Department of Neurology and Center of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic.
Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
Mult Scler. 2021 Jan;27(1):52-60. doi: 10.1177/1352458519901272. Epub 2020 Jan 21.
Serum neurofilament light chain (sNfL) is a marker of neuroaxonal injury. There is a lack of studies investigating the dynamics of relationships between sNfL levels and radiological disease activity over long-term follow-up in multiple sclerosis (MS).
To investigate the relationship among repeated measures of sNfL, lesion burden accumulation, brain volume loss and clinical measures.
We investigated 172 patients in the early stages of MS (McDonald 2017 criteria). Clinical exams were performed every 3 months and brain magnetic resonance imaging (MRI) scans were collected annually over 48 months. sNfL levels were measured in serum by Simoa assay at the time of treatment initiation and then annually over 36 months.
In repeated-measures analysis, considering all time points, we found a strong relationship between percentage changes of sNfL and lesion burden accumulation assessed by T1 lesion volume ( < 0.001) and T2 lesion number ( < 0.001). There was no relationship between percentage changes of sNfL and brain volume loss over 36 months ( > 0.1). Early sNfL levels were associated with delayed brain volume loss after 48 months ( < 0.001). Patients with No Evidence of Disease Activity (NEDA-3) status showed lower sNfL levels compared with active MS patients.
sNfL is associated with ongoing neuroinflammation and predictive of future neurodegeneration in early MS.
血清神经丝轻链（sNfL）是神经轴突损伤的标志物。在多发性硬化症（MS）的长期随访中，缺乏研究调查 sNfL 水平与放射学疾病活动之间的动态关系。
研究重复测量 sNfL 水平与病变负荷积累、脑体积损失和临床指标之间的关系。
我们调查了 172 名处于 MS 早期阶段的患者（2017 年麦克唐纳标准）。临床检查每 3 个月进行一次，脑磁共振成像（MRI）扫描每年收集一次，共 48 个月。在开始治疗时通过 Simoa 测定法测量血清中的 sNfL 水平，然后在 36 个月内每年测量一次。
在重复测量分析中，考虑所有时间点，我们发现 sNfL 的百分比变化与 T1 病变体积（ < 0.001）和 T2 病变数量（ < 0.001）评估的病变负荷积累之间存在很强的关系。sNfL 的百分比变化与 36 个月内的脑体积损失之间没有关系（ > 0.1）。早期 sNfL 水平与 48 个月后脑体积损失有关（ < 0.001）。无疾病活动证据（NEDA-3）状态的患者与活动性 MS 患者相比，sNfL 水平较低。
sNfL 与持续的神经炎症有关，并可预测早期 MS 中的未来神经退行性变。
