From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York.
Neurol Neuroimmunol Neuroinflamm. 2020 May 18;7(4). doi: 10.1212/NXI.0000000000000737. Print 2020 Jul.
To study the association between serum neurofilament light chain (sNfL) and multiple optical coherence tomography (OCT) measures in patients with MS and healthy controls (HCs).
In this prospective study, 110 patients with MS were recruited, together with 52 age- and sex-matched HCs. Clinical evaluation and spectral domain OCT and sNfL were obtained at baseline and after 5.5 years of follow-up. Nested linear mixed models were used to assess differences between MS vs HC and associations between sNfL and OCT measures. Partial correlation coefficients are reported, and values were adjusted for the false discovery rate.
At baseline, peripapillary retinal nerve fiber layer thickness (pRNFLT) and macular ganglion cell and inner plexiform layer thickness (mGCIP) were significantly lower in MS than HC both in MS-associated optic neuritis (MSON) ( = 0.007, = 0.001) and nonaffected MSON (n-MSON) eyes ( = 0.003, = 0.018), along with total macular volume (TMV) in n-MSON eyes ( = 0.011). At follow-up, MS showed significantly lower pRNFLT, mGCIP, and TMV both in MSON and n-MSON eyes ( < 0.001) compared with HC. In MS n-MSON eyes, sNfL was significantly associated with baseline pRNFLT and mGCIP ( = 0.019). No significant associations were found in MSON eyes.
This study confirms the ability of sNfL to detect neurodegeneration in MS and advocates for the inclusion of sNfL and OCT measures in clinical trials.
This study provides Class III evidence that sNfL levels were associated with MS neurodegeneration measured by OCT.
研究多发性硬化症（MS）患者和健康对照者（HCs）血清神经丝轻链（sNfL）与多种光学相干断层扫描（OCT）测量值之间的相关性。
在这项前瞻性研究中，共纳入了 110 名 MS 患者和 52 名年龄和性别匹配的 HCs。在基线和 5.5 年随访时，对其进行临床评估和光谱域 OCT 和 sNfL 检查。采用嵌套线性混合模型来评估 MS 与 HC 之间的差异以及 sNfL 与 OCT 测量值之间的相关性。报告偏相关系数，并校正错误发现率。
基线时，MS 患者的视盘周围视网膜神经纤维层厚度（pRNFLT）和黄斑神经节细胞和内丛状层厚度（mGCIP）在 MS 相关性视神经炎（MSON）（ = 0.007， = 0.001）和非 MSON 眼（n-MSON）（ = 0.003， = 0.018）中均显著低于 HC，同时 n-MSON 眼的总黄斑体积（TMV）也显著降低（ = 0.011）。随访时，MSON 和 n-MSON 眼的 MS 患者的 pRNFLT、mGCIP 和 TMV 均显著低于 HC（ < 0.001）。在 MS n-MSON 眼，sNfL 与基线时的 pRNFLT 和 mGCIP 显著相关（ = 0.019）。在 MSON 眼则未发现显著相关性。
本研究证实了 sNfL 检测 MS 神经退行性变的能力，并主张在临床试验中纳入 sNfL 和 OCT 测量值。
本研究提供了 III 级证据，表明 sNfL 水平与 OCT 测量的 MS 神经退行性变有关。
