- Cerebrospinal fluid (CSF) levels of neurofilament light chain (NfL) protein correlated with disease activity throughout the course of multiple sclerosis (MS).
- Elevated levels were more strongly associated with relapse (inflammatory disease activity) than with progression.
Why this matters
- Role of NfL levels in clinical practice is unclear.
- Mean CSF levels of NfL were higher in patients with MS than in unaffected controls (1965.8 vs 578.3 ng/L; effect size, 0.61; P<.00001>
- Among patients with MS, mean CSF levels of NfL higher:
- In those with relapsing disease vs progressive disease (2124.8 vs 1121.4 ng/L; P=.0108).
- In those having a relapse (irrespective of MS subtype) vs those in remission (3080.6 vs 1541.7 ng/L; P<.0001>
- Levels did not differ significantly between treated vs untreated MS or between primary vs secondary progressive MS.
- Systematic review and meta-analysis of 20 case-control studies:
- 746 patients with MS.
- 435 control individuals without MS (103 healthy, 332 with noninflammatory neurologic diseases).
- Main outcome: CSF levels of NfL.
- Funding: None disclosed.
- Single author reviewed literature.
- Studies with insufficient data excluded.
- Use of raw data uncorrected for age.