RT Journal Article SR Electronic T1 Neurofilament Light Chain Levels Are Predictive of Clinical Conversion in Radiologically Isolated Syndrome JF Neurology - Neuroimmunology Neuroinflammation JO Neurol Neuroimmunol Neuroinflamm FD Lippincott Williams & Wilkins SP e200044 DO 10.1212/NXI.0000000000200044 VO 10 IS 1 A1 Manon Rival A1 Eric Thouvenot A1 Lucile Du Trieu de Terdonck A1 Sabine Laurent-Chabalier A1 Christophe Demattei A1 Ugur Uygunoglu A1 Giovanni Castelnovo A1 Mikael Cohen A1 Darin T. Okuda A1 Orhun H. Kantarci A1 Daniel Pelletier A1 Christina Azevedo A1 Philippe Marin A1 Sylvain Lehmann A1 Aksel Siva A1 Thibault Mura A1 Christine Lebrun-Frenay A1 , YR 2023 UL http://nn.neurology.org/content/10/1/e200044.abstract AB Background and Objectives To evaluate the predictive value of serum neurofilament light chain (sNfL) and CSF NfL (cNfL) in patients with radiologically isolated syndrome (RIS) for evidence of disease activity (EDA) and clinical conversion (CC).Methods sNfL and cNfL were measured at RIS diagnosis by single-molecule array (Simoa). The risk of EDA and CC according to sNfL and cNfL was evaluated using the Kaplan-Meier analysis and multivariate Cox regression models including age, spinal cord (SC) or infratentorial lesions, oligoclonal bands, CSF chitinase 3–like protein 1, and CSF white blood cells.Results Sixty-one patients with RIS were included. At diagnosis, sNfL and cNfL were correlated (Spearman r = 0.78, p < 0.001). During follow-up, 47 patients with RIS showed EDA and 36 patients showed CC (median time 12.6 months, 1–86). When compared with low levels, medium and high cNfL (>260 pg/mL) and sNfL (>5.0 pg/mL) levels were predictive of EDA (log rank, p < 0.01 and p = 0.02, respectively). Medium-high cNfL levels were predictive of CC (log rank, p < 0.01). In Cox regression models, cNfL and sNfL were independent factors of EDA, while SC lesions, cNfL, and sNfL were independent factors of CC.Discussion cNfL >260 pg/mL and sNfL >5.0 pg/mL at diagnosis are independent predictive factors of EDA and CC in RIS. Although cNfL predicts disease activity better, sNfL is more accessible than cNfL and can be considered when a lumbar puncture is not performed.Classification of Evidence This study provides Class II evidence that in people with radiologic isolated syndrome (RIS), initial serum and CSF NfL levels are associated with subsequent evidence of disease activity or clinical conversion.AUC=area under the curve; CC=clinical conversion; CHI3L1=CSF chitinase 3–like protein 1; DIS=dissemination in space; EDA=evidence of disease activity; MS=multiple sclerosis; NEDA=nonevidence of disease activity; OCBs=oligoclonal bands; RIS=radiologically isolated syndrome; RRMS=relapsing-remitting MS; sNfL=serum neurofilament light chain; SC=spinal cord