participants at baseline and at the end of the study after 6 months using single molecule array assay.Results sNfL levels were investigated in 9 controls, 14 participants on CR, and 17 participants on AKD. Correlation analysis showed an association of sNfL with age and disease duration; an association was also found between sNfL and the Multiple Sclerosis Functional Composite. AKD significantly reduced sNfL levels at 6 months compared with the common diet group (p = 0.001).Discussion For clinical or study use, consider that AKD may incline sNfL levels independent of relapse activity up to 3 months after initiation. At 6 months, AKD, which complements current therapies, reduced sNfL levels, therefore suggesting potential neuroprotective effects in MS. A single cycle of seven-day fasting did not affect sNfL. AKD may be an addition to the armamentarium to help clinicians support patients with MS in a personalized manner with tailored diet strategies.Trial Registration Information Clinical trial registration number NCT01538355.AKD=adapted ketogenic diet; BMI=body mass index; CD=common diet; CR=caloric restriction; DMT=disease-modifying therapy; MS=multiple sclerosis; MSFC=Multiple Sclerosis Functional Composite; PASAT=Paced Auditory Serial Addition Test; SiMoA=single molecule assay; sNfL=serum neurofilament light chain