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Serum neurofilament light is associated with future disease activity in clinically isolated syndrome and early multiple sclerosis only after non-optic neuritis onset

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Item Type:Article
Title:Serum neurofilament light is associated with future disease activity in clinically isolated syndrome and early multiple sclerosis only after non-optic neuritis onset
Creators Name:Klyscz, Philipp, Ruprecht, Klemens, Anderhalten, Lina Carlotta, Schmitz-Hübsch, Tanja, Kuhle, Jens, Usnich, Tatiana, Bellmann-Strobl, Judith, Paul, Friedemann, Schindler, Patrick and Asseyer, Susanna
Abstract:BACKGROUND: We compared the prognostic value of serum neurofilament light chain (sNFL) and glial fibrillary acidic protein (sGFAP) for clinical and radiologic disease activity among patients with clinically isolated syndrome or early multiple sclerosis (MS) with optic neuritis (pwON) and non-optic neuritis (pwNON) as the first manifestation. METHODS: Patients within 7 months (pwON and pwNON) from disease onset and patients with MS with a disease duration longer than 12 months (pwMS) as controls were included. sNFL and sGFAP were analyzed at baseline and at follow-ups using SIMOA technology. Linear mixed models and Cox regression analyses were applied. RESULTS: We included 165 samples of 86 patients (18 pwON, 46 pwNON, 21 pwMS). Median follow-up time was 80 months. Mean sNFL z scores were higher in pwNON (1.06) than pwON (0.53) and pwMS (0.94). In pwNON, but not pwON, higher sNFL z scores were associated with an elevated risk for a subsequent attack (pwNON: HR 1.63 [95% CI 1.12 to 2.27], p = 0.005; pwON: HR 0.80 [95% CI 0.51-2.27], p = 0.318) and new MRI T2 lesions (pwNON: HR 1.66 [95% CI 1.31 to 2.11], p < 0.001; pwON: HR 1.16 [95% CI 0.82 to 1.63], p = 0.404). sGFAP z scores were associated with a lower risk of a subsequent attack in pwON (HR 0.34 [95% CI 0.12 to 0.98], p = 0.047). CONCLUSION: sNFL but not sGFAP predicted future clinical and MRI disease activity only in pwNON, potentially suggesting that the prognostic value of sNFL may depend on the type of the first manifestation.
Keywords:Biomarker, Glial Fibrillary Acidic Protein, Multiple Sclerosis, Neurofilament, Optic Neuritis
Source:European Journal of Neurology
ISSN:1351-5101
Publisher:Wiley
Volume:32
Number:11
Page Range:e70375
Date:November 2025
Official Publication:https://doi.org/10.1111/ene.70375
PubMed:View item in PubMed

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