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 Rival, Manon A1 Thouvenot, Eric A1 Du Trieu de Terdonck, Lucile A1 Laurent-Chabalier, Sabine A1 Demattei, Christophe A1 Uygunoglu, Ugur A1 Castelnovo, Giovanni A1 Cohen, Mikael A1 Okuda, Darin T. A1 Kantarci, Orhun H. A1 Pelletier, Daniel A1 Azevedo, Christina A1 Marin, Philippe A1 Lehmann, Sylvain A1 Siva, Aksel A1 Mura, Thibault A1 Lebrun-Frenay, Christine 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