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